Ask a PT: What is cervical myelopathy?

Cervical myelopathy is a condition that is present in 90% of individuals over the age of sixty, and is recognized as the most common spinal cord dysfunction in individuals over the age of fifty-five.1 It is characterized by hyperactive reflexes, significant difficulty with walking and balance, neck/ shoulder pain, intermittent shooting pain into the arms/legs especially when bending the head forwards, and numbness/tingling in one or both upper or lower extremities or in the genital area. However, not all of the symptoms are always present.

If the myelopathy goes unrecognized and untreated, there is a possibility that it could progress to more serious conditions that result from the compression on the spinal cord and subsequent ischemia. This could lead, in the worst cases, to paraplegia, and loss of bowel/bladder function.

If you are being treated for neck/should pain in physical therapy, and have any of those other symptoms mentioned in the first paragraph, bring it up with your PT. A physical therapist has a number of clinical tests, including Hoffman’s and Babinski signs, that can help determine if you need to be evaluated further. The most effective method for diagnosing myelopathy is an MRI, and a neurologist or primary care physician will determine how appropriate this imaging is for you.

1. Cook C, Wilhelm M, Cook A, Petrosino C, Isaacs R. Clinical tests for screening and diagnosis of cervical spine myelopathy: A systematic review.

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