Spinal Cord Compression (Myelopathy)

The spinal cord is a bundle of nerves going down the middle of your back. The nerves are protected by the vertebrae, the stacked bones that form your spine. The stacked vertebrae have holes, which line up to form the spinal canal. The vertebrae are separated by discs that cushion them and allow them to move properly.

If the vertebrae or discs become diseased or damaged, they can pinch or compress the spinal nerves. This can cause pain, weakness, or numbness.

Spinal cord compression can be a result of injury, infection, tumors, or diseases. It can happen in any part of the spine. These parts are referred to by their location:

• Cervical spine—in the neck
• Thoracic (thor-AS-ik) spine—in the chest
• Lumbar spine—in the lower back
• Sacral spine—in the pelvis

Symptoms of spinal cord compression can include:

• Pain
• Numbness or tingling
• Loss of sensation
• Muscle weakness or slow reflexes
• Bowel or bladder weakness
• Dizziness or headaches
• Unusual weight gain or loss
• Sexual dysfunction

Mention these or any other unusual changes or symptoms to your healthcare providers. Even if something doesn’t seem related to your spine problem, it can help your healthcare providers get a more complete picture of your health.

See a healthcare provider if you have:

• Sudden, severe pain
• Back pain that gets worse over several weeks
• Numbness, weakness, or tingling in your legs
• Loss of bowel or bladder control

Spinal cord compression can be a result of:

• Fractures. Like any bones, vertebrae can crack or break and put pressure on the surrounding nerves. Reasons for a spine fracture include injury, repeated stress, or a condition like osteoarthritis.
• Spinal stenosis, or narrowing of the spinal canal. This can be caused by enlargement of the tissues around the spinal cord, or by abnormal bone growths such as bone spurs.
• A bulging or herniated disc. If the outer wall of a spinal disc weakens or tears, the disc can move out of place and push against spinal nerves.
• Spinal bones that are not aligned correctly. This can result from diseases like scoliosis.

To find out what’s causing your pain, your healthcare providers will ask about your pain and other symptoms, your daily habits, your medical history, and your family’s medical history. They may also do:

• A physical exam to identify pain, weakness, numbness, and range of motion.
• Laboratory tests to check for illnesses that could be adding to your pain.
• Imaging studies, such as an x-ray, MRI, CT scan, or bone density scan.
• Nerve studies to see how well your nerves send signals through your body and control your muscles.
• Other procedures, such as injecting medicine into the vertebrae can help find out what’s causing your problem.

Treatment for spinal cord compression may include one or more of the following:

• Education and activity. Learning better ways to sit, sleep, or lift can help prevent spinal pain in the future. You can also learn how to use heat or ice to prevent swelling of tissues.
• Physical therapy. A physical therapist can create exercises to help promote healing, build strength and flexibility, and relieve pain.
• Medicine. Your healthcare provider may prescribe medicine to reduce swelling, relax muscles, or ease pain.
• Traction. Traction uses braces or devices that gently lengthen the spine.
• Spinal injections. An injection can deliver medicine directly to the source of the pain. It can be used to both treat pain, or to find out what’s causing the pain.
• Other non-surgical procedures.
• Surgery. Most spine problems can be treated without surgery. In some cases your healthcare providers may advise spine surgery as the best way to treat your symptoms. There are several types of spine surgery, and your healthcare providers will discuss your options with you.

Some cases of spinal cord compression can be prevented by keeping your back strong.

• Keep moving. Regular exercise can strengthen the muscles in your back and keep you flexible.
• Practice good posture. Stand and sit so you don’t put extra pressure on your back. Learn how to lift heavy objects safely.
• Maintain a healthy weight. Extra weight puts extra pressure on your back.