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Many people have never heard of myelopathy. So, if you've been diagnosed with it, you might not even be sure what it is. But you're certainly familiar with the symptoms. You know your back or neck hurts, sometimes quite badly. You might also be experiencing odd symptoms, like weakness in your arms or legs. But what causes the condition? And what can you do about it?
Myelopathy is a nerve injury in your spinal cord, which is the grouping of nerves that runs from your skull to your tailbone. The condition is caused by compression of the spinal cord, resulting in pain, loss of sensation, or loss of control of certain body parts. Anyone can develop it, but it's more commonly diagnosed in people who are older than 55 because it's often related to the wear and tear your body endures over time.
Causes of Myelopathy
There are several possible causes of this condition. The most common triggers are a piece of bone (a bone spur) or part of a disc (a herniated disc) sticking out from your spine. These press on the nerves in your spinal column, causing pain or decreased ability to use certain parts of your body. The problem can be acute, which means it starts suddenly, or chronic, which means the pressure grows gradually over time. Acute myelopathy can be caused by trauma to the spine or an infection in or around the spinal cord. Chronic myelopathy can be caused by a tumor on or near the spinal cord, spinal stenosis, rheumatoid arthritis, or neurogenerative diseases such as amyotrophic lateral sclerosis (ALS) or Parkinson's disease.
Types of Myelopathy
Just as there are several possible causes of myelopathy, there are several types of this condition. The type depends on where the compression is on the spine.
- Cervical myelopathy, which affects the neck, is the most common type. It's most frequently caused by degeneration in the cervical spine, and it can cause weakness, numbness, and tingling in your arms, hands, and legs.
- Thoracic myelopathy affects the mid-spine. It's most frequently caused by bulging or herniated discs, bone spurs, or spinal trauma. Unless the compression is caused by trauma, the signs and symptoms generally come on slowly. These include numbness and weakness in your legs, loss of coordination, and difficulty walking.
- Lumbar myelopathy is the least common type. It affects the lower part of the spine, called the lumbar region.
Treatment varies according to the type of myelopathy, how far it has progressed, and the cause. For example, if the cause is a bacterial infection, treating the infection with antibiotics may also treat the compression on the nerves. Here are some other possible treatments:
- A neck brace can help support your neck and relieve pressure on the cervical part of your spinal cord. This will not remove the cause of the pressure, but it may delay the progression, and can reduce associated pain and symptoms.
- A physical therapist can show you physical therapy exercises that may help relieve pressure on the spinal cord.
- Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) and oral corticosteroids may help reduce inflammation and relieve symptoms. Steroid injections directly into the affected area are another option that may provide temporary relief.
- Surgery to remove tumors and bone spurs, or to repair herniated discs, is the only treatment that addresses the actual cause and may provide permanent relief.
Living with myelopathy can be frustrating, but by working with your healthcare team, you may find the right combination of treatments to help relieve your discomfort and increase your quality of life.