Most spinal conditions are not dangerous and settle with time. There is one, however, that is worth understanding a little better, because its early symptoms can be subtle and are easily put down to other things. It is called myelopathy – compression of the spinal cord itself – and recognising it early genuinely matters. In this article I will explain what it is and the symptoms worth taking seriously, without, I hope, causing unnecessary alarm.

What myelopathy is

Myelopathy is the term for dysfunction of the spinal cord, most commonly caused by compression. The spinal cord is the main bundle of nerves running from the brain down through the spine, carrying the signals that control sensation and movement throughout the body. When it becomes compressed – most often in the neck – those signals can be disrupted.

The usual cause is gradual wear and tear changes that narrow the space around the spinal cord over time, which is why it tends to affect people in later life and comes on slowly rather than suddenly.

Why it can be missed

Because myelopathy usually develops gradually, its early signs are easy to attribute to ageing or general clumsiness. There may be no significant pain, which is part of why it can go unrecognised. People often adjust to the slow changes without realising they add up to a pattern worth investigating.

Symptoms worth taking seriously

The symptoms of myelopathy reflect the spinal cord’s role in controlling movement and sensation. Worth paying attention to are:

• A change in the way you walk – feeling less steady on your feet, or a sense of clumsiness in the legs
• Difficulty with fine hand movements, such as doing up buttons, handling coins, or writing
• Numbness, tingling or a feeling of heaviness in the hands or legs
• A general loss of coordination that has come on gradually

Individually, any of these can have an innocent explanation. But where several appear together and are slowly progressing, it is worth having them assessed rather than assuming they are simply part of getting older.

Why early assessment helps

The reason it is worth recognising myelopathy is that assessment allows the cause to be identified and, where appropriate, treated before symptoms progress. Where compression of the spinal cord is significant, surgery to relieve the pressure can halt the progression and protect function. As with all spinal surgery, whether an operation is appropriate depends on the individual situation, and a careful assessment is the starting point.

Speaking to a specialist in Cambridge

If you recognise some of these symptoms in yourself or a family member, particularly if they are slowly worsening, it is sensible to seek a specialist opinion. As a Consultant Neurosurgeon in Cambridge with a particular interest in conditions of the spinal cord and nerves, I can assess what is happening and explain whether any treatment is needed – which, in many cases, it may not be. You can read more about my spinal surgery in Cambridge.