Myelopathy: Part 1

In previous posts, we have discussed a number of disabling conditions, such as Parkinson’s disease, essential tremors, carpal tunnel syndrome, and fibromyalgia. In this post, we are going to talk about another serious condition that can severely limit a physician or dentist’s ability to practice—myelopathy. In Part 1, we will discuss some of the causes and symptoms of myelopathy. In Part 2, we will discuss some of the methods used to treat myelopathy.

What is Myelopathy?

Myelopathy is an overarching term used to describe any neurologic deficit caused by compression of the spinal cord.

The onset of myelopathy can be rapid or it can develop slowly over a period of months. In most cases, myelopathy is progressive; however, the timing and progression of symptoms varies significantly from person to person.

What Causes Myelopathy?

There are several potential causes of myelopathy, including:

  • Bone fractures or dislocations due to trauma/injury;
  • Inflammatory diseases/autoimmune disorders (e.g. rheumatoid arthritis);
  • Structural abnormalities (e.g. bone spurs, disc bulges, herniated discs, thickened ligaments);
  • Vascular problems;
  • Tumors;
  • Infections; and
  • Degenerative changes due to aging.

Symptoms of Myelopathy

The symptoms of myelopathy will vary from case to case, because the nature and severity of the symptoms will depend on which level of the spine is being compressed—i.e. cervical (neck), thoracic (middle), or lumbar (lower)—and the extent of the compression.

Some of the symptoms of myelopathy include:

  • Neck stiffness;
  • Deep aching pain in one or both sides of neck, and possibly arms and shoulders;
  • Grating or crackling sensation when moving neck;
  • Stabbing pain in arm, elbow, wrist or arms;
  • Dull ache/tingling/numbness/weakness in arms, hands, legs or feet;
  • Position sense loss (i.e. the inability to know where your arms are without looking at them);
  • Deterioration of fine motor skills (such as handwriting and the ability to button shirts);
  • Lack of coordination, imbalance, heavy feeling in the legs, and difficulty walking;
  • Clumsiness of hands and trouble grasping;
  • Intermittent shooting pains in arms and legs (especially when bending head forward);
  • Incontinence; and
  • Paralysis (in extreme cases).

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