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Am Fam Physician. 2020;102(12):online

See related article on degenerative cervical myelopathy

What is degenerative cervical myelopathy?

Degenerative cervical myelopathy is when the spinal cord in the neck gets squeezed (compressed). This can happen when changes in the bones, disks, and ligaments of the spine push on the spinal cord. It is more common in older adults. Some of these changes are a normal part of aging. Others are caused by arthritis of the spine.

Degenerative cervical myelopathy is the most common spinal cord problem in people 55 years and older in the United States. If it is not treated, it usually stays the same or gets worse. There is no way to tell whether it will get worse.

What are the symptoms?

Degenerative cervical myelopathy develops very slowly. You may have neck stiffness, arm pain, numbness in the hands, weakness of the arms and legs, or stiff legs. It may be hard to use your hands or to walk steadily. Other conditions, such as multiple sclerosis, amyotrophic lateral sclerosis, and tumors on the spinal cord, can cause similar symptoms.

How do I know if I have it?

Your doctor will do a physical examination to see if you have changes in your strength, reflexes, and ability to feel things. Your doctor might order magnetic resonance imaging (MRI for short). An MRI scan is a picture that can show whether you have spinal cord compression in your neck and other problems that have similar symptoms. If your doctor is not sure whether you have degenerative cervical myelopathy, you may need other tests. You may also need to see a specialist.

How is it treated?

Mild cases can be treated with neck braces, physical therapy, and medicine. It is not clear whether these treatments help in the long run. Surgery to reduce the compression of the spinal cord may help. But surgery does not help everyone and can sometimes cause more damage. There are medicines that can relieve pain caused by degenerative cervical myelopathy, but they do not help cure the disease or relieve other symptoms, like weakness or numbness.

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