About Physiatry

About Physiatry

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Cervical Spondylotic Myelopathy

Condition: Cervical spondylotic myelopathy (CMS) is a condition where the spinal cord is damaged or pinched, either due to an injury, abnormal movements, or as a part of aging.

Background: In the U.S., CMS is the most common cause of spinal cord dysfunction in people over 55. As a person ages, the bones and cartilage of the backbone and neck begin to deteriorate. For instance, spinal disks can develop cracks or lose their ability to cushion the vertebrae. This deterioration can cause damage to the spinal cord.

Risk Factors: Although the primary risk factor is aging, others who are at greater risk for CSM are people who have had neck injuries previously, as well as smokers and people with jobs that require them to use their neck repetitively or awkwardly. Men are also at greater risk.

History and Symptoms: Loss of balance is usually the first symptom a patient notices. Examples of other symptoms are less flexibility in the legs and neck, lack of coordination, arm pain, numbness and weakness and less dexterity in the hands and legs. 

Physical Exam:  A physician will likely ask the patient to move his or her neck into various positions, have the patient walk and test his or her reflexes and muscle strength.

Diagnostic Process: To accurately diagnose CSM, a physician may order an MRI or CT scan, or other tests to check the function of the nerves.

Rehab Management: Rehabilitation depends on the extent of the damage and the patient’s symptoms. For example, some patients may wear soft cervical collars to prevent additional injury, others may take pain relievers or muscle relaxants. CSM patients should not participate in high-impact activities.

Other Resources for Patients and Families: The American Academy of Orthopaedic Surgeons has additional resources that can help patients and families.

For Patients and Families:

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