Myelopathy: Does it ever go away?

Myelopathy is a spinal cord condition that occurs due to compression, leading to a range of symptoms that can impact daily life, such as pain, weakness, numbness and coordination difficulties. Whether or not myelopathy can fully resolve depends on several factors, including its cause, severity, and how early it's treated.

What causes myelopathy?

Myelopathy can result from conditions like:

• Cervical spondylotic myelopathy: Degeneration in the cervical spine (neck) due to ageing or arthritis, which compresses the spinal cord.
• Spinal stenosis: Narrowing of the spinal canal, often related to ageing, that can put pressure on the spinal cord.
• Disc herniation: A bulging or slipped disc that presses on the spinal cord.
• Injury or trauma: A spinal cord injury can lead to acute or chronic myelopathy.
• Autoimmune or inflammatory diseases: Conditions like multiple sclerosis may impact the spinal cord.

Can myelopathy go away on its own?

In general, myelopathy does not resolve on its own, especially if it’s caused by structural changes in the spine, like bone spurs or herniated discs. Left untreated, myelopathy can worsen over time and potentially lead to permanent damage to the spinal cord. Early detection and management are crucial to avoid progression.

How is myelopathy treated?

Treatment options for myelopathy aim to relieve spinal cord pressure, reduce symptoms, and prevent further deterioration:

• Conservative treatments: Mild cases may be managed through physical therapy, pain management, and lifestyle adjustments. However, these treatments often manage symptoms rather than curing the underlying issue.
• Medications: Anti-inflammatory medications or pain relievers may alleviate discomfort and swelling but do not treat the cause of compression.
• Surgery: In moderate to severe cases, surgery may be necessary to decompress the spinal cord. Procedures such as laminectomy, discectomy, or spinal fusion remove or reduce the structures causing pressure. Surgery can halt progression and sometimes improve symptoms, but recovery outcomes vary.

Can symptoms improve after treatment?

Following treatment, especially surgery, some individuals experience a significant reduction in symptoms. However, the degree of recovery depends on:

• Extent of spinal cord damage: Nerve tissues in the spinal cord may not fully recover if damage is advanced.
• Time of diagnosis and treatment: Early intervention can prevent worsening symptoms and may improve outcomes.
• Overall health: Physical conditioning, age and lifestyle factors can affect recovery.

Living with myelopathy

While myelopathy may not completely go away, many people can manage their symptoms effectively. Engaging in physical therapy, staying active within limits and following a doctor’s guidance on movement and lifestyle can help. Additionally, managing underlying conditions like arthritis can prevent further damage.

When should I seek help for myelopathy?

If you or a loved one experiences persistent symptoms such as neck pain, numbness, weakness or coordination issues, it’s essential to consult a healthcare professional. Early intervention can improve the chances of managing symptoms and slowing the progression of myelopathy.