Low Back & Pelvis

What It Is

A less common neck condition that occurs with age is cervical spondylotic myelopathy (CSM). Over the course of time, normal age-related wear and tear can lead to a narrowing of the spinal canal. This squeezes (compresses) the spinal cord and can cause a range of symptoms, from weakness to pain and numbness (American Academy of Orthopaedic Surgeons, n.d.).

So what exactly does it all mean? Cervical means neck, and spondylosis means wear and tear / degeneration of the spine. Myelopathy refers to a problem with the spinal cord. So a literal translation could simply be spinal cord compression in the neck due to degenerative changes.

Spinal cord compression is not hugely common, but it can certainly occur. Many of the symptoms are vague, so many people have spinal cord compression for a long time without knowing it (American Academy of Orthopaedic Surgeons, n.d.). It commonly occurs in people over the age of 40, but it can also occur in younger people who were born with a narrower spinal canal (American Academy of Orthopaedic Surgeons, n.d.).

Typically, the symptoms develop slowly and steadily get worse over several years. In some people, however, the condition worsens more quickly. Whatever the pace, CSM will progress over time (American Academy of Orthopaedic Surgeons, n.d.). In research studies, between 20 and 62 percent of people with symptoms got worse without surgery (Fehlings et al., 2017).

Cervical Spondylotic Myelopathy Anatomy

There are seven cervical vertebrae, which are stacked on top of each other, with discs in-between. As the neck ages, the discs lose height, dry out and can bulge, and the body forms extra bone (bone spurs) around them. These bone spurs, and bulging or herniated discs, can narrow the spinal canal and press on the spinal cord (American Academy of Orthopaedic Surgeons, n.d.).

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Symptoms

How It Feels

Symptoms of Cervical Spondylotic Myelopathy

Symptoms can include (American Academy of Orthopaedic Surgeons, n.d.)

Tingling or numbness in the arms, hands or fingers
Weakness in the arms, shoulders or hands, such as trouble gripping and holding on to things
Problems with balance and co-ordination, such as trouble walking or falling
Loss of fine control in the hands, such as difficulty with handwriting or doing up buttons

Treatment

Self-Care & Treatment

How to Treat Cervical Spondylotic Myelopathy

CSM is generally a condition treated with surgery. In milder cases, treatment may start without surgery. Non-surgical treatment aims to ease pain and help with daily activities, but it does not create more space for the spinal cord, so it does not treat the underlying problem (American Academy of Orthopaedic Surgeons, n.d.).

1. Physical Therapy

Alongside your medical care, I can help with gentle hands-on work and exercises to ease pain and stiffness and keep you strong for daily life, although this does not take the pressure off the spinal cord. See the My Approach tab for how I work.

Specific exercises can help relieve pain, strengthen the neck muscles and increase flexibility. Physical therapy can also help you keep your strength and endurance so you can carry on with your daily activities. In some cases, traction (gently stretching the joints and muscles of the neck) can be used (American Academy of Orthopaedic Surgeons, n.d.). Spinal manipulation, such as chiropractic manipulation, should never be used for spinal cord compression (American Academy of Orthopaedic Surgeons, n.d.).

2. Anti-Inflammatory Medication

The American Academy of Orthopaedic Surgeons (n.d.) says anti-inflammatory medicines like aspirin, ibuprofen and naproxen can help relieve pain and reduce inflammation in CSM. (This medicine information comes from the American Academy of Orthopaedic Surgeons, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

3. Soft Neck Collar

Your doctor may advise you to wear a soft collar to let the neck muscles rest and to limit neck movement. It should only be worn for a short time, because long-term use can weaken the neck muscles (American Academy of Orthopaedic Surgeons, n.d.). Follow your doctor's advice about its use.

Treatments you may want to discuss with your family doctor or nurse practitioner

Options outside my scope

MRI scan: if you have not already had one, an MRI scan can show spinal cord compression and what is causing it (American Academy of Orthopaedic Surgeons, n.d.).
Surgery: an operation to relieve the pressure on the spinal cord (decompression) is recommended for moderate and severe myelopathy, and is one of the options for mild myelopathy (Fehlings et al., 2017).
Strong painkillers and steroids: a short course of steroid tablets or, for severe pain not relieved by other options, prescription painkillers (opioids) for a limited time may be used. Steroid injections are rarely used for CSM because they can make it worse (American Academy of Orthopaedic Surgeons, n.d.).

How I can help (see the My Approach tab)

Gentle hands-on work for neck and shoulder pain and tension
Exercises for strength, balance and hand use
Regular checks of strength and feeling, with prompt referral if anything changes

Tips

Age-related wear and tear of the discs can lead to the development of cervical spondylotic myelopathy (American Academy of Orthopaedic Surgeons, n.d.).
As you age, your discs lose some of their water content, so they dry out and become stiffer (American Academy of Orthopaedic Surgeons, n.d.).
A disc herniates when its soft, jelly-like centre pushes out through the tough outer ring. As discs wear with age, the risk of herniation rises, and herniation often happens with lifting, pulling, bending or twisting movements (American Academy of Orthopaedic Surgeons, n.d.).
An injury to the neck, such as from a car accident, sport or a fall, can also lead to myelopathy (American Academy of Orthopaedic Surgeons, n.d.).
Older people are more prone to wear and tear, and hence more likely to develop cervical spondylosis and related conditions.

Treatment

My Approach

Cervical spondylotic myelopathy is managed by your medical team, and massage and exercise don't take the pressure off the spinal cord. What I can do is ease the pain, tension and stiffness that often come with it, and help you stay strong, steady and active. If you've had surgery, I need your surgeon's okay before we start hands-on treatment.

I start by assessing how your neck and shoulders move, and checking strength, feeling and reflexes in your arms and legs, plus your grip and balance. I repeat these checks as we go, so any change is picked up early.

Hands-On Treatment

Gentle massage and myofascial work for the neck, shoulders, upper back and chest
Comfortable positions, avoiding holding your head tipped back or anything that brings on tingling or numbness
No manipulation or forceful neck movements, ever
Gentle work around the scar once it has healed, if you had surgery

Movement and Strength

Gentle, pain-free neck movement and posture work
Strengthening for the shoulders, upper back and legs, and grip and hand exercises
Balance work, holding on if falls are a worry
A home programme and, after surgery, a gradual return to activity within your surgeon's limits

If your symptoms get worse, see your family doctor or nurse practitioner promptly. New problems walking, loss of bladder or bowel control, or a sudden lack of co-ordination mean calling 911 (see When to Get Help).

What to Expect

Typical Course

Typical course: Usually twice a week for about three weeks, then weekly for a month, then spacing out as you manage more on your own, with a reassessment along the way. Most people notice pain and stiffness easing over these first weeks, but the condition itself follows your medical team's plan, and after surgery we follow your surgeon's timeline.

What I Focus On

Regular Nerve Checks

Gentle Pain Relief

No Manipulation

Strength & Balance

Working With Your Team

Please read

When to See a Doctor First

When to Get Help

If you notice any of the symptoms above, see your family doctor or nurse practitioner promptly so you can be referred to a specialist. Ask for an urgent appointment with your family doctor or nurse practitioner if you have heaviness or weakness in your arms or legs, or pins and needles in an arm as well as pain in your neck or arm (NHS, 2023).

Call 911 or go to the emergency room at your nearest hospital if you have new problems walking, loss of bladder or bowel control, or a sudden lack of co-ordination, for example with tasks like buttoning a shirt (NHS, 2023).

Sources

References

American Academy of Orthopaedic Surgeons (n.d.) Cervical spondylotic myelopathy (spinal cord compression). OrthoInfo. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/cervical-spondylotic-myelopathy-spinal-cord-compression/ (Accessed: 7 October 2026).
Fehlings, M.G., Tetreault, L.A., Riew, K.D. et al. (2017) 'A clinical practice guideline for the management of patients with degenerative cervical myelopathy: recommendations for patients with mild, moderate, and severe disease and nonmyelopathic patients with evidence of cord compression', Global Spine Journal, 7(3 Suppl), pp. 70S–83S. doi: 10.1177/2192568217701914
NHS (2023) Cervical spondylosis. Available at: https://www.nhs.uk/conditions/cervical-spondylosis/ (Accessed: 7 October 2026).

Massage therapy · Kitchener–WaterlooCervical Spondylotic Myelopathy

What It Is

Cervical Spondylotic Myelopathy Anatomy

How It Feels

Symptoms of Cervical Spondylotic Myelopathy

Self-Care & Treatment

How to Treat Cervical Spondylotic Myelopathy

1. Physical Therapy

2. Anti-Inflammatory Medication

3. Soft Neck Collar

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

Hands-On Treatment

Movement and Strength

Typical Course

When to See a Doctor First

When to Get Help

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooCervical Spondylotic Myelopathy

What It Is

Cervical Spondylotic Myelopathy Anatomy

How It Feels

Symptoms of Cervical Spondylotic Myelopathy

Self-Care & Treatment

How to Treat Cervical Spondylotic Myelopathy

1. Physical Therapy

2. Anti-Inflammatory Medication

3. Soft Neck Collar

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

Hands-On Treatment

Movement and Strength

Typical Course

When to See a Doctor First

When to Get Help

References

Related Conditions

Lumbar Spinal Stenosis

Spinal Stenosis

Cervical Disc Herniation

Degenerative Disc Disease (DDD)

Book a session