Spinal Cord Compression
Spinal cord compression is caused by any condition that puts pressure on your spinal cord. Your spinal cord is the bundle of nerves that carries messages back and forth from your brain to your muscles and other soft tissues. As your spinal cord travels down your back, it is protected by a stack of backbones called vertebrae (they also hold your body upright). The nerves of your spinal cord run out to your muscles through openings between the vertebrae.
Spinal cord compression can occur anywhere from your neck down to your lower spine and cause symptoms, such as numbness, pain, and weakness. Depending on the cause of the compression, symptoms may develop suddenly or gradually, and they may require anything from supportive care to emergency surgery.
Facts about spinal cord compression
Your spine is divided into three areas. The cervical spine is the upper part of your spine that supports your neck. The cervical spine has seven vertebrae. The middle part of your back is your thoracic spine. It is made up of 12 vertebrae. The lumbar spine is your lower back and has five vertebrae. Spinal compression can occur in any of these areas.
One of the most common causes of spinal compression is the gradual wear and tear of osteoarthritis. People who develop spinal cord compression from this are usually older than 50. Other conditions that may cause spinal cord compression can develop more quickly, even very suddenly, and can occur at any age.
Types of spinal cord compression
These are common conditions that may cause spinal cord compression:
Abnormal spine alignment
Injury to the spine
Certain bone diseases
Symptoms of spinal cord compression can develop quickly or slowly, depending on the cause. Injuries may cause immediate symptoms. Tumors or infections may cause symptoms that develop over days or weeks. Wear and tear of the spine may take years to cause symptoms.
These are common symptoms:
Pain and stiffness in the neck, back, or lower back
Burning pain that spreads to the arms, buttocks, or down into the legs (sciatica)
Numbness, cramping, or weakness in the arms, hands, or legs
Loss of sensation in the feet
Difficulty with hand coordination
"Foot drop," weakness in a foot that causes a limp
Loss of sexual ability
Pressure on nerves in the lumbar region can also cause more serious symptoms known as cauda equina syndrome. If you have any of these symptoms, you need to get medical attention right away, typically in the emergency room:
Loss of bowel or bladder control
Severe or increasing numbness between the legs, inner thighs, and back of the legs
Severe pain and weakness that spreads into one or both legs, making it hard to walk or get out of a chair
To diagnose spinal compression, your doctor will ask you questions about your symptoms and do a complete physical examination. During the exam, your doctor will look for signs of spinal compression, such as loss of sensation, weakness, and abnormal reflexes. Tests that help with your diagnosis may include:
X-rays of your spine. These may show bone growths called spurs that push against spinal nerves. X-rays may also show an abnormal alignment of your spine.
Special imaging tests of your spine. A CT or MRI scan will give a more detailed look at the spinal cord and the structures surrounding it.
Other studies that may be done include a bone scan, myelogram (a special X-ray or CT scan taken after injecting dye into the spinal column), and electromyography, or EMG, an electrical test of muscle activity.
The medical team involved in treating your spinal cord compression may include arthritis specialists, bone surgeons, nerve specialists, and physical therapists. Treatment may involve medication, physical therapy, injections, and/or surgery. Except in cases of emergency, such as cauda equina syndrome or a broken back, surgery is usually the last resort.
Medications may include nonsteroidal anti-inflammatory drugs that relieve pain and swelling, and steroid injections that reduce swelling.
Physical therapy may include exercises to strengthen your back, abdominal, and leg muscles. You may learn how to do activities more safely. Braces to support your back or a cervical collar may also be helpful.
Surgical treatments include removing bone spurs and widening the space between vertebrae. Other procedures may be done to relieve pressure on the spine or repair fractured vertebrae. The back may also be stabilized by fusing some of the vertebrae together.
Some other treatments that may be helpful for some people include acupuncture and chiropractic care.
Many causes of spinal cord compression can’t be prevented. You can help prevent symptoms of spinal cord compression caused by gradual wear and tear by keeping your back as strong and healthy as possible:
Get regular exercise. Exercise strengthens the muscles that support your back and helps keep your spine flexible.
Maintain good posture and learn how to safely lift heavy objects. Other good body mechanics include sleeping on a firm mattress and sitting in a chair that supports the natural curves of your back.
Maintain a healthy weight. If you are overweight, know that excess weight puts more stress on your back and can contribute to developing symptoms of spinal compression.
Managing spinal cord compression
The best way to manage spinal cord compression is to learn as much as you can about your condition, work closely with your health care providers and caregivers, and take an active role in your treatment. Keep your back as healthy as possible by maintaining a healthy weight, practicing good body mechanics, and getting regular exercise.
Simple home remedies like an ice bag, heating pad, massage, or a long hot shower can help.
The nutritional supplements glucosamine and chondroitin have been recommended as nutritional supplements for osteoarthritis, but recent studies have been disappointing. Ask your health care provider if he or she recommends any supplements for you and always discuss any alternative treatments or medications you’d like to try.