Around one million UK adults may be living with cervical myelopathy, a spinal condition that can cause serious damage if ignored, according to a BBC doctor who has urged people not to dismiss its symptoms as simply a sign of ageing.
Dr Tom Naylor, an orthopaedic registrar who has worked as a full-time NHS doctor since graduating in 2015, appeared on BBC Morning Live to explain that the condition affects both men and women and is not related to the womb or female reproductive system, despite what its name might suggest.
Cervical myelopathy occurs when the spinal cord is compressed in the cervical spine, which is the neck. Although it is more common in older people, Dr Naylor said symptoms should not be automatically blamed on getting older.
What is cervical myelopathy?
Dr Naylor said a team in Cambridge estimated the condition affects one million UK adults, which is around one in 25 people over the age of 75.
He explained the name can be misleading, with some mistakenly thinking it only affects women. "A lot of people think about cervical being related to the uterus and the womb, but it comes from the Latin for neck - so that's where the cervical bit is," he said. "Mylo is Greek for spinal cord, and pathy means a disorder. So that's how we get to that name that people haven't heard a lot of."
Warning signs to look out for
Dr Naylor warned that the signs are often missed or dismissed as part of "getting older". One warning sign is a loss of dexterity in the hands, which can make everyday activities increasingly difficult. People may struggle to fasten shirt buttons, tie shoelaces, turn a key in a lock, or grip objects properly.
Other symptoms include problems with balance, unexplained falls, and neck pain. In more serious cases, people may notice changes in their bladder or bowel habits, including accidents where there is no sensation.
Some people may also experience weakness or heaviness in their legs, making walking feel unusual or difficult. Dr Naylor said patients describe it as though their legs "don't seem to do what you want them to do", while others describe the sensation as walking on cotton wool.
Pins and needles or tingling in the arms and legs, particularly in the hands and fingertips, may also occur, especially when both hands are affected.
Experts at Johns Hopkins Medicine add that some people may have neck pain, stiffness and a limited range of movement. They stress that while neck pain is common, it is not always caused by cervical myelopathy, and some patients with the condition have no neck pain at all.
When to see a GP
Dr Naylor urged people not to brush off symptoms and to seek help if worried. He said: "It is important to get assessed by a GP because there are a variety of symptoms that can be due to a lot of things, but if you're having new or persistent clumsiness, weakness, loss of balance, falls without causes - it's useful to keep a diary to build up over time of what's been going on and then take it to a GP."
He added: "But if you have a sudden major weakness and suddenly you can't walk, you can't get out of bed - something that changes really quickly, especially that's affecting your coordination - that's something that I would suggest you see somebody more urgently, so rather than waiting for a routine GP appointment, seek urgent care through the NHS 111 or similar."
If symptoms persist, a GP can carry out a full assessment, including reviewing medical history and performing a physical examination. If needed, patients may be referred to a spinal or orthopaedic specialist team for further tests.
An MRI scan may also be needed to determine whether the spinal cord is being compressed and whether any damage has already occurred. Dr Naylor explained: "This is how we pick up on how tight the spinal canal and cord is and whether there has been any damage caused."
Treatment options
If left untreated, the condition can progress, so spotting symptoms early is important. Physiotherapy can help with some issues, such as balance, but it will not take pressure off the spinal cord.
Dr Naylor said: "The early symptoms can be treated early with physiotherapy like the balance issues," but explained that the definitive treatment for spinal cord compression is surgery to relieve the pressure, where clinically appropriate.
The main goal is to stop the condition getting worse. Not everyone will need surgery, and specialists will weigh up how severe the symptoms are alongside scan results before recommending the most suitable treatment.
The key point is that symptoms such as ongoing clumsiness, unexplained falls, weakness and problems walking should not be written off as "just old age". An earlier assessment could help spot the condition before any permanent damage occurs.
