Cervical Myelopathy

Explanation of Diagnosis

Cervical myelopathy means the spinal cord in your neck (cervical spine) is being compressed or irritated. This can happen from conditions such as spinal stenosis, arthritis-related narrowing, disc changes, or bone spurs over time. Because the spinal cord controls signals to your arms, hands, and legs, symptoms often include trouble with balance or walking, hand clumsiness, weakness, numbness or tingling, and sometimes changes in bladder or bowel function. The goal of conservative care is to reduce symptoms, protect nerve function, and keep you moving safely while your care team monitors progression.

Specific Work Modifications

• Set your computer monitor so the top of the screen is near eye level to avoid looking up or down for long periods.
• Take a posture break every 30 to 45 minutes to stand, reset your shoulders, and gently change positions.
• Reduce overhead work and prolonged reach; use tools with longer handles or move your work to waist height.
• Avoid long periods of neck flexion such as leaning forward on a keyboard, phone, or paperwork; use a headset or phone stand when possible.
• Limit heavy lifting and pushing/pulling that makes you brace with your neck; use proper body mechanics and ask for help when needed.
• Keep your workstation keyboard and mouse close to your body so your elbows stay supported and your shoulders stay relaxed.

Specific Activity Modifications

• Avoid contact sports, high-impact activities, and anything that risks a sudden fall or neck jolt.
• Skip or modify aggressive stretching, deep neck bending, or high-velocity movements (including “cracking” the neck).
• Use caution with overhead lifting and strenuous core bracing that increases neck strain; choose lighter loads and shorter sets.
• Choose low-impact cardio such as walking on level ground or a stationary bike with good posture rather than running on uneven surfaces.
• Avoid activities that worsen coordination problems, such as climbing ladders, hiking on rough terrain, or sports requiring quick directional changes.
• Stop and reassess if you notice worsening numbness, new weakness, or a clear change in walking or balance during or after an activity.

Recommended Supplements

None

Recommended Nutrition and Hydration

Diet Recommendations

• Aim for a Mediterranean-style pattern with vegetables, fruits, beans, whole grains, nuts, fish, and olive oil to support overall tissue health.
• Prioritize adequate protein at most meals (such as eggs, poultry, fish, tofu, beans, or Greek yogurt) to support recovery of muscles and connective tissues.
• Include omega-3 rich foods (fatty fish like salmon or sardines) if you can, since diet can help reduce inflammatory signals.
• Limit added sugars and highly processed foods, which can contribute to a more inflammatory environment.

Hydration Tips

• Drink enough fluids so your urine is light yellow, especially if you’re walking more or exercising gently.
• Spread fluids through the day rather than “catching up” late, and be mindful that dehydration can worsen fatigue and coordination.

Home Exercise Prescription

Perform these exercises most days, typically 4 to 6 days per week, unless your clinician advises otherwise.

1. Chin tuck (posture reset): Sit tall with shoulders relaxed; gently glide your head straight back as if making a “double chin” without looking down, hold 3 to 5 seconds, repeat 8 to 10 times.
2. Scapular retractions: With arms by your sides, gently pull shoulder blades back and down; hold 5 seconds, repeat 8 to 12 times.
3. Isometric neck strengthening (gentle): Using your hand, press lightly into your forehead, then your hand into the back of your head, without letting your head move; hold 5 seconds each direction for 5 to 6 reps total per side/position.
4. Thoracic extension over a towel: Roll a small towel lengthwise and place it mid-back over a chair or couch, then gently lean back to extend the upper back only; hold 2 to 3 seconds, repeat 6 to 10 times.
5. Supported upper-extremity mobility: With your elbow supported on a pillow, slowly open and close the hand and move the wrist through comfortable ranges; do 1 to 2 sets of 10 to 15 gentle reps.
6. Avoid painful resistance and stop if symptoms sharply worsen, especially if balance, strength, or numbness changes noticeably.

Helpful Books

• "The Cervical Spine: A Patient’s Guide" written by Dr. Dawn D. Comstock
• "Healing Back Pain" written by Dr. John E. Sarno
• "Back In Shape" written by Dr. Michael Brusch and Dr. Lynn Rose Brusch
• "Managing Pain: The Breakthrough Guide to Understanding and Using Your Mind to Manage Pain" written by Dr. Martin Rossman and Dr. Robyn R. Crawford