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A wheelchair may be required for mobility with advanced cervical myelopathy.
Hand numbness is caused by compression of a nerve, anywhere from the spine to the fingertips. Cervical myelopathy is a serious condition caused by pressure on the spinal cord that can lead to hand numbness along with arm weakness and, possibly, difficulty walking. Cervical myelopathy can be caused by infections, trauma or degenerative disorders of the spine. Immediate medical attention is necessary to reduce the risk for long-term spinal cord damage.
Compression on the spinal cord in the neck is called cervical myelopathy. Nerves in the neck carry signals for sensation and control of the arms and hands. Cervical myelopathy frequently causes numbness in the hands. Age-related breakdown of the spinal bones is the leading cause of cervical myelopathy. People with cervical myelopathy due to this cause are usually older than age 50. In the third and fourth decades of life, cervical myelopathy is often caused a narrow spinal canal -- the bony "tunnel" through which the spinal cord travels. This is present at birth, however symptoms usually don't occur until later in life, when age-related degenerative changes begin to develop in the spine.
Hand numbness, tingling and "electrical shocks" are often early symptoms of cervical myelopathy. This numbness typically affects the whole hand. Decreased fine motor skills -- such as writing and tying shoelaces -- are also common. Some people experience neck pain, although many with the condition do not have this symptom.
Cervical myelopathy can also cause weakness and poor coordination in the legs due to compression on the spinal cord. People with this condition may experience difficulty walking and frequent falls. Cervical spinal cord compression can also cause problems with bowel and bladder control.
Imaging tests are used to help diagnose cervical myelopathy. X-rays of the neck show how bones in the spine are lined up, as well as bone spurs that may have developed. However, the exact size of the spinal canal cannot be determined from x-rays. Magnetic resonance imaging is commonly used to take a 3-dimensional picture of the spinal cord, showing areas of compression. CT scans are less commonly used to visualize bone spurs from multiple angles.
Treatment for hand numbness caused by cervical myelopathy due to spinal bone degeneration is focused on the neck. Physical therapy is sometimes prescribed for conservative management of this condition. Heat, ultrasound and traction -- stretching of the neck -- are used to decrease pressure on the spinal cord. Epidural steroid shots may be administered by the doctor.
Surgery is frequently required to alleviate symptoms caused by cervical myelopathy. Several techniques can be used, all with the goal of increasing the size of the spinal canal to decrease pressure on the spinal cord. Metal plates and screws are used to hold the bones in place after these procedures. After surgery, physical therapy is often prescribed to strengthen the hands, arms and legs and improve overall ability to move.
Symptom relief after surgery varies by individual. Numbness in the hands after surgery may be permanent, improve or even get worse. According to the American Academy of Orthopaedic Surgeons, approximately 1/3 of patients fall into each of these categories. Symptoms caused by cervical myelopathy can continue to change for 1 to 2 years after surgery.