Cervical Myelopathy: Physiotherapy and When to See a Surgeon

Why this condition is treated differently

In cervical radiculopathy a single nerve root is irritated, and the symptoms stay in one arm. In myelopathy the cord itself is under pressure. The signals affected aren't just to one arm but to both hands, and often the legs.

Common early signs are easy to dismiss: dropping things, difficulty with buttons or writing, hands that feel numb and clumsy, and a slightly unsteady walk as if balance has gone off. Neck pain may be mild or absent. People often put it down to age.

Because cord compression can progress, you should see a spine surgeon or neurologist promptly if these signs appear. If we find them during an assessment for something else, we refer you before continuing treatment.

Where physiotherapy fits

When myelopathy is mild and stable, and your specialist has advised a period of monitoring, physiotherapy focuses on safe function. That means balance training, walking practice, hand dexterity work and general strength, all without forceful neck manipulation or aggressive traction.

After decompression surgery, rehabilitation becomes the main event. Recovery of hand function and gait continues for months. We work on fine motor tasks, leg strength, balance on different surfaces and confidence with stairs and uneven ground. Progress is often steady but slow, and it's measured in what you can do rather than in pain scores.

What we avoid

High-velocity neck manipulation is not appropriate. Heavy cervical traction is avoided unless the surgeon specifically advises it. Our job is to improve function around the problem while the medical team manages the compression itself.

Exercises often used for Cervical Myelopathy

These are exercises our physiotherapists commonly include. Which ones suit you, how many and in what order depends on your assessment and stage of recovery.

All back and spine exercises

Frequently asked questions