If you have symptoms of spinal cord compression, get medical advice right away.
Speak with your GP, oncologist or cancer nurse urgently.
If you cannot contact anyone, go to the nearest emergency department (A&E).
What is spinal cord compression?
Your spinal cord is a set of nerves inside your backbone (spine). It connects your brain to the rest of your body. The nerves transport signals that control your movement, feeling and automatic reactions.
Spinal cord compression is when something else puts pressure on your spinal cord. This pressure stops the nerves from working properly. It is sometimes called spinal compression for short, but it is the nerves in the cord that are being compressed rather than the spine itself.
Cervical compression is in your neck. Thoracic compression is in the upper or middle part of your back. Lumbar compression is in the lower part of your back.
What are the symptoms of spinal cord compression?
Symptoms depend on which part of your spinal cord is under pressure and why.
Most people with spinal cord compression have severe pain in their back or neck. It might be a burning or shooting pain. It might feel like you have a tight band around your tummy or chest. The pain may keep you awake at night. It can get worse when you cough or sneeze. You might also feel the pain in your arm or leg.
Other symptoms include:
- tingling or numbness anywhere in your body
- having difficulty controlling your bladder (pee) or bowels (poo)
- feeling unsteady, weak or unbalanced
These symptoms can also be caused by things other than spinal cord compression, for example a pinched nerve.
If you have symptoms of spinal cord compression, get medical advice straight away. If spinal cord compression is left untreated, there is a risk of permanent damage to your spinal cord.
What causes spinal cord compression?
Spinal cord compression can happen for different reasons. Here are some common causes:
Fractured spine
One of the small bones around your spine (vertebrae) has been damaged. This may happen if you have been injured through a big impact like a car accident.
Slipped disc
Part of the soft tissue between the bones in your spine has moved out of place. This may happen if you have been injured through a sports accident or a fall.
Cancer
A tumour is growing in a place that puts pressure on your spinal cord. A primary tumour is when the cancer has started in your spine. A secondary or metastatic tumour is when the cancer has spread from another part of your body.
Spinal infections
Swelling (inflammation) from an infection is putting pressure on your spinal cord.
Age-related wear and tear
Extra bits of bone (spurs) have grown and are pressing on your spinal cord. This can happen in conditions like osteoarthritis.
How is spinal cord compression diagnosed?
You will usually have an urgent MRI scan . This is short for magnetic resonance imaging. You lie flat on your back on a bed. The bed moves through a short tunnel (the scanner).
If an MRI scan is not suitable for you, you may have a CT scan instead. This is short for computed tomography. You lie flat on your back on a bed, and a ring (the scanner) moves around you. You will need to stay very still.
You may have other tests and physical checks. These will depend on the nature and cause of your spinal cord compression.
Your medical team will try to diagnose your condition as quickly as possible.
What are the treatments for spinal cord compression?
Treatment for spinal cord compression should start as soon as possible. It can cause permanent damage to your spinal cord. In bad cases, this means not being able to move your muscles (paralysis).
Your medical team will explain your treatment options. These will depend on:
- what is causing your spinal cord compression
- how severe it is
- where it is
- whether you have other injuries or conditions
- whether it is an emergency situation
Here are some common treatments:
Steroids
These medicines will help to reduce swelling and pressure.
Radiotherapy (for tumours)
A machine directs beams of radiation at the tumour to kill cancer cells. This can shrink the tumour that is putting pressure on your spinal cord. You may still need surgery to fully remove the tumour.
Chemotherapy (for tumours)
You may have chemotherapy or other cancer medicines as well as having radiotherapy. These medicines kill cancer cells and stop them from spreading. You may still need surgery to fully remove the tumour.
Surgery
You may need an operation to remove pressure on your spinal cord. This may be done by a neurosurgeon (specialising in the central nervous system) or an orthopaedic surgeon (specialising in bones and muscles). This will depend on the nature of your spinal cord compression. Your cancer team will also be involved if your surgery is to remove a tumour.
Pain relief
You will usually have pain relief medicines at the same time as other treatments. This will help you to feel more comfortable.
Relief from other symptoms
You may have a tube in your bladder, to drain your pee into a bag.
Ongoing treatment during recovery
Recovery can take 12 weeks. Your medical team will tell you what needs to happen and whether you need any more treatment.
This may include:
- lie flat on your back
- continuing to take painkillers or medicines to reduce inflammation
- wearing a collar to keep your neck and spine still
- doing exercises to build your strength back up (physiotherapy)
How do I get private treatment for spinal cord compression?
If you have symptoms of spinal cord compression, get medical advice straight away.
This can be through a GP or emergency department. If you are already having cancer treatment, you can also go through your cancer care team. You can access any of these services through the NHS or a private healthcare provider.
If you already have a healthcare plan with a private provider, contact them directly to arrange an urgent appointment.
Even if your first appointment is with the NHS, you may be able to transfer to private care for your scans and treatment. The process for this will depend on the urgency of your care and the cause of your spinal cord compression.
A private MRI scan may cost between £300 and £600. The cost may be higher if you need a scan of your whole spine rather than just a specific area.
Treatment costs following diagnosis will vary significantly. This will depend on the nature of your spinal cord compression and what is causing it. Talk to your care team about your individual treatment options and costs.
Cancer Research – Spinal cord compression and cancer
https://www.cancerresearchuk.org/about-cancer/coping/physically/spinal-cord-compression
Macmillan – Metastatic spinal cord compression (MSCC)
https://www.macmillan.org.uk/cancer-information-and-support/impacts-of-cancer/metastatic-spinal-cord-compression
NHS – CT scan
https://www.nhs.uk/tests-and-treatments/ct-scan/
NHS – Lumbar decompression surgery
https://www.nhs.uk/tests-and-treatments/lumbar-decompression-surgery/
NHS – MRI scan
https://www.nhs.uk/tests-and-treatments/mri-scan/
Spinal Injuries Association – UK charity
https://www.spinal.co.uk/
