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Spinal cord compression

Spinal cord compression happens when pressure on the spinal cord stops the nerves working normally.

Spinal cord compression is an emergency and needs to be treated quickly. Contact your doctor straight away if you have any symptoms of spinal cord compression.

Symptoms

Symptoms depend on where the pressure in the spinal cord is. Pain is often the first symptom and more than 9 out of 10 people (90%) with spinal cord compression have it. The pain:

  • could be anywhere in your back, spine or neck
  • may feel like a tight band around your body
  • in your spine could be made worse when you cough, sneeze or go to the toilet
  • is getting worse or doesn’t go away
  • is stopping you sleeping or wakes you up at night
  • is made worse by lying flat on your back

Other symptoms might include:

  • weakness in your legs or arms
  • difficulty walking
  • changes to sensations in your body, such as pins and needles or numbness
  • not being able to go for a wee or poo
  • difficulty controlling your bladder or bowel
  • erection problems

What to do if you have symptoms

Contact your hospital team straight away if you have any symptoms of spinal cord compression. You should have an emergency number to call.

They might ask you to go to your nearest hospital straight away. This might not be your usual hospital. It’s important to follow their instructions so you are seen quickly.

If you can't get through to your hospital team, contact your GP or go to your nearest accident and emergency department (A&E). 

The spinal cord

The spinal cord is a long bundle of nerves that stretches from the brain to the lower part of the back. The nerves send messages from the brain to control movement and feeling in different parts of our body.

Bones called vertebrae protect the spinal cord. The vertebrae make up the spinal column. Cerebral spinal fluid (CSF), fat and tissue also help protect the spinal cord inside the spinal column. These help to soak up any impact the spinal cord might get and help prevent any damage happening.

The nerves from the spinal cord extend into regions. The diagram below shows what regions of the body the nerves control. 

Diagram of the spinal cord

What is spinal cord compression?

Spinal cord compression happens when there is pressure on the spinal cord. Pressure on the spinal cord causes the nerves in the spinal cord to swell and slows down or blocks their blood supply. This stops the nerves working normally.

Spinal cord compression can happen in people who do not have cancer.

Cancer in the spinal bones can cause pressure. There are different names depending on where the cancer started. You might hear it called:

  • malignant spinal cord compression when the cancer started in the spine
  • metastatic spinal cord compression when the cancer cells have spread into the spinal bones from another part of the body
Diagram showing spinal cord compression

Who is at risk?

Around 3 to 5 in 100 people (3 to 5%) with cancer develop spinal cord compression. Almost any type of cancer can spread to the spine.

You’re at higher risk of developing spinal cord compression if you have cancer that:

  • has already spread to your bones
  • is at high risk of spreading to your bones, such as prostate, breast, lung or myeloma
  • started in your spine

Tests for spinal cord compression

You’ll have an urgent MRI scan of your back if your doctors think you might have spinal cord compression.

You might also have a CT scan. You usually have this scan within 24 hours of your doctor suspecting you have spinal cord compression. 

Treatment

Starting treatment early helps stop the symptoms getting worse or becoming permanent.

Your feelings

It can be difficult to cope with the changes caused by spinal cord compression. It’s normal to feel a range of emotions, including being upset and frightened. There is no ‘right’ way to feel and everyone is different.

Tell your healthcare team how you feel. They can find the best person to help.

You can do some supportive things. Getting information about spinal cord compression and your cancer can help you cope, so you know what to expect. Take some time out to look after yourself. Some hospitals have a complementary therapy service you could access for free.

You can also talk about this with the Cancer Research UK nurses on freephone 0808 800 4040, from 9am to 5pm, Monday to Friday.
Last reviewed: 
20 Jan 2021
Next review due: 
20 Jan 2024
  • The Royal Marsden Manual of Clinical Nursing Procedures (9th Professional Edition)
    Dougherty and Lister
    Wiley-Blackwell, 2015

  • BMJ Best Practice. Spinal cord compression
    K F Casey and others
    BMJ Publishing Group, ast updated August 2019

  • Acute Oncology Initial Management Guidelines (Version 2)
    UKONS Oncology Nursing Society, March 2018

  • Clinical Review. Metastatic spinal cord compression: diagnosis and management
    R Al-Qurainy and E Collis
    The BMJ, 2016. Volume 353, Issue i2539

  • 2019 surveillance of metastatic spinal cord compression in adults: risk assessment, diagnosis and management
    National Institute for Health and Care Excellence (NICE), February 2019

  • The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. Please contact patientinformation@cancer.org.uk with details of the particular issue you are interested in if you need additional references for this information.