What causes spinal cord compression?

Spinal cord compression is usually caused by cancer affecting the spine, weakened or collapsed vertebrae, or a mass pressing on the spinal cord. In oncology, cancer that has spread to the bones of the spine is a frequent cause. Multiple myeloma can also weaken vertebrae or form tissue that narrows the space around the cord. Less commonly, pressure may come from bleeding, infection, a fracture, or a non-cancerous growth.

The spinal cord travels through a protected channel inside the spine. A tumour or other tissue can grow into the channel, while cancer-weakened bone can break down, shift, or collapse into it. This pressure can interfere with messages travelling between the brain and the body. Symptoms may begin with persistent back pain, pain that travels around the chest or abdomen, tingling, numbness, or weakness. Difficulty walking and changes in bladder or bowel control can develop as pressure increases.

Contact your oncology team or an emergency service promptly if you have new back pain with weakness, altered sensation, or difficulty walking. A clinician may assess strength, reflexes, sensation, and movement, then arrange urgent imaging such as magnetic resonance imaging. Treatment depends on the cause and may include corticosteroids, radiotherapy, surgery, stabilisation of the spine, or treatment directed at the cancer. Do not wait for a routine appointment when neurological symptoms are new or worsening.

Seek emergency medical care now for new or rapidly worsening leg or arm weakness, inability to walk, loss of feeling, or loss of bladder or bowel control. Severe or persistent back pain, especially in someone with cancer or a history of cancer affecting bone, also needs urgent medical advice. Early assessment can help the team protect nerve function and address spinal instability before symptoms become more difficult to reverse.

Ask what may be pressing on the spinal cord, which symptoms should trigger an emergency call, and whether urgent imaging is needed. You can also ask how treatment could affect walking, pain, sensation, bladder or bowel function, and whether you need to limit lifting or other movements while the spine is assessed.