Digital illustration representing cervical spondylotic myelopathy and the DOWN questionnaire.

Is It Just a Stiff Neck? How to Spot Cervical Spondylotic Myelopathy Early

Kai Mendoza in Health & Wellness June 2025 • 4 min read.

"A simple 4-question quiz could help you identify early warning signs of CSM, a condition that can lead to serious spinal cord issues if left untreated."

That nagging neck stiffness... is it just a part of getting older, or could it be something more? Cervical spondylotic myelopathy (CSM) is a condition where the spinal cord in your neck gets compressed, often due to age-related changes. This compression can lead to neuronal damage and all sorts of problems with movement, sensation, and even balance.

The tricky thing about CSM is that it often creeps up slowly. Recognizing it early is crucial, as early intervention can make a huge difference in preventing further decline. While it's not something to panic about, being informed can empower you to take proactive steps for your health.

Researchers at the University of Southern California have developed a simple, 4-question screening tool, nicknamed the DOWN questionnaire, to help identify individuals who may be at risk for CSM. Let’s dive into this tool and understand how it can help you stay ahead of potential spinal cord issues.

The DOWN Questionnaire: 4 Questions That Could Change Everything

Digital illustration representing cervical spondylotic myelopathy and the DOWN questionnaire.

The DOWN questionnaire is designed to be a quick and easy way to assess your risk of CSM. It focuses on common symptoms that people with CSM often experience. Think of it as a first step – not a definitive diagnosis, but a helpful flag that suggests further evaluation might be needed.

Here are the four questions that make up the DOWN questionnaire:

Dropping things or feeling clumsy in your hands?
Feeling off-balance or unsteady?
Weakness in one or both arms or hands?
Numbness or tingling in your arms or hands?

If you answered "yes" to three or more of these questions, it doesn't automatically mean you have CSM. However, it does suggest that you should discuss these symptoms with your doctor. They may recommend further evaluation, including a neurological exam and possibly imaging tests like an MRI.

Empower Yourself: Early Detection for a Healthier Spine

CSM can significantly impact your quality of life, affecting everything from your ability to perform everyday tasks to your emotional well-being. The DOWN questionnaire offers a simple yet powerful tool for early detection, prompting timely discussions with your healthcare provider and potentially preventing further progression of the condition. Don't let neck stiffness and subtle changes hold you back – take control of your spinal health!

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

Everything You Need To Know

What is Cervical Spondylotic Myelopathy (CSM), and why is early detection so important?

Cervical Spondylotic Myelopathy (CSM) is a condition where the spinal cord in your neck becomes compressed, often due to age-related changes. This compression can cause neuronal damage, leading to problems with movement, sensation, and balance. Early detection is crucial because timely intervention can prevent the progression of CSM and mitigate further decline. Without early action, CSM can significantly affect your quality of life.

How does the DOWN questionnaire help in identifying potential CSM cases?

The DOWN questionnaire is a simple, 4-question screening tool designed to identify individuals who may be at risk for Cervical Spondylotic Myelopathy (CSM). It focuses on common symptoms associated with CSM. If you answer "yes" to three or more questions in the DOWN questionnaire, it suggests you should consult your doctor for further evaluation. It serves as an initial step, not a definitive diagnosis, indicating a need for further medical assessment, potentially including neurological exams and imaging tests like an MRI.

What are the four questions included in the DOWN questionnaire?

The four questions in the DOWN questionnaire are: 1. Dropping things or feeling clumsy in your hands? 2. Feeling off-balance or unsteady? 3. Weakness in one or both arms or hands? 4. Numbness or tingling in your arms or hands?

If I answer "yes" to several questions on the DOWN questionnaire, does that mean I definitely have CSM?

Answering "yes" to multiple questions on the DOWN questionnaire does not definitively diagnose Cervical Spondylotic Myelopathy (CSM). It indicates that you may be at risk and should discuss your symptoms with your doctor. They can then recommend further evaluation, which may involve a neurological exam or imaging tests, such as an MRI, to confirm the diagnosis.

How can I take control of my spinal health when it comes to Cervical Spondylotic Myelopathy (CSM)?

You can take control of your spinal health by being proactive. Utilize the DOWN questionnaire as a screening tool and discuss any concerns with your healthcare provider. Early detection through the DOWN questionnaire enables timely discussions with your doctor and may prevent the progression of Cervical Spondylotic Myelopathy (CSM). Being informed and seeking medical advice when necessary are key steps in managing and potentially preventing CSM-related issues, ensuring a proactive approach to your spinal well-being.