A question mark formed by a spine, symbolizing questions about spinal health.

Is It Just Age or Something More? A Simple Quiz to Check Your Cervical Spine Health

Theo Raines in Health & Wellness August 2025 • 4 min read.

"Could your neck pain and clumsiness be signs of cervical spondylotic myelopathy (CSM)? Learn about a new screening tool."

As we navigate the journey of life, aches and pains become familiar companions. However, it's crucial to distinguish between typical aging and potential underlying health issues. One such concern is Cervical Spondylotic Myelopathy (CSM), a condition affecting the spinal cord in the neck. While it's more common in adults over 55, knowing the signs can lead to earlier diagnosis and better outcomes.

CSM occurs when the spinal cord in the neck becomes compressed due to degenerative changes. These changes can include disc herniation, bone spurs, and thickening of ligaments. Because the onset of CSM is usually insidious, diagnosing CSM can be challenging, often requiring referral to a subspecialist and advanced imaging.

Now, researchers have developed a simple, four-question screening tool, called the DOWN questionnaire, to help identify individuals who might be at risk for CSM. This questionnaire focuses on common symptoms associated with the condition and can be a first step in determining whether further evaluation is needed.

The DOWN Questionnaire: Four Questions That Could Change Your Life

A question mark formed by a spine, symbolizing questions about spinal health.

The DOWN questionnaire is designed to be a quick and easy way to assess your risk of CSM. It consists of four simple questions about common symptoms associated with the condition. If you answer “yes” to three or more of these questions, it's recommended to consult with a healthcare professional for further evaluation. Remember, this questionnaire is not a substitute for a professional medical diagnosis, but it can be a helpful tool for early detection.

The DOWN questionnaire focuses on symptoms commonly experienced by those with CSM. These symptoms can sometimes be subtle and easy to dismiss as normal signs of aging, but recognizing them is the first step toward getting the care you need. The questionnaire is named with the acronym DOWN, each letter represents a question:

Dropping things or feeling clumsy in your hands?
Off-balance or unsteady on your feet more often?
Feeling Weakness in one or both of your arms or hands?
Experiencing Numbness or tingling in your arms or hands?

It’s important to note that these symptoms can also be caused by other conditions. However, if you're experiencing these issues, especially if they're new or worsening, it's worth discussing them with your doctor. Early diagnosis and intervention can significantly improve outcomes for individuals with CSM.

Take Charge of Your Spinal Health

Don't let neck pain, clumsiness, or balance issues hold you back. By being proactive and informed, you can take charge of your spinal health and enjoy a more active and fulfilling life. If you're concerned about CSM, talk to your doctor and ask if the DOWN questionnaire is right for you. Early detection and intervention are key to managing this condition and improving your long-term well-being.

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.

This article is based on research published under:

DOI-LINK: 10.1177/2192568218815863, Alternate LINK

Title: The Down Questionnaire: A Novel Screening Tool For Cervical Spondylotic Myelopathy

Subject: Neurology (clinical)

Journal: Global Spine Journal

Publisher: SAGE Publications

Authors: Kaku Barkoh, Ifije E. Ohiorhenuan, Larry Lee, Joshua Lucas, Anush Arakelyan, Christopher Ornelas, Zorica Buser, Patrick Hsieh, Frank Acosta, John Liu, Jeffrey C. Wang, Raymond Hah

Published: 2018-12-04

Everything You Need To Know

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

Cervical Spondylotic Myelopathy, or CSM, is a condition where the spinal cord in the neck becomes compressed due to degenerative changes like disc herniation, bone spurs, or thickening ligaments. Early detection of CSM is crucial because the onset is usually gradual and subtle. The sooner CSM is diagnosed, the earlier interventions can begin, potentially leading to better long-term outcomes and management of the condition's progression. Recognizing the signs and symptoms is the first step toward getting the necessary care.

What is the DOWN questionnaire, and how does it help in identifying Cervical Spondylotic Myelopathy (CSM)?

The DOWN questionnaire is a four-question screening tool designed to help identify individuals who may be at risk for Cervical Spondylotic Myelopathy, or CSM. It consists of questions related to common symptoms associated with CSM. The acronym DOWN represents the four questions: Dropping things or feeling clumsy, Off-balance or unsteady, Weakness in arms or hands, and Numbness or tingling in arms or hands. Answering 'yes' to three or more questions suggests consulting with a healthcare professional for further evaluation to determine if further investigation for CSM is needed.

The DOWN questionnaire asks about dropping things, unsteadiness, weakness, and numbness. Could these symptoms indicate conditions other than Cervical Spondylotic Myelopathy (CSM)?

Yes, the symptoms included in the DOWN questionnaire, such as dropping things, feeling unsteady, experiencing weakness, and numbness, can indeed be caused by conditions other than Cervical Spondylotic Myelopathy (CSM). For example, peripheral neuropathy, multiple sclerosis, or even vitamin deficiencies can present similar symptoms. Therefore, the DOWN questionnaire serves as an initial screening tool, and a comprehensive medical evaluation is necessary to reach an accurate diagnosis. If these symptoms are new or worsening, consulting a doctor is crucial to explore all potential causes.

How can I proactively manage my spinal health and determine if the DOWN questionnaire is appropriate for me?

To proactively manage your spinal health, pay attention to any new or worsening symptoms such as neck pain, clumsiness, balance issues, or numbness and tingling in your arms or hands. If you are concerned about Cervical Spondylotic Myelopathy, or CSM, discuss these symptoms with your doctor. Specifically, ask your doctor if the DOWN questionnaire is a suitable screening tool for you, considering your symptoms and medical history. Early detection and intervention are vital for managing CSM and improving your overall well-being.

If I am over 55 and experiencing some clumsiness, is it likely to be Cervical Spondylotic Myelopathy (CSM)?

While Cervical Spondylotic Myelopathy, or CSM, is more common in individuals over 55, experiencing clumsiness alone does not automatically indicate CSM. Clumsiness can result from various age-related changes or other underlying conditions. However, given that CSM is a possibility, especially with other symptoms such as neck pain, balance issues, weakness, or numbness, it is advisable to discuss your symptoms with a healthcare professional. They can assess your specific situation, conduct appropriate examinations, and determine if further evaluation, including the DOWN questionnaire or advanced imaging, is necessary to rule out or diagnose CSM.