Help from Dr. Paulette Hugulet, DC, LLC for Cervical Spine Myelopathy: From Diagnosis to Gentle Care
When everyday tasks feel more difficult to do — buttoning a shirt, holding a cup, walking steadily — your neck may be at the root of it. Together, these may be early warning signs of degenerative cervical myelopathy (DCM) [aka cervical spine myelopathy (CSM)] — a condition that's often missed until it becomes more difficult to treat.
WHAT IS CERVICAL MYELOPATHY?
DCM develops when the spinal cord in the neck is gradually squeezed by age-related changes — bone spurs, thickened ligaments, or degenerating discs. Unlike a simple pinched nerve, spinal cord involvement is more serious — and regrettably, it often remains unknown for months or even years.
WHY EARLY DIAGNOSIS IS SO IMPORTANT
A 2022 case report and literature review published in Cureus highlighted exactly this challenge. Trager and colleagues made the case that the chiropractic office is a natural first checkpoint for DCM — where red flags get recognized, neurological screening gets done, and referrals happen at the right time. (1) The takeaway? Your chiropractor at Dr. Paulette Hugulet, DC, LLC isn't just there for back pain — our La Grande chiropractic practice may be the first provider to find something more serious. Chiropractic physicians go through vast training in diagnosis, neurology, and musculoskeletal medicine — including orthopedic and neurological examination, imaging interpretation, and knowing when to manage, co-manage, or refer. The diagnostic process can start right in your chiropractor's office.
CONSERVATIVE CARE HAS A ROLE — WHEN APPROPRIATE
Not every cervical spine condition requires urgent surgery. A 2025 study in the North American Spine Society Journal found that physical therapy, chiropractic care, and acupuncture are all utilized in the management of cervical spine conditions, with a variety of patient and provider factors influencing which path is chosen. (2) For milder cases, conservative management may be a reasonable starting point — but only when the diagnosis is clear and the severity is correctly assessed.
One gentle option worth knowing about is Cox® Technic — a specialized, evidence-based chiropractic method that uses a segmented table and gently controlled, low-force flexion-distraction movements. For appropriate patients, it offers a way to address cervical spine symptoms without the forceful manipulation some people worry about. It's not right for every case, but in the hands of a trained chiropractor, it represents the kind of thoughtful, tailored care that can make conservative management a viable first step.
Medication is another conversation worth having carefully. A 2026 retrospective cohort study in the Journal of Clinical Neuroscience compared gabapentin to NSAIDs for cervical radiculopathy, stressing that treatment choices carry real safety and utilization implications. (3)
THE BOTTOM LINE, IN La Grande: CONTACT Dr. Paulette Hugulet, DC, LLC
Catching this early changes what's possible. It allows for informed conversations about whether conservative care, referral, or co-management is the right way to go — before the window for some options closes.
Listen to this PODCAST with Dr. James Cox on The Back Doctors Podcast with Dr. Michael Johnson as he shares two cases of cervical spine myelopathy and their management along guidelines for management and referral that coincide with The Cox® Technic System of Spinal Pain Management.
If you have neck-related neurological symptoms, don't push them aside. Get examined. Schedule your La Grande chiropractic appointment today.
