This group followed up 135 patients with CSM, of which some patients underwent surgery and some did not. They found that the blood pressure of patients undergoing surgery improved (lowered) after surgery, whereas those who did not, remained the same. You of course might say, well 'stress and pain' are a result of CSM, surely if they improve after surgery, my blood pressure will go down? Well the group measured pain, and found that the improvement of blood pressure did not relate to pain, but instead severity of CSM... This puts the cat amongst the pigeons. Why should CSM cause high blood pressure? That remains an unanswered question. This study did not measure stress, additionally some limitations in the study, particularly the number of patients, may have hidden a relationship with pain. However there is some theory to the idea that CSM could affect your blood pressure. Control of blood pressure is naturally dependent on many things. Partly it relies on some very small nerve fibres called your 'Sympathetic Nervous System'. Although this nervous system is separate to your spinal cord, there is some communication which could be potentially disrupted in CSM. If we look at patients who have a traumatic spinal cord injury, their blood pressure is often unstable as a result. So there could be something more to this than simply pain or stress! We will have to watch this space! But be prepared to reduce your blood pressure medication after surgery if that is applicable. References1. Yang L et al. Cervical decompression surgery for cervical spondylotic myelopathy and concomitant hypertension: a multicenter prospective cohort study. Spine Oct 2016
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