Cervical Spinal Stenosis Causes, Symptoms & Treatment

Overview

Cervical spinal stenosis, also called neck stenosis, happens when the space inside the spinal canal in the neck becomes too narrow. This can put pressure on the nerves or on the spinal cord itself.

If the nerves are pinched, cervical radiculopathy occurs. It usually causes neck, shoulder, or arm pain, numbness, tingling, or weakness in one arm or hand.

If the narrowing presses on the spinal cord, it’s called cervical myelopathy. This can lead to balance problems, leg stiffness or weakness, and hand clumsiness.

Cervical spinal stenosis most commonly affects people over 50. While degenerative changes are the primary cause, younger individuals may develop the condition due to trauma, congenital spinal deformities such as scoliosis, or genetic disorders that affect bone and muscle development.

What causes Cervical Spinal Stenosis?

Cervical spinal stenosis can develop for several reasons, including:

• Arthritis (Most Commonly Osteoarthritis): Degeneration of joints in the spine leads to inflammation and bone thickening that narrows the spinal canal.
• Wear and Tear from Aging: Over time, natural changes in the spine, such as disc drying and joint stiffness, reduce the space around the spinal cord.
• Bone Spurs (Osteophytes): Extra bone growth forms as the spine tries to repair itself, which can press on the spinal cord or nerves.
• Injury or Trauma to the Cervical Spine: Sudden impact or repeated stress can damage spinal structures, leading to narrowing and nerve compression.

How the Injury Occurs: The condition often develops gradually due to age-related degeneration. Repeated pressure, poor posture, or high-impact movements can accelerate wear on the cervical spine, leading to narrowing and compression.

Common Everyday Causes: Cervical spinal stenosis can affect people who spend long hours working at a desk, frequently look down at their phones, or perform repetitive neck movements, such as mechanics, computer professionals, or musicians who maintain fixed head positions.

Long-term participation in high-impact or contact sports also increases the risk of cervical spine compression and injury:

• Football: Frequent tackles and head collisions can cause repetitive trauma to the neck, leading to disc or ligament damage.
• Ice Hockey: Sudden falls or hits against the boards can strain neck muscles and, over time, cause spinal cord compression.
• Rugby: Continuous scrums, tackles, and physical contact place significant pressure on the cervical spine, heightening the risk of stenosis.
• Wrestling: Repeated neck holds, slams, and joint strain can injure the cervical discs and joints, reducing spinal space.

Symptoms

Cervical spinal stenosis affects people in different ways. Some may not experience any noticeable symptoms, while others develop gradual signs that worsen over time as the spinal canal narrows.

Early symptoms often include:

• Neck stiffness, pain, or tingling: Discomfort or tightness in the neck that may spread to the shoulders.
• Numbness, tingling, or weakness: These sensations may appear in the arms, hands, legs, feet, or fingers, depending on which nerves are affected.

At first, these symptoms may be mild and occasional. However, as the condition progresses and pressure on the spinal cord increases(Cervical Myelopathy), more serious issues can develop, such as:

• Difficulty with balance and coordination: Feeling unsteady when walking or performing daily activities.
• Trouble walking: Stiffness or weakness in the legs can make movement more difficult.
• Loss of bladder or bowel control: In advanced cases, nerve compression can impair the body’s ability to regulate these functions.

Recognizing these symptoms early and seeking medical advice can help prevent further spinal cord damage and improve long-term outcomes.

Non-operative treatment

Cervical spinal stenosis in the neck that causes mild or moderate  symptoms is often treated with conservative, non-operative methods, including:

• Wearing a neck collar: Provides support and allows the neck to heal.
• Non-steroidal anti-inflammatory drugs (NSAIDs): Medications like ibuprofen and naproxen help relieve pain.
• Physical therapy: People with spinal stenosis may lower their activity levels to reduce pain, but this can lead to muscle weakness and further discomfort. A physical therapist can teach exercises that:
  • Build strength and endurance
  • Maintain the flexibility and stability of the spine
  • Improve balance

Alternative treatments may also help manage spinal stenosis pain, including:

• Massage therapy
• Chiropractic treatment
• Acupuncture

Try these exercises to help address your condition:

Below is a PDF of the Exercise Program

Cervical Stenosis

Surgical Treatment

If symptoms do not improve with conservative treatments or continue to worsen, your doctor may recommend surgical intervention. Surgery for cervical spinal stenosis usually has two main goals:

1. Decompression – to make more space for the spinal cord and nerves

2. Stabilization – to keep the spine strong and properly aligned after decompression

Examples of surgical procedures to treat cervical spinal stenosis include:

Laminectomy (Decompression Surgery)

In this procedure, the lamina, the back part of the vertebra, is removed to create more space in the spinal canal. It’s often used for moderate to severe stenosis that presses on the spinal cord. If removing bone makes the spine unstable, the surgeon may perform a spinal fusion at the same time.

Laminotomy

Only a small portion of the lamina is removed to relieve pressure on a specific nerve root, usually on one side. This is typically done when symptoms affect only one arm or side of the body.

Laminoplasty

Used mainly in the neck (cervical spine), this procedure hinges open one side of the lamina, like opening a door, and holds it open with a small metal plate or spacer. This widens the spinal canal and relieves pressure on the spinal cord while keeping most of the bone in place.

Spinal Fusion

Spinal fusion stabilizes the spine when it becomes or could become unstable after decompression surgery. The surgeon places bone grafts (sometimes with metal plates, rods, or screws) between two or more vertebrae so they heal together as one solid bone.