Cervical Spinal Stenosis Causes, Symptoms & Treatment

Cervical spinal stenosis in the neck is a common problem characterized by a narrowing of the space surrounding the spinal cord, called the spinal canal. Inflammation or compression from one of the spine’s structures can decrease space in the spinal canal, placing pressure on the spinal cord. Pressure on the spinal cord can cause symptoms in different body parts, particularly the arms and legs. Cervical spinal stenosis can lead to injury of the spinal cord in the neck region, which is called cervical myelopathy.

Most people with spinal stenosis are over the age of 50. Though degenerative changes can cause spinal stenosis in younger people, other causes need to be considered, such as trauma, congenital spinal deformity such as scoliosis, or a genetic disease affecting bone and muscle development throughout the body.

Cervical spinal stenosis can occur due to:

• Herniated vertebral disc
• Arthritis, most commonly osteoarthritis
• Wear and tear from getting older
• Bone spurs
• Injury or trauma to the cervical spine

Cervical spinal stenosis can also occur as a consequence of long-term participation in these sports:

• Football
• Ice Hockey
• Rugby
• Wrestling

Some people with cervical spinal stenosis in the neck may not experience any symptoms. If you do have symptoms, they may include:

• Stiffness, pain, and/or tingling of the neck
• Numbness, tingling, and/or weakness in the arm, hand, leg, foot, or fingers

Symptoms of spinal stenosis tend to start mild and progressively worsen. More severe symptoms of cervical spinal stenosis may include:

• Difficulty with balance and coordination
• Difficulty walking
• Loss of bladder and/or bowel control

If you are experiencing symptoms of cervical spinal stenosis or have persistent neck pain, make an appointment with an orthopedic specialist. During your appointment, your doctor will ask if you’ve experienced a traumatic injury to the neck or if you’ve been diagnosed with an inflammatory disorder like arthritis.

Your doctor will perform a physical examination of the neck to check for tenderness and neurologic symptoms, like weakness in the arms or hands. Your doctor may perform the Spurling’s test — your doctor will move the neck and place minimal pressure on the head — to assess nerve root pain.

To make a diagnosis, your doctor may prescribe the following imaging tests:

• X-rays
• MRI

Cervical spinal stenosis in the neck that causes mild to no symptoms is treated using conservative, non-operative treatment methods, including:

• Wearing a collar to support the neck and allow it to heal
• Non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen and naproxen, for pain relief
• Epidural steroid injections to reduce inflammation and relieve pain
• If arthritis is the cause of cervical spinal stenosis, your doctor will focus on treating the arthritis
• Physical therapy: It’s common for people who have spinal stenosis to lower their activity levels in an effort to reduce pain. Lower activity can actually lead to muscle weakness, which can result in more pain. A physical therapist can teach you exercises that may help:
• Build up your strength and endurance
• Maintain the flexibility and stability of your spine
• Improve your balance
• Alternative treatments are also an option to help you cope with spinal stenosis pain. Some examples of alternative treatments include:
• Massage therapy
• Chiropractic treatment
• Acupuncture

Try these exercises to help address your condition:

Below is a PDF of the Exercise Program

Cervical Stenosis

If symptoms do not subside with conservative treatments, or if symptoms continue to get worse, your doctor will recommend surgical intervention. Examples of surgical procedures to treat spinal stenosis include:

• Laminectomy: Also referred to as decompression surgery. During a laminectomy, the lamina (the back portion of the vertebral bone) is removed to create more space in the spinal canal.
• Laminotomy: A portion of the lamina is removed. Typically, a hole is carved in the lamina just big enough to relieve pressure on the spinal canal.
• Laminoplasty: A portion of the lamina is removed and fixed in an open position using a metal bridge to widen the spinal canal.
• Minimally invasive surgery: This approach to surgery removes bone or lamina in a way that minimizes the damage to nearby healthy tissue and decreases the need for a spinal fusion.

The time it takes to find relief from symptoms of cervical spinal stenosis depends on the root cause of the condition and the treatment required. There is no cure for spinal stenosis, and treatment involves managing symptoms. Patients who respond to conservative treatment methods may find relief in just a few weeks.

Complete recovery from cervical decompression and fusion surgery could take three to six months. Patients will be required to stay in the hospital for two to four nights following the procedure. Your doctor will want you to schedule a follow-up appointment two weeks after the procedure to check on the healing progress. It’s important to follow all post-operative instructions as outlined by your doctor to ensure proper healing. Your doctor will let you know when you can start doing light activities such as walking, and when you can begin physical therapy to strengthen the muscles surrounding the spine.