Cervical spine refers to your neck, a frequent area for pain and soreness. Cervical spine conditions may result from overuse injuries, trauma and certain diseases. Cervical stenosis refers to narrowing of the spinal canal that protects the spinal cord and its branching nerves. Cervical stenosis has a gradual onset so you may not realize there is a problem until the condition has developed enough to cause your neck pain. Stenosis causes neck pain that will radiate to your arms and hands, causing numbness and weakness. Cervical stenosis can also cause cervical myelopathy and cervical radiculopathy. Abnormal pressure may be placed on your spinal cord, which causes damage and can result in spinal cord dysfunction. Your neck doctor will refer to this as cervical stenosis with myelopathy.

CAUSES

Patients are more likely to develop spinal stenosis after turning 50 as a consequence of aging and spinal wear and tear. You may develop cervical stenosis naturally or have a history of back injury or trauma. Your spinal canal will narrow as a result of any of these conditions:

  • Thickening of Spinal Ligaments – Ligaments hold the joints of your spine in place as you move. After injury, stress, or even calcium deficiency, your ligaments may thicken, taking up space in the spinal canal.
  • Osteophytes (bony overgrowths) – Inevitable wear and tear on the spine can cause bone spurs to form on vertebrae.
  • Bulging or herniated discs – Soft discs lie between vertebrae of your spine, cushioning them so you can move smoothly. Damage to these discs may cause them to inflame, expanding in the spinal canal.
  • Degenerative disc disease – Degenerative disc disease will also cause inflammation as vertebrae begin to grind together and put pressure on the nerves of the spinal canal.
  • Trauma – Sports injuries or accidents can cause dislocations or fractures of the spine. Displaced bone and swelling can cause damage to the nerves or spinal cord itself.
  • Tumors – Overdeveloped tumors can put pressure on surrounding nerves.

SYMPTOMS

Symptoms may not begin until well after cervical stenosis has developed. However, your symptoms may then begin to worsen over time. The most common symptom of cervical stenosis is dull to intense neck pain. Other symptoms include:

  • Problems with gait and balance
  • Clumsy hand coordination
  • Upper extremity pain and weakness
  • Numbness, tingling, pins and needles sensation
  • Rarely, loss of function (paraplegia)

DIAGNOSIS

Your neck doctor will diagnosis cervical stenosis through one or multiple tests, as well as determine if your condition is accompanied by myelopathy or radiculopathy. MRIs are the best imaging technique to determine cervical stenosis. It can detect damage to spinal discs and ligaments, tumors, and pressure on the spinal canal.

TREATMENT

CONSERVATIVE

Your neck doctor will recommend appropriate conservative methods to first treat cervical stenosis.

  • Physical Therapy -Your physical therapy session will begin with modalities, usually ice, to reduce inflammation and ease pain. Your physical therapist will begin treating cervical stenosis by manual massaging your neck, breaking down and stretching thick ligaments and strained tissues. You will be guided through stretches to increase the flexibility of your neck and regain its mobility. A few weeks into your routine, your therapist will guide you through exercises to strengthen your cervical muscles to better withstand strain and prevent further injury.
  • Cervical Injections – Chronically irritated nerves in the spinal cord may benefit from a corticosteroid injection. Corticosteroids will provide long term relief for inflammation, usually up to six months. Your pain management and rehabilitation doctor can discuss injection treatment along with a physical therapy regimen.

SURGICAL

Your neck doctor will recommend surgery only if your cervical stenosis is causing myelopathy, is debilitating, and is not responding to conservative treatments.

A number of different procedures will relieve pressure on the spinal canal depending on the cause of impingement. Often bone spurs, damaged ligament or bone, or damaged discs will be removed if they are the cause of inflammation and pressure on nerve roots.

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