What is cervical spinal stenosis?

Spinal stenosis is a narrowing of the canal that surrounds the spinal cord and nerve roots. Sometimes bone and other tissue grow into this canal and press on the nerves that branch out from the spinal cord. This can happen as a part of aging.

When the narrowing happens in your neck, it's called cervical spinal stenosis. It often causes stiffness, pain, numbness, and weakness in the neck, shoulders, arms, hands, or legs. It can even cause problems with your balance, coordination, and bowel or bladder control. But some people have no symptoms.

You may be able to get relief from the symptoms of spinal stenosis by taking medicine. Your doctor may suggest physical therapy and exercises to keep your spine strong and flexible. Some people try steroid shots to reduce swelling. If pain and numbness in your neck, arms, or legs are still so bad that you cannot do your normal activities, you may need surgery.

Many people older than age 50 have some narrowing of the spinal canal but do not have symptoms. Cervical spinal stenosis does not cause symptoms unless the spinal cord or nerves becomes squeezed. Symptoms usually develop gradually over a long period of time and may include:

• Stiffness, pain, numbness, or weakness in the neck, shoulders, arms, hands, or legs.
• Balance and coordination problems, such as shuffling or tripping while walking. Cervical spinal stenosis can be crippling if the spinal cord is damaged.
• Loss of bowel or bladder control (incontinence).

In mild cases of spinal stenosis, symptoms can usually be controlled with medicine to relieve pain, exercise to maintain strength and flexibility, and physical therapy. If your symptoms are severe, you have progressive weakness of your muscles, or the pictures of your spine show that your spinal cord or nerves are being tightly squeezed, your doctor is likely to recommend decompressive surgery to relieve the pressure. This surgery may be done from the front or the back of the neck. It involves removing some of the disc, bone, and/or tissue that may be pressing on the nerve roots. Vertebrae are often joined together surgically (fused) to provide stability to the spine.

A diagnosis of cervical spinal stenosis usually is based on your history of symptoms and a physical exam. Your doctor will ask you if neck movements cause pain, numbness, or weakness. If cervical spinal stenosis is suspected, your doctor will recommend imaging tests of your neck and back to confirm the diagnosis and to see what is causing the narrowing of the spinal canal. Imaging tests that may be used include X-rays, magnetic resonance imaging (MRI), and computed tomography (CT) scans. Your doctor will use the results of tests, including imaging and blood tests, to eliminate other diseases—such as multiple sclerosis (MS) and vitamin B12 deficiency—as the cause of your symptoms.

• Ask your doctor if you can take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Be safe with medicines. Read and follow all instructions on the label.
• Do not take two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
• Change positions often when you are standing or sitting. This may reduce pressure on the spinal cord and its nerves.
• When you rest, use pillows or towel rolls to support your neck and head in a comfortable position.
• Follow your doctor's instructions about activity. The doctor may tell you not to do sports or activities that could injure your neck.
• Stretch your neck and shoulders as your doctor or physical therapist recommends. If your doctor says it is okay to do them, these exercises may help:
  • Neck stretches to the side. Keep your shoulders relaxed and slowly tilt your head straight over toward one shoulder. Hold for 15 seconds. Let the weight of your head stretch your muscles. Then do the same toward the other shoulder.
  • Neck rotations. Keep your chin level and slowly turn your head to one side. Hold for 15 seconds. Then do the same to the other side.
  • Shoulder rolls. Roll your shoulders up, then back, and then down in a smooth, circular motion. Repeat several times.

Cervical spinal stenosis is usually caused by age-related changes in the shape and size of the spinal canal and so is most common in people older than age 50. The aging process can cause a "bulging of the discs"—the spongy discs between the bones of the spine bulge out farther than normal—or a thickening of tissues that connect bones (ligaments). Aging can also lead to destruction of tissues that cover bones (cartilage) and excessive growth of the bones in joints. These conditions can narrow the spinal canal (spinal stenosis).

In rare cases, the spinal canal is narrowed from birth because of the way the bones are formed.

Cervical spinal stenosis is a narrowing of the spinal canal in the neck. When the spinal canal narrows, it can squeeze the nerves and spinal cord in the cervical spine. This can cause pain, stiffness, numbness, or weakness in the neck, arms, and legs. It can also affect control of the bowels and bladder.