What is cervical spinal stenosis?

Cervical spinal stenosis is the narrowing of the spinal canal in the neck.

The spinal canal is the open area in the bones (vertebrae) that make up the spinal column. The spinal cord is a collection of nerves that runs through the spinal canal from the base of the brain to the lower back. These nerves allow us to feel, to move, and to control the bowel and bladder and other body functions.

The seven vertebrae between the head and the chest make up the cervical spine. In cervical spinal stenosis, the spinal canal narrows and can squeeze and compress the nerve roots where they leave the spinal cord, or it may compress or damage the spinal cord itself.

Squeezing the nerves and cord in the cervical spine can change how the spinal cord functions and cause pain, stiffness, numbness, or weakness in the neck, arms, and legs. It can also affect your control of your bowels and bladder.

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).

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.

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.

• 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.