Cervical spinal stenosis refers to a narrowing of the spinal canal. If the canal narrows significantly, it can become too small for the spinal cord and nerve roots. This can cause pressure and result in damage to the spinal cord, which may lead to pain, weakness, and sensory changes.

Cervical spinal stenosis is a spinal problem. It describes a type of spinal stenosis that occurs in the part of the spine present in the neck, known as the cervical spine. When the spinal canal narrows, it compresses the spinal cord and can lead to a variety of symptoms that affect movement.

Age, injury, poor posture, and certain conditions can all contribute to the development of cervical spinal stenosis.

In this article, we discuss cervical spinal stenosis, including the symptoms, treatments, and exercises that may help.

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Spinal stenosis describes when the gaps between spinal bones, known as vertebrae, decrease. This narrowing can lead to the compression of structures within the spinal canal, such as the spinal cord, nerve tissue, and cerebrospinal fluid. Spinal stenosis typically occurs in one of two areas: the lower back or the neck. Doctors will describe these as lumbar and cervical, respectively.

The cervical spine refers to the neck region of the spinal column. It consists of seven bones known as the C1–C7 vertebrae. The spinal canal is a tunnel that runs down the center of the spine. Within this canal is a collection of nerves that make up the spinal cord, which runs from the bottom of the neck all the way down to the bottom of the lower back.

At each vertebral level, a pair of spinal nerves exit through small openings known as foramina. These nerves are responsible for many functions, and a narrowing pressure around them can affect movement, the sensation of touch, and bladder and bowel function.

Although multiple factors can contribute to the onset of cervical spinal stenosis, it tends to be more common in people over the age of 50 years. This is generally due to how aging can affect the spine. Some possible causes of cervical spinal stenosis include:

  • Bone spurs: These are lumps of bone that grow on the spine or around joints. They can occur due to medical conditions, injuries, or aging.
  • Bulging or herniated disk: Disks are small pads that lie between vertebrae and act as cushions. Age or injury can cause these disks to crack or become misshapen. As a result, they begin to bulge out of place.
  • Osteoarthritis: The most common form of arthritis is a degenerative disease that involves the cartilage in joints breaking down and causing changes to the bones.
  • Injuries: Injuries such as a fracture or dislocation can change the shape of the spinal canal and put pressure on nerves.
  • Tumors: Narrowing of the spine can occur due to the development of tumors on the spinal cord or the bones of the spinal canal.
  • Paget’s disease: This chronic condition changes the way bones repair, resulting in them becoming misshapen.
  • Congenital stenosis: Some people do not develop a narrowing over time but are born with a narrow spinal canal.

Healthcare professionals may differentiate cervical spinal stenosis into two different types, depending on the site where the compression in the spine is happening. If narrowing occurs in the central canal, they may refer to it as cervical canal stenosis. When narrowing occurs in the small openings known as foramina, it is known as cervical foraminal stenosis.

Spinal stenosis can occur not only in the neck but also anywhere along the spine. Although the neck is a common place for stenosis, another commonly affected area is the lower back. This type is called lumbar spinal stenosis.

The symptoms of cervical spinal stenosis tend to develop gradually over time, and some people may have no symptoms at all. The symptoms can vary depending on the location of the compression and its severity, but they may include:

  • pain in the neck
  • pain or tingling that radiates down the arms into the hands
  • numbness in the arms and hands
  • weakness in the arms, hands, or fingers
  • trouble walking
  • balance problems
  • bowel dysfunction
  • sexual dysfunction

When diagnosing cervical spinal stenosis, a doctor will ask a person about their symptoms and perform a physical exam to assess any areas of pain, numbness, and weakness and to evaluate any balance issues. To get a better understanding of the extent and location of the possible stenosis, the doctor can perform the following imaging tests:

  • X-rays: This imaging only shows bone, but it can help identify the health of disks and joints and reveal injuries and other inherited conditions that may explain the spinal compression.
  • MRI scans: MRI can help diagnose issues with soft tissue around the spine, such as ligaments, disks, and the nerve roots.
  • CT scans: A CT scan can identify problems with the bones in the spinal canal and the surrounding tissue.

The treatment for cervical spinal stenosis can involve surgical and nonsurgical interventions. A doctor will usually suggest conservative treatment in the first instance. This will typically involve bed rest, reduction of strenuous activities, and physical therapy.

A doctor may also recommend taking medications that reduce pain and inflammation and muscle relaxants to encourage healing. For example, they may prescribe a corticosteroid injection. This involves a healthcare professional injecting a combination of corticosteroids and a local anesthetic into the spinal canal to reduce pain and inflammation.

In severe cases, a doctor may recommend surgery. Surgical treatment aims to help strengthen the spine and relieve pressure on the affected area. The type of surgery can vary, but it may involve:

  • widening the spinal canal
  • removing a bulging disk
  • removing parts of the vertebrae, potentially replacing them with metal plates to add support
  • fusing parts of the spine to make it more stable

Certain exercises can also help a person with cervical spinal stenosis build and maintain strength in their muscles to help with balance, movement, and pain. A physical therapist can help a person understand which exercises may work for them. With a doctor or physical therapist’s approval, some exercises that may help include:

  • Neck rotations: Keeping the chin level, turn the head to one side, hold for 15 seconds, and then do the same on the other side.
  • Neck stretches: Keeping the shoulders relaxed, slowly tilt the head straight over toward one shoulder, letting the weight of the head stretch the muscles. Repeat on the other side.
  • Shoulder rolls: Roll the shoulders up, back, and down in a circular motion, repeating this several times.
  • Chin tuck: Lie on the back with a small rolled-up towel under the curve in the neck. Tuck the chin down toward the chest and hold for 5 seconds before releasing it. Repeat this movement several times.
  • Wall posture: Stand up against a wall and try to have the head, shoulders, buttocks, and heels all touching the wall at the same time. Hold for 20 seconds.

A person should speak with a doctor or physical therapist about what exercise is right for them. Activities that might put pressure on the spine and worsen stenosis may include walking long distances, lifting heavy objects, or participating in contact sports.

In rare cases, a person may experience the following complications from surgery:

  • infection
  • chronic neck or arm pain
  • damage to the spinal cord, nerves, or nerve roots
  • unsatisfactory symptom relief
  • instrumentation failure or breakage
  • swallowing or speech disturbances

Cervical spinal stenosis refers to a narrowing of the spinal canal in the neck. Many factors can contribute to stenosis, which is more common in people over the age of 50 years.

The symptoms can range from mild discomfort to severe pain. The condition can affect a person’s movement and control of bodily functions.

The treatment options may include medications, physical therapy, and surgery. A doctor can advise on which treatment is most suitable.