Neck Pain and Other Signs and Symptoms of Spinal Stenosis

Spinal stenosis occurs in two areas: the lumbar section, which includes the lower vertebrae of the back, and cervical vertebrae located in the neck. It is very rare for spinal stenosis to occur in the center section of the spine or thoracic vertebrae. This article focuses on spinal stenosis in the neck.

Cervical Spinal Stenosis

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 split off from the spinal cord. Squeezing the nerves and cord can change how the spinal cord functions, which can cause you pain; stiffness; numbness; or weakness in the neck, arms, and legs.

Causes of Cervical Spinal Stenosis

Cervical spinal stenosis is a condition that’s mostly attributed to age. By age 50, problems that lead to stenosis may develop in one’s spinal canal. One such condition, known as bulging discs, occurs when the spongy tissue between your vertebrae extends into the spinal canal. As you age, tissues within the spinal canal, including the bones themselves, can deteriorate or change shape and apply pressure on surrounding nerves. 

Symptoms of Cervical Spinal Stenosis

While changes to the spine and its related tissues are common over age 50, most people in this age group won’t experience symptoms of cervical spinal stenosis. Symptoms only occur when the spinal cord or its nerves are compressed. This is a slow process, and symptoms of cervical spinal stenosis can appear over time. These include:

  • Stiffness, numbness, or weakness in the neck, shoulders, arms, hands, or legs
  • Balance and coordination issues, as if you might fall every time you walk  

How Is Cervical Spinal Stenosis Diagnosed?

A cervical spinal stenosis diagnosis relies heavily on the way you report your symptoms to your physician. The physician will ask you to describe the location and type of problems you are experiencing. If your neck problem causes pain, numbness, or weakness, a doctor will ask about its severity. They also will want to know how it affects your quality of life. 

If the physician believes you have cervical spinal stenosis, they will order imaging tests. These may include X-Rays, MRIs, or CTs. These tests will help determine if there is a narrowing of the spinal canal in the neck area. Your physician will use these results to determine your treatment recommendations. They may also run blood tests and other laboratory testing to eliminate other conditions that may be causing your pain.

How Is Cervical Spinal Stenosis Treated?

For mild to moderately painful cervical spinal stenosis cases, the physician may choose to treat with any of the following types of medications:

  1. Pain relievers for short time discomfort relief
  2. Antidepressants for chronic pain and sleep aid
  3. Anti-seizure meds for relief of nerve pain
  4. Opioids for short time use when the pain gets worse

Some mild exercise and physical therapy can help with strength and flexibility. Steroid injections may be given to help relieve the nerve pain when the medications are no longer effective. However, they do not work for some patients and can be dangerous to the surrounding bones and tissues.

If your symptoms are severe, decompression surgery may become necessary. Decompression extracts some of the bone, discs, and/or other tissues that may be applying pressure on spinal nerves roots. Without surgical treatment, cervical spinal stenosis may lead to severe complications for the nervous system. This includes problems with bowel or bladder control, as well as permanent loss of strength and sensation in the arms, legs, hands, or other areas of the body. 

Our Medical and Scientific Board has expertise on all of these issues. Check out the team here and be sure to browse through Spine-Talks videos to find more information on this issue and many others.