If “pain in the neck” is a reality for you and not just a familiar saying, you could have a condition called cervical spinal stenosis.
Cervical spinal stenosis is a type of spinal stenosis, a condition that occurs when your spinal canal narrows. The narrowing can put pressure on the spinal cord, which can lead to myelopathy, which is damage to the spinal cord.
Spinal stenosis can typically occur in one of two areas: your lower back or your neck. In some cases, this condition can affect both areas.
Spinal stenosis that develops in the lower back causes a condition called lumbar stenosis, which is the most common kind of spinal stenosis.
Spinal stenosis that occurs in the part of the spine that’s in your neck is called cervical spinal stenosis. A number of factors can contribute to the development of cervical stenosis, including:
- Rheumatoid arthritis
- Diffuse idiopathic skeletal hyperostosis (DISH)
- Cartilage loss
- Slipped or herniated discs
- Thickened ligaments
- Spinal injuries
- Tumors on or near the spine
Tandem spinal stenosis
Some people develop a version of spinal stenosis known as tandem spinal stenosis, in which the narrowing of the spinal canal happens in two separate areas, usually the cervical and lumbar regions. It’s often overlooked, but some research suggests that it occurs in as many as 60 percent of people with spinal stenosis.
This is why it’s often recommended that those with cervical stenosis also get lumbar imaging done to rule out this tandem condition.
Common symptoms of cervical spinal stenosis include:
- Neck pain
- Pain in one or both arms
- A feeling of electrical charge or tingling sensation that shoots down the back when you move your head
- Numbness in your arms or hands
You may also experience some weakness in your legs or feet, which can create some problems with walking and balance.
If you also experience lumbar stenosis, you might develop symptoms such as:
- Numbness, weakness, or tingling in the legs
- Numbness or loss of sensation in the feet
- Cramping in your legs when you’re on your feet for extended periods
- Loss of bowel or bladder function
You may suspect that you have cervical spinal stenosis from your symptoms, but a doctor will probably want to collect several types of information and conduct several tests before making a diagnosis:
- Complete medical history. Make sure to discuss any major illnesses or injuries you may have had in the past. You may also want to talk with your family members to see if a history of these symptoms may run in your family.
- Physical examination. A doctor may test your range of mobility and when you feel pain, as well as your overall health.
- Complete neurological exam. This will test your gait, balance, motor strength, sensation, proprioception, reflexes, and more.
- Description of your symptoms. Discuss your symptoms, such as pain and tingling or numbness in your extremities. It can be helpful to keep a journal of your symptoms to help the doctor get a full understanding of how this is affecting your life.
- Imaging tests. Tests could include MRI, an X-ray, or a CT scan of your cervical spine or related areas.
- Electromyography (EMG). An EMG test may also be needed. This test measures your muscle response and nerve conduction to determine whether the compression is happening in the spine or within an extremity.
The severity of your stenosis, as well as your symptoms, will determine the type of treatment that a doctor suggests. Your treatment plan will likely include a variety of approaches, both at home and with a physical therapist. In some cases, surgery may be needed, but it’s not usually the first option.
A doctor may recommend:
- Medications. If your symptoms are mild, a doctor might suggest some over-the-counter pain relievers, such as acetaminophen or ibuprofen.
- Physical therapy. This can help relieve pain and inflammation, as well as improve the range of motion in your neck.
- Epidurals. Some people with neck or back pain receive temporary benefits from cervical epidural steroid injections.
Surgery options for cervical spinal stenosis
In more severe cases, a doctor might suggest surgery to create some extra space in your spinal canal to lessen the pressure and the pain. If you’re a candidate for surgery, a doctor may talk with you about one of these surgical procedures:
- Anterior cervical discectomy and fusion. During this surgery, the surgeon makes a small incision in the front of your neck in order to remove the ruptured or herniated disc and replace it with a small piece of bone.
- Cervical laminoplasty. Your surgeon will create more room in your spinal canal by creating a hinge on one side of a piece of bone called the lamina, which covers the spinal column, and inserting a small plate or piece of bone on the other. The goal is to prop up the lamina.
- Posterior laminectomy and fusion. During this procedure, the surgeon goes in through the back of your neck and removes the lamina, which should reduce the compression on the spine.
- Disc replacement. This procedure was developed to help preserve your range of motion following other decompression procedures or surgeries. It is known to have a high success rate.
A doctor or physical therapist will likely give you a more in-depth regime of stretching and exercises that you’ll want to follow, but we’ve also rounded up some common recommendations. Each of these exercises is geared toward increasing flexibility and strength in the spine. You could try any or all of these exercises at home to see if they help relieve pain or stiffness in your neck.
Each exercise can be repeated about 10 times each day. However, if they cause you more pain, stop doing them and let a doctor know.
Start in a standing or seated position while looking straight ahead.
Tilt your head down until your chin just about reaches your chest. Hold for 5 seconds, and then gently raise your head until you’re looking straight ahead.
Tilt your head slowly to one side until your ear almost touches your shoulder. Hold the position for 5 seconds, and then return to your original position.
Turn your head to one side and try to get your chin parallel with your shoulder, but don’t strain yourself. Hold for 5 seconds, and then return to a frontward-facing position.
Put two fingers on your chin and then “push” your chin inward toward your spine, so that your head and neck retract. Hold for 5 seconds, and then return to your original position.
Median nerve slider
Lift one palm up and keep your elbow bent. Put your opposite hand on that shoulder. Gently straighten your bent arm outward while tilting your head in the opposite direction so that your ear approaches your shoulder.
Gently roll your shoulders back in a shrug, and then continue downward and back into your original position.
Some experts will caution you to avoid or limit certain activities if you have cervical spinal stenosis. A doctor might suggest avoiding exercises that put too much stress on your neck. For some people, that might mean forsaking contact sports.
One thing that you can easily avoid doing is slouching. Poor posture can aggravate cervical spinal stenosis symptoms. So, if you spend a lot of time sitting in front of a computer, you might want to check your posture. If you notice that you tend to slump, consider strategies such as getting an ergonomic chair or taking frequent breaks to stand up.
Is cervical spinal stenosis considered a disability?
The Social Security Administration has determined that spinal stenosis is a disability in the United States. If you have severe spinal stenosis and can’t work, you may be able to qualify for disability benefits.
You may have to provide documented proof of your medical situation and your needs. When you apply for disability, your caseworker will let you know what documentation is needed for your case.
Most people with cervical spinal stenosis have mild cases or symptoms and don’t have to adjust their lives much to accommodate the condition. In fact, many people find that their pain doesn’t necessarily get progressively worse over time, and they can manage their pain and symptoms.
However, for some people, the condition goes get worse as time goes by. They may develop more serious symptoms, such as loss of bowel or bladder function and trouble walking. This is more likely to happen to people who have cervical stenosis with myelopathy.
However, even in those situations, there are treatment options available, so talk with a doctor so you can monitor your symptoms and adjust your treatment accordingly.
Having a “normal life” will mean different things to different people, but you can definitely live a very full life with cervical spinal stenosis. If you have a mild case, exercises and nonsurgical treatments may be enough to keep cervical spinal stenosis from impacting your usual routines and activities.
If your case progresses and gets worse, it may have a more serious impact on your quality of life. You may need to consider surgery to stop the progression and reduce the pain caused by the compression of your spinal cord and nerve roots. While surgery may not be an option for everyone, most people do very well after a cervical spinal stenosis surgery.
If it’s difficult to manage your symptoms, you might seek out help from others who have the same condition for support and camaraderie — and possibly even useful information about coping strategies and treatment options. You can also ask a doctor or physical therapist if they know of any local support groups.
Cervical spinal stenosis is a sometimes progressive condition in which inflammation in the spine can put pressure on and ultimately damage the delicate nerves that run through it. This can cause mild to severe pain, numbness, and occasionally balance problems.
Don’t ignore any pain in your neck or back. There are treatments for conditions such as cervical spinal stenosis that can help you feel much better. Seeing a doctor can also help you understand exactly what you’re coping with and help get you the treatment you need.