The spinal canal is a circular opening that transcends the length of the spine and contains the spinal cord and existing nerve roots. The term spinal stenosis refers to the narrowing of this canal and/or the space a nerve root exits the spine. Stenosis can occur along any portion of the spine. Cervical spinal stenosis is a narrowing of spinal canal specifically in the neck region. This narrowing can be caused by physiological changes such as enlargement in the joints or soft tissues such as the disc. Significant narrowing can result in compression of the nerve roots and/or the spinal cord and affect the function of the nervous system. This may cause variety of symptoms including pain and tingling into the upper extremities and/or all four limbs.
What Causes Cervical Stenosis?
Some of the most common causes of cervical stenosis include:
- Postural or Spinal Dysfunction: repetitive prolonged positions can lead to stiffness in certain areas of the spine. This creates areas in the spine that do not move well and areas that compensate by moving too much. This can contribute to stenosis and eventually lead to arthritis.
- Arthritis: Everyone experiences some degeneration with age. Arthritic changes in the spine can result in bone spurs (outgrowth of bone), disc bulges, swollen ligaments, and enlarged joints of the spine, which can all cause spinal stenosis.
- Herniated discs: Leaking of the inner material from the disc can cause compression or irritation of the nerve roots or spinal cord.
- Trauma: Traumatic injury to the neck can sometimes cause fractures or inflammation severe enough to compress the nerve roots or spinal cord.
- Tumor: Cancer growths can encroach on the nerves and the spinal cord.
What are the Signs and Symptoms of Cervical Stenosis?
People with a cervical nerve compression may not recognize any symptoms in the early stages. However, overtime, symptoms could become more noticeable and they may include:
- Neck pain: Neck can be stiff and sore with reduced ranges of motion. Sometimes audible grinding sounds may be evident with neck movement.
- Nerve pain: Sharp, shooting, burning, and/or numbness and pain down the arm(s) and/or leg(s) may be evident especially with bending the neck down or up.
- Weakness or numbness: Hand weakness and/or numbness in the arm could get bad enough to affect grip. These symptoms could also be experienced in other parts of the body, such as the both arms or legs.
- Reduced motor skills: The person might encounter difficulty with fine motor movements such as hand writing, buttoning a shirt, opening a door, turning a key, typing, etc.
Rare but severe cases of cervical stenosis, can compress the spinal cord and more severe symptoms can appear which include:
- Changes in walking: Legs may feel heavy and slow to react which may cause difficulty with balance and walking.
- Changes in sensation and the control of all 4 limbs
- Incontinence: May develop difficulty controlling bowel and/or bladder.
- Paralaysis: May completely lose function and sensation of any body parts below the level of the spinal cord impingement.
If these symptoms are present it is important to seek emergency medical care from a doctor at your nearest hospital emergency room.
How Can my Chiropractor and/or Physiotherapist Help?
The chiropractors and/or physiotherapists at Rebalance Sports Medicine are able to catch early signs and symptoms of potential cervical stenosis through detailed history taking and physical examination. If stenosis is suspected, therapists may recommend getting a referral for an X-ray of the neck spine to determine the exact cause of the symptoms. Meanwhile, if the symptoms are minimal the therapists can perform variety of treatment techniques such as manual therapy, acupuncture, soft tissue release, and exercise rehab to manage the symptoms.
How Long Does it Take to Recover from Cervical Stenosis?
Cervical stenosis recovery time is largely dependent on the severity and the cause of the stenosis. The majority of people experiencing nerve root compression pain (numbness, tingling, weakness, shooting pain) will get better in a month but low-grade symptoms will persist for a few months. Research supports those who receive manual therapy treatment with a home exercise program will have significant improvement in their neck and arm pain within six weeks.
What are Safe Home Exercises I can do for Cervical Stenosis?
Cervical stenosis is a condition that should be properly diagnosed and examined by a professional to determine the exact types of exercises required. The earlier you start with the best rehabilitation exercises for you the faster your recovery and better pain management is achieved.
Some of your rehabilitation exercises may include.
- Nerve gliding or flossing exercises
- Deep Neck Flexor strengthening
- Scapular (shoulder blade) Stabilization Exercises
- Stretch for Pectoralis muscles
- Neck stretches including Upper Trapezius & Scalene Stretch
Due to the nature of nerve pain associated with this condition it is important to seek care from your trusted medical professional before starting a rehabilitation program. This is to ensure your program is safe for your individual needs.