Cervical Stenosis is the narrowing of the spinal column that results in pressure being put on the nerves that pass through the cervical spinal column. Stenosis can be caused by bone spurs as a result of arthritic changes and soft tissue damage such as disc herniations. Stenosis primarily affects people in their 60s and 70s, but can start as early as your 40s.
Symptoms of cervical stenosis include neck pain and arm pain, numbness, tingling, and weakness. In more serious cases stenosis can lead to cervical myelopathy in which reflexes are altered and normal hand dexterity is lost.
X-rays are usually ordered by your physician to determine the spacing between the cervical discs. Obvious narrowing on imaging can lead to a clinical diagnosis of stenosis. Your physician may order an MRI in order to further determine the extent of the soft tissue damage or potential disc pathology.
Physical therapy diagnosis includes assessing cervical spine range of motion and upper extremity strength, sensation, and deep tendon reflexes. Other more specific testing can include assessing segmental spine mobility.
Your physician may order medications to help relieve your symptoms. Those of which include anti-inflammatories, pain medications, muscle relaxors, and oral steroids. Your physician can prescribe physical therapy which will use stretching and strengthening exercises, joint and soft tissue mobilization techniques, and traction to relieve neck and arm pain as well as restore range of motion, mobility and strength.
As a means of last resort, epidural steroid injections and cervical spine surgery may be necessary to relieve your symptoms. Steroid injections target the inflamed area more specifically than taking an oral steroid will. Surgical procedures may include cervical discectomy, posterior cervical decompression, and/or cervical fusion. Discectomy being the removal of the damaged part of the disc while fusion would be the complete removal of the disc nucleus and a subsequent fusion of the adjoining vertebra. Decompression may include the removal of bone spurs and/or the shaving of bone to relieve pressure on the spinal nerves.
In any case, your physician will be your source for diagnosing the type of pathology and ordering the proper tests and treatments. Physical therapy will be one of your primary treatment options.
Submitted by Brian Manning, MPT, CSCS