What Causes Stenosis of the Neck & How is it Treated?
What is Stenosis of the Neck?
Stenosis of the neck is narrowing of the canal in the neck region of the spine (cervical spine). The spinal vertebrae are arranged in a manner such that there is a space in between the bones, through which the bundle of nerves or spinal cord passes. Stenosis of neck occurs when this space gets narrowed and the spinal cord can potentially get compressed causing various medical problems.
Stenosis of the neck, also known as cervical stenosis can affect the spinal cord and if nerves get compressed, can show neurological complications as well.
What Can Cause Stenosis of the Neck?
Various factors can contribute and increase the risk of cervical stenosis.
Stenosis of the Neck Caused Due to Degeneration - The commonest cause being age related changes that can cause disc degeneration of the cervical spine. With aging and natural wear and tear of the spinal structures, discs between the vertebrae become weak. The intervertebral discs act as shock absorbers and also protect other structures from damage.
As age advances, the supporting ligaments and soft tissues become weaker and can cause protrusion or prolapse of the discs, which can increase the chances of stenosis of the neck. Other changes like thickening of soft tissues, damage to ligaments and formation of bone spurs or osteophytes too can cause stenosis of the neck. All these changes cause narrowing of the spinal canal and can exert pressure on the spinal nerves.
Stenosis of the Neck Caused Due to Trauma - Another cause of cervical stenosis or stenosis of the neck is trauma to the cervical spine and scar tissue formation in the area. As scar tissue healing makes the joint stiffer and with increasing use increases the chances of stenosis of the neck.
Other Causes of Stenosis of the Neck – Other conditions of the joints that affect the cervical vertebrae, calcification of soft tissues around the neck vertebrae, infections like tuberculosis, tumors around the neck or certain type of cancers can cause stenosis of the neck.
What are the Symptoms of Stenosis of the Neck?
Cervical stenosis or stenosis of the neck may remain asymptomatic or sometimes produce discomfort and pain in the neck. When symptoms are noted, there may be pain in the neck, difficulty in movement of the neck with a feeling of stiffness in the neck joint area.
Sometimes stenosis of the neck with radiculopathy is noted with pain, numbness or tingling extending to the arms, hands and fingers. It results from a nerve root being pinched in the narrowed spinal canal. It can also present with difficulty in using hands for coordinated movements or fine motor skills like buttoning, holding objects, etc. Weakness and difficulty in movement of limbs can occur. Difficulty in balance and co-ordination, dizziness, vertigo and headaches may be noted.
In severe stenosis of neck, where the spinal cord gets compressed, loss of bowel and bladder control can be seen. Stenosis of the neck with myelopathy, can affect both hands and legs. Like hands, there may be pain, numbness and weakness in legs with difficulty in walking. Inability to assess the sense of position, difficulty in sensing the position and movements of hands, legs may be seen.
How is Stenosis of the Neck Diagnosed?
Diagnosis of stenosis of the neck can be made based on the history, presenting complaints, if any and physical examination. Investigations like X-ray, MRI and CT scans are required to confirm the condition and rule out any other underlying medical problems.
How is Stenosis of the Neck Treated?
Treatment for cervical stenosis or stenosis of the neck depends on the severity of the condition. For mild cases, with minimal stenosis and none or milder symptoms, medications to relieve pain, inflammation, rest and neck strengthening exercises maybe advised. Injection of steroids may be considered for some cases of stenosis of the neck.
For severe cases of stenosis of the neck, where the stenosis is causing compression of the spinal cord and the symptoms are worsening with increased risk of loss of control, surgical treatment may be advised.
Physical therapy for stenosis of the neck is advised for all depending on the severity, and the regimen may differ for non-operative cases and post-surgical cases. Neck support or cervical braces may be advised as appropriate for cases related to cervical stenosis or stenosis of the neck.
Surgery for Stenosis of the Neck
The aim of surgery for stenosis of the neck is to make the spinal canal wider and relieve pressure on the spinal cord. Surgical procedures that may be considered are:
- Surgical procedures to remove the herniated, damaged intervertebral disc or structures exerting pressure on the spinal cord can be considered to treat stenosis of the neck.
- Laminectomy and Laminoplasty for Stenosis of the Neck– The vertebrae are opened or a hinge is created from behind to make more space in the spinal canal.
- Corpectomy to Treat Stenosis of the Neck – A damaged vertebral body, which is exerting pressure on the cord is removed and replaced with a bone graft, which heals naturally over time.
- Other procedures that involve placing plates, rods and other metal instruments maybe considered depending on the case.
Exercises for Stenosis of the Neck
Neck strengthening exercises can help in all stages of recovery from stenosis of the neck. The main aim is to reduce neck pain, improve flexibility and strengthen the neck muscles. Some of the exercises that can help include
Neck Stretches for Stenosis of the Neck:
- Free neck movements up/down, turning left/right and bending neck sideways.
- Tuck the chin backwards and bend neck to touch chin to the chest, feel the stretch at back of the neck.
- Tuck the chin to the chest and turn to the left to feel stretch on the right side of neck, hold. Then tuck the chin and turn to the right and hold, to stretch the left side.
Shoulder Shrug Exercise for Stenosis of the Neck – Raise shoulders straight up, hold to feel the stretch in the back of neck and upper back.
Neck Strengthening and Stabilizing Exercises for Stenosis of the Neck
- Press forehead and try to push behind, while the neck tries to push the head forwards, without bending.
- Press back of head forwards, while neck tries to resist, without bending.
- Press one side of the head and try to push to the other side, without turning the neck. Allow neck to resist. Repeat the same on the other side.