Table of ContentsView All
View All
Table of Contents
Causes
Asymptomatic CSS
Progression With Symptoms
Secondary Effects
Treatment
Post-Op Complications
Recovery From Surgery
Self-Care
Cervical spinal stenosis(CSS) is when the spinal canal of the neck becomes narrow and starts to press on thespinal cord. “Stenosis” means a narrowing of a body area.Spinal stenosiscan also affect the lumbar spine (low back).
This article will cover causes, risk factors, symptoms, how the condition progresses, secondary effects, treatment options, and more.
Spinal Stenosis
Why Does Cervical Spinal Stenosis Happen?
CSS has many causes, including spinal changes and injuries that cause the spinal canal to narrow. These causes fall into two categories—congenital (present at birth) and acquired (developing after birth, usually later in life).
Congenital CSS is extremely rare.If someone has it, they were born with a narrow spinal canal. It generally does not produce symptoms until adulthood, so most parents do not know their child has the condition.
Congenital CSS cannot be prevented or detected before birth and seems more common in people withachondroplasia dwarfism.When occurring with achondroplasia dwarfism, it may either be benign and not produce symptoms or begin to show symptoms later in adulthood.
Acquired CSS is much more common and results from wear and tear changes with age. Epidemiological data suggest acquired CSS affects 1 in 100,000 people.
Additional causes of acquired CSS are:
Your risk of developing CSS increases with age. Most people with the condition are over 50.Younger people withcervical scoliosis(curvature of the cervical spine) and other cervical spine disorders are also at risk for cervical spine narrowing.
Asymptomatic Cervical Spinal Stenosis
It is possible to have CSS and not experience any symptoms. In this case, it is considered asymptomatic (no symptoms). Even so, there is still a narrowing in the spinal canal of the cervical spine. Asymptomatic CSS does not cause symptoms despite spinal canal narrowing.
Asymptomatic CSS is often found during imaging done for another purpose. While treatment may not be immediately necessary, regular monitoring and follow-up with a healthcare provider can address symptoms if they develop.
Progressive Cervical Spinal Stenosis With Symptoms
If your healthcare provider says your CSS is progressive, the spinal canal has narrowed with time. If the condition keeps progressing, it might lead to spinal cord or nerve compression. The narrowing will worsen without treatment, and you will experience more severe symptoms.
Symptoms of progressive CSS might include:
Various factors can aggravate CSS progression.This includes injuries to theintervertebral discs, which can accelerate degeneration (bone aging) processes.
Diagnosing Cervical Spinal StenosisA healthcare provider,chiropractor, orphysical therapistmight suspect a diagnosis of CSS based on the symptoms. They will then want to collect additional information from you and perform testing. They may refer you to the appropriate healthcare provider for a diagnosis.Information and testing to confirm a diagnosis might include:Your complete medical history: Your healthcare provider will want to know about any significant illnesses or injuries you have had. They will also ask about your family history and the symptoms you are currently experiencing.Physical and neurological exam: Your healthcare provider may check your range of mobility and the areas of the neck in which you feel pain. They will also test your gait (the way you walk), strength, sensation, and reflexes.Imaging: This can includemagnetic resonance imaging(MRI),X-ray, orcomputed tomography(CT) scans of the cervical spine. MRI plays a vital role in assessing CSS and other spinal disorders.Even so, a diagnosis can be challenging because specific references or measures for the spinal canal have not been established. The healthcare provider must use their judgment to differentiate normal findings from abnormal ones.Electromyography(EMG): An EMG can help measure muscle response and nerve conduction to help your healthcare provider determine if there is compression in the cervical spine.
Diagnosing Cervical Spinal Stenosis
A healthcare provider,chiropractor, orphysical therapistmight suspect a diagnosis of CSS based on the symptoms. They will then want to collect additional information from you and perform testing. They may refer you to the appropriate healthcare provider for a diagnosis.Information and testing to confirm a diagnosis might include:Your complete medical history: Your healthcare provider will want to know about any significant illnesses or injuries you have had. They will also ask about your family history and the symptoms you are currently experiencing.Physical and neurological exam: Your healthcare provider may check your range of mobility and the areas of the neck in which you feel pain. They will also test your gait (the way you walk), strength, sensation, and reflexes.Imaging: This can includemagnetic resonance imaging(MRI),X-ray, orcomputed tomography(CT) scans of the cervical spine. MRI plays a vital role in assessing CSS and other spinal disorders.Even so, a diagnosis can be challenging because specific references or measures for the spinal canal have not been established. The healthcare provider must use their judgment to differentiate normal findings from abnormal ones.Electromyography(EMG): An EMG can help measure muscle response and nerve conduction to help your healthcare provider determine if there is compression in the cervical spine.
A healthcare provider,chiropractor, orphysical therapistmight suspect a diagnosis of CSS based on the symptoms. They will then want to collect additional information from you and perform testing. They may refer you to the appropriate healthcare provider for a diagnosis.
Information and testing to confirm a diagnosis might include:
Secondary Effects of Cervical Spinal Stenosis
CSS is generally not life-threatening but can be extremely serious and lead to long-term problems.Without treatment, symptoms worsen, making it hard for you to do normal daily activities and affecting your ability to get a good night’s sleep.
If CSS affects other areas of the spine, it can impact your gait or ability to carry and lift. It may also cause nerve cells to become damaged, including the nerves that control urination and bowel movements. In rare cases, it can lead toparalysisof one or both arms and legs.
CSS can also progress tocervical spondylotic myelopathy—a condition where the spinal cord becomes compressed—sometimes called spinal cord compression.People with myelopathy will experience a wide range of symptoms, although those symptoms may seem vague early on.
Symptoms of cervical spondylotic myelopathy might include:
Weighing Cervical Spinal Stenosis Treatment Options
Treatment of CSS will depend on the severity of your symptoms. Your treatment options include medications, physical therapy,complementary alternative medicine (CAM) therapies, and surgery.
Medicines
Your healthcare provider can prescribe medicines to treat the symptoms of cervical spinal stenosis.
Medicinal options include:
Physical Therapy
While physical therapy can help manage pain, it is not a long-term treatment for spinal stenosis.This means you will need to get PT along with other treatments and exercise and continue to stretch the neck and back after other treatments have been completed to keep symptoms from coming back.
What to Expect from Spinal Stenosis Physical Therapy
Complementary Alternative Medicine
CAM therapies are used as alternative treatments and in addition to traditional therapies. CAM therapies that might help manage CSS includechiropractic medicine,acupuncture, andmassage, as follows:
Surgery
Healthcare providers will first offer nonsurgical management as a first treatment strategy for most people with progressive cervical stenosis. Surgery might be considered for people with severe symptoms, quality-of-life struggles, and neurologically difficult presentations.The goal of surgery would be to create space in the spinal canal and reduce pain and pressure.
Surgeries used to treat CSS include:
Spinal Stenosis Surgery: Overview
Cervical Spinal Stenosis Post-Op Complications
All surgeries come with risks, especially surgery on the spine near the spinal cord. Even so, spine surgery today is safer than ever, and results tend to be positive.
Postoperative risks associated with spine surgery include:
Recovery After Surgery
Recovering From Cervical Spinal Stenosis Surgery
After surgery, you may need to wear a neck brace to stabilize the spine while you heal.You will likely stay in the hospital for a day or two for observation. In a few days, you will start physical therapy to help you adjust to the surgically treated bones. It might also help rebuild muscle in and around the affected part of the spine.
How quickly you recover will depend on different factors, such as your age, overall health, the type of procedure, and whether you had nerve damage from cervical stenosis.
You will have follow-ups with your healthcare provider a week or two after the surgery, then every six weeks until the bones have healed. This timeline might vary based on your surgery, health situation, and your healthcare provider’s practice. Your healthcare provider will rely on imaging to monitor your healing.
Cervical Spinal Stenosis Self-Care
Self-care techniques to manage CSS include:
Self-Care for Lumbar Spinal Stenosis
Cervical spinal stenosis is a treatable condition, but it cannot be cured, and its effects cannot be reversed. Even following surgery and spine stabilization, it is still possible to experience pain and other cervical spine symptoms. Fortunately, CSS responds well to both nonsurgical and surgical treatments.
To avoid disability and manage symptoms of CSS, you will want to do everything you can to keep your back as healthy as possible. This includes keeping a good posture, exercising and stretching regularly, maintaining a healthy weight, and following up with your healthcare provider, especially if symptoms return or worsen.
Summary
Cervical spinal stenosis (CSS) is a condition in which the spinal canal of the neck becomes narrow and presses on the spinal cord, producing pain and other symptoms that affect the neck, shoulders, arms, and spinal cord. CSS can sometimes be a progressive condition where inflammation of the spine leads to nerve damage.
CSS is a treatable and manageable condition. Treatments can help you feel better and include pain relief and anti-inflammatory medications, physical therapy, chiropractic care, and injections. Surgery is considered for people with severe pain and difficulties related to quality of life.
Self-care with CSS is vital and includes being active, avoiding activities that increase symptoms, and practicing good posture. You will want to follow up with your healthcare provider if symptoms return or worsen to avoid disability and disease complications like cervical spondylotic myelopathy.
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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