What is Cervical Spinal Stenosis?
In older adults, chronic neck pain is often caused by cervical spinal stenosis (CSS). CSS is a condition in which the spinal canal narrows. This pinches the nerves, causing pain, tingling, and numbness in the neck, upper back, and extremities.
The cervical spine refers to the set of seven cervical vertebrae connecting the thoracic spine to the base of the skull. These vertebrae contain hollow spaces, which together form the spinal canal. The spinal canal is home to the spinal nerves, this bundle of nerves transmits messages between the brain and all other areas of the body, including the sensation of pain.
In a healthy spine, there is plenty of room inside the spinal canal and/or the spinal nerve roots for the nerves to function properly. But as we age, wear-and-tear on the cervical vertebrae can cause the degenerative changes to the spinal canal, which then begins to narrow, closing in on the nerves, and causing a painful condition known as CSS.
If your spinal canal narrows in the lower part of your spine, it’s called as lumbar spinal stenosis. If cervical spinal stenosis is caused by spinal cord compression, your condition could also be called cervical myelopathy.
Causes of Neck Pain due to Cervical Stenosis
Why does the spinal canal narrow? There are a number of possible causes. The precise cause of your condition may be difficult to pinpoint, but it may be due to one or a combination of the following:
- Spinal trauma or injury
- Disc protrusions
- Herniated disc
- Degenerative changes
- Degenerative disc disease
- Bone spurs (osteophytes) on the vertebrae or facet joints
- Tumorous growth
Cervical spinal stenosis is most commonly found in older adults, who are more susceptible to disc degeneration and osteoarthritis in their advanced age.
Over time, the cartilage which cushions and lubricates the cervical joints wears thin. This causes bone-on-bone friction when moving the neck, leading to pain, stiffness, and inflammation. Bone spurs may start to develop, making the spinal canal even smaller. Before long, the bone spurs are closing in on those sensitive nerve endings, called a “pinched nerve.”
Advanced Pain Management Treatments for Cervical Spinal Stenosis Include:
Cervical Spinal Stenosis Symptoms
Signs and symptoms of CSS include:
- Neck pain
- Upper back pain, low back pain may or may not be present
- Muscle spasms in the affected area
- Pain that radiates into the arms and fingers
- Muscle weakness
- Numbness in the arms
- Pins and needles sensations
Myelopathy. Myelopathy refers to neurological symptoms resulting from damage to the spinal cord caused by CSS. Myelopathy is a dangerous condition that could cause permanent neurological damage, paralysis, or death.
If you experience any symptoms of myelopathy, call your doctor right away. These symptoms include:
- Loss of balance or changes in gait
- Changes in fine motor skills
- Changes in handwriting
- Loss of dexterity or grip strength
- Changes in bowel/bladder function
- Loss of positional awareness in arms and legs
Diagnosing Spinal Stenosis
In addition to a physical examination, imaging will usually be required. The most common imaging test are:
An X-ray of your back can show us any changes in your vertebrae or bony structures. That is how we can see if you have bone spurs that could be the cause of a narrowing the space within the spinal canal.
X-rays do expose the patient to small amounts of radiation and are very easy to perform and the most cost-effective imaging available.
Magnetic resonance imaging (MRI)
MRI’s uses very strong magnets and radio waves to produce amazingly detailed cross-sectional images of your spine and the muscles and tissues as well (something x-rays cannot show).
Because an MRI detects damage to your disks and ligaments and can detect any tumors or fatty deposits that could be causing issues. They can show with great precision if the nerves in your spinal cord are being pressured and where.
MRI’s do not subject the patient to radiation but are expensive. Thus they usually require pre-approval from your insurance company.
CT or CT Myelogram
If you can’t have an MRI because of its expense or your insurance company will not approve it, you may get a CT scan (also known as “computerized tomography”) instead.
A CT scan is a test that combines x-ray images taken from many different angles to produce detailed, cross-sectional images of your body. In a CT myelogram, the CT scan is conducted after a contrast dye is injected. The dye outlines the spinal cord and nerves, and it can reveal herniated disks, bone spurs, and tumors.
CT Scans do subject the patient to more radiation than an x-ray, which is one of several key reasons an MRI is superior, but they are significantly less expensive than an MRI.
Cervical Spinal Stenosis Treatment
Spinal surgery is an option you want to avoid whenever possible. All spine surgery procedures, such as spinal fusion, laminectomy and laminoplasty should only be explored after all conservative and non-invasive treatments have failed.
A non-surgical treatment plan will be custom-tailored to your spinal health care needs, and may include a combination of the following:
- Physical therapy with a highly skilled physical therapist
- NSAIDs (non-steroidal anti-inflammatory drugs).
- Epidural steroid injections.
- Platelet-rich plasma injections – harnesses the body’s own regenerative healing powers.
- Hydrodisectomy – water jets was away herniated disc tissue.
If you suffer from chronic neck pain, herniated disc pain, or a pinched nerve, call our offices today, and learn what our award-winning pain management specialist can do for you. Nuvo Spine offers a variety of nonsurgical treatments for CSS patients, including the most advanced minimally-invasive techniques.
Dr. Vahedifar's pain management strategies integrate cutting-edge medical technology with targeted interventions to minimize pain and treat pain’s underlying causes.
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