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Spinal Stenosis: A common (but sometimes misdiagnosed) pain in the neck

Cervical spinal stenosis is a common spine condition affecting patients over 50, but while it may be a common problem, it can go undiagnosed or get misdiagnosed as just another part of getting older.

However, depending on the cause, cervical spinal stenosis can get progressively worse over time and could also lead to serious health issues and complications such as loss of bladder and bowel control and/or permanent paralysis.

What causes cervical stenosis?

Cervical spinal stenosis is a narrowing of the spinal canal inside the vertebrae that make up the neck (known as the cervical vertebrae), and it usually happens gradually as people get older. But in some cases, like those involving trauma – such as a car accident – the condition can progress more quickly. The danger is that as the spinal canal gets narrower, it starts to put pressure on the spinal cord and the nerves that branch off to the various parts of the body.

Arthritic inflammation in and around the vertebral joints (spondylitis) is the most common cause. In addition, the discs between our vertebrae wear out as people age (a condition known as degenerative disc disease or spondylosis) and as they do, they can also cause inflammation of the surrounding tissues in the spine and even slip out of place into the spinal canal themselves (herniated disc). Another common cause is bone spurs, which are bony growths that can start crowding the spinal cord over time.

Other conditions that can lead to stenosis include:

  • Osteoarthritis
  • Rheumatoid arthritis
  • Spondylolisthesis
  • Degenerative scoliosis
  • Spinal tumors

When the spinal cord becomes compressed, the electrical signals that need to pass through the nerves can get disrupted, which can cause pain, sensations like tingling and numbness in the extremities, as well as loss of muscle control in the areas of the body these nerves travel to.

The most common symptoms of cervical stenosis are:

  • Neck pain (though it’s not always present)
  • Numbness or tingling sensation in the hands, legs or feet
  • Muscle weakness in the hands, legs or feet
  • Difficulty with fine hand movements

How can spinal stenosis go undiagnosed or misdiagnosed?

Many of the symptoms of spinal stenosis appear gradually over time, making them difficult to notice unless you know what you’re looking for – and because of this slow progression, they’re often brushed aside by both the patient and a general practitioner as a normal part of getting older. Another problem is that the symptoms that accompany stenosis are fairly vague, so they can easily be attributed to other things like arthritis, bulging or herniated discs, and even carpal tunnel syndrome. These are just a couple reasons why it’s so important to see an orthopedic specialist like the doctors at Southwest Scoliosis Institute if you’re experiencing symptoms like the ones listed above.

In addition, X-rays are usually the first diagnostic imaging tool doctors use to determine what’s going on with the spine, but these can be misleading in cases of stenosis. This is because X-ray imaging can only show issues with the bones of the spine, such as bone spurs, loss of bone height or spondylolisthesis. They don’t give an accurate interpretation of the soft tissue like the spinal cord and nerves. For this, computed tomography (CT) and magnetic resonance imaging (MRI) scans are needed.

Treatment for cervical spinal stenosis

“For most of the patients we see, their cervical spinal stenosis can be treated successfully with conservative modalities. More often than not, anti-inflammatory medications and targeted exercises are all they need to start getting relief from their symptoms.”

– Dr. Richard Hostin

Pain management

For most patients with cervical spinal stenosis, conservative nonsurgical treatment is enough to improve their condition. This starts by managing the pain and inflammation with nonsteroidal anti-inflammatory drugs such as acetaminophen (Tylenol), ibuprofen (Advil) or naproxen (Aleve) – and if the pain is severe, we may also opt to use epidural steroid injections in and around any affected nerves as well. 

Cervical Spinal Stenosis Exercises

After a brief period of rest, we will most likely recommend physical therapy and exercise as the first course of treatment. Exercises for cervical spinal stenosis are designed to strengthen the muscles that support the spine and to improve flexibility in your neck and upper back. They can also help by bringing the spine back into the proper alignment following an injury like a herniated disc.

Many of the exercises for cervical spinal stenosis are very simple and can be performed while seated, meaning you can do them at home or at work when you have some spare time.

Surgery for Cervical Spinal Stenosis

“At Southwest Scoliosis Institute, our philosophy of care is to always look at minimally invasive options first before considering traditional surgery. We’re specially trained and equipped to perform these kinds of delicate procedures, and our patients are usually able to get back to their daily routine faster as a result.”

– Dr. Ioannis Avramis

If conservative treatment is not enough to relieve your symptoms, or if they start to get worse, Drs. Hostin, Avramis or Kishan may recommend surgery. Surgical procedures to treat spinal stenosis are primarily designed to relieve the pressure on the spinal cord and nerves, which is why they’re called decompression surgery.

The most common surgeries for cervical spinal stenosis include:

  • Spinal fusion
  • Decompressive laminectomy
  • Decompressive laminotomy
  • Discectomy
  • Foraminotomy

For many people, these surgeries can be performed as a minimally invasive surgery. These kinds of procedures involve much smaller (typically around 3- to 15-millimeter) incisions, and the surgeon uses highly specialized surgical instruments with magnification in order to perform them. There are a lot of benefits to using minimally invasive surgery, including less bleeding, scarring, and pain compared with traditional methods, as well as a significantly reduced recovery time compared to traditional surgery. In addition, minimally invasive surgeries can often be performed on an outpatient basis, meaning most patients are able to return home the same day as their surgery.

Getting an evaluation and treatment for cervical stenosis at Southwest Scoliosis Institute

If you have any of the symptoms listed above and you think you may have cervical spinal stenosis, it’s important to be seen by an orthopedic spine specialist who can properly evaluate and treat it. All of our orthopedic surgeons, Dr. Richard HostinDr. Ioannis Avramis and Dr. Shyam Kishan, have extensive experience diagnosing and treating complex spine conditions like cervical spinal stenosis.

If you are in pain and think you may be suffering from cervical spinal stenosis, Southwest Scoliosis Institute can help. Call us to make an appointment at (214) 308-0227 or visit our contact page today.