Cervical Stenosis And Neck Pain

Cervical stenosis is a narrowing of the cervical spinal canal.

This narrowing of the spinal canal may result in compression of the spinal cord and/or the nerve roots and affect the function of the spinal cord or the nerve, which may cause symptoms associated with cervical radiculopathy or cervical myelopathy. Spinal stenosis may occur as a result of spondylosis (degenerative changes in the cervical spine) but can also be the result of traumatic (fractures and instability) and inflammatory conditions or caused by herniated discs or tumors. Cervical stenosis does not necessarily cause symptoms, but if symptoms are present they will mainly be caused by associated cervical radiculopathy or cervical myelopathy.

Clinical Features:

1. Pain in neck or arms, radiating pain
2. Weakness, stiffness or clumsiness in the hands
3. Diminished or altered proprioception
4. Leg weakness and pain
5. Arm and leg dysfunction
6. Difficulty walking
7. Frequent falling 
8. Urinary urgency which may progress to bladder and bowel incontinence

Diagnostic Procedures:

X-rays of the cervical spine do not provide enough information to confirm cervical stenosis but can be used to rule out other conditions. Cervical stenosis can occur at one level or multiple levels of the spine, therefore an MRI is useful for looking at several levels at one time.

A detailed MRI image may also be useful to show the tight spinal canal and pinching of the spinal cord. A CT scan can provide information about the bony invasion of the canal and can be combined with myelography. the full neurological examination is required if nerves are intact.

Management for stenosis:

for increased severity of symptoms, decompression at cervical spine level is the only option. Patient must consult an Orthopedic surgeon for further treatment.

Physiotherapy Management:

Nonoperative treatments, such as physical therapy management, are aimed at reducing pain and increasing the patient's function. Nonoperative treatments do not change the narrowing of the spinal canal but can provide the patient of a long-lasting pain control and improved function without surgery. A rehabilitation program may require 3 or more months of supervised treatment. Physical therapy helps in many ways to achieve daily activity without pain.

According to condition, A physical therapy program may include

• Stretching exercises
• Postural re-education
• Scapular stabilization and strengthening of scapular, shoulder and neck muscles.
• Training of activity of daily living (ADL) and functional movements.
• Manual therapy
• Proper lifting, pushing and pulling techniques.
• Cardiovascular exercises for arms and legs
• Breathing Exercise
• Relaxation ( General/ local ) Techniques to overcome the pain
• Aquatic exercises