Spinal Stenosis (Cervical)
What is Spinal Stenosis?
Spinal stenosis is narrowing of the spinal canal due to degeneration of discs, bones and/or joints. When the spinal canal is narrowed, nerve roots can be pinched and lead to pain, numbness and weakness in that part of the body served by the nerve. Lumbar (lower spine) spinal stenosis causes pain in the back shooting down into the legs and feet. Cervical (upper spine) spinal stenosis causes pain in the neck shooting down into the arms and hands.
What are the causes?
Age and overuse can lead to degeneration of the spine’s discs, bones and joints. These degenerative changes can cause bone spur formation and enlargement of ligaments in the spine. The new bone growth, and ligament enlargement can narrow the spinal canal. The nerve roots can be pinched as it travels through the spinal canal causing, pain, numbness and weakness. The spinal cord can be pinched as it travels through the spinal canal in the neck. Pinching of the spinal cord can also initially lead to hand numbness.
What are the symptoms?
Spinal stenosis in the lumbar spine leads to back pain shooting down to the buttocks, legs and feet. Numbness and tingling in the legs and feet may also be present. Prolonged walking may cause the leg symptoms to get worse. The pain may improve once the patient sits down. Spinal stenosis in the cervical spine leads to neck pain shooting to the shoulders, arms, and hands. Numbness and tingling in the hands may be present. Severe spinal stenosis in the cervical spine can lead to pinching of the spinal cord, causing hand numbness, and loss of fine coordination. The coordination of walking may also be affected if there is pinching of the spinal cord. This condition is called myelopathy.
What treatments are available?
Treatment options may include anti-inflammatory medications, pain medications, physical therapy, and epidural steroid injections. As this is a chronic condition, epidural steroid injections may be repeated up to 3-4 times per year to help reduce pain. If the pain persists, or the injections are no longer effective, surgery may be needed to decompress the spinal canal.