What is cervical spinal stenosis?
Cervical spinal stenosis is the narrowing of the spinal canal in the neck.
The spinal canal is the open area in the bones (vertebrae) that make up the spinal column. The spinal cord is a collection of nerves that runs through the spinal canal from the base of the brain to the lower back. These nerves allow us to feel, to move, and to control the bowel and bladder and other body functions.
The seven vertebrae between the head and the chest make up the cervical spine. In cervical spinal stenosis, the spinal canal narrows and can squeeze and compress the nerve roots where they leave the spinal cord, or it may compress or damage the spinal cord itself.
Squeezing the nerves and cord in the cervical spine can change how the spinal cord functions and cause pain, stiffness, numbness, or weakness in the neck, arms, and legs. It can also affect your control of your bowels and bladder.
Spinal Stenosis: Cervical
When the spinal canal becomes narrower (stenosis), the spinal cord and/or nerve roots get squeezed.
What is lumbar spinal stenosis?
Lumbar spinal stenosis is a narrowing of the spinal canal in the lower back, known as the lumbar area.
The spine is made up of bones called vertebrae. The spinal cord runs through an opening in the bones called the spinal canal. Sometimes bones and tissue grow into this canal and press on the spinal cord and/or the nerves that branch out from it. This causes pain, numbness, or weakness in the back, buttocks, legs, and feet.
Spinal Stenosis: Lumbar
When the spinal canal in the low back becomes narrower (stenosis), the nerve roots get squeezed.
Spinal Stenosis: Home Treatment and Physical Therapy
How is cervical spinal stenosis treated?
In mild cases of spinal stenosis, symptoms can usually be controlled with medicine to relieve pain, exercise to maintain strength and flexibility, and physical therapy. If your symptoms are severe, you have progressive weakness of your muscles, or the pictures of your spine show that your spinal cord or nerves are being tightly squeezed, your doctor is likely to recommend decompressive surgery to relieve the pressure. This surgery may be done from the front or the back of the neck. It involves removing some of the disc, bone, and/or tissue that may be pressing on the nerve roots. Vertebrae are often joined together surgically (fused) to provide stability to the spine.
Cervical spinal stenosis can potentially cause serious problems with the nervous system, including problems with bowel or bladder control (incontinence) and permanent loss of strength and feeling in the arms, hands, legs, and chest. Your doctor will not wait for you to have severe symptoms of pain, weakness, and numbness before considering treatment to relieve pressure on your spinal cord and nerves.
How is lumbar spinal stenosis treated?
The goals of treatment for lumbar spinal stenosis are to relieve pain and numbness and weakness in the legs, to make it easier for you to move around, and to improve your quality of life.
Nonsurgical treatments for spinal stenosis include:
- Medicines to manage pain.
- Medicines include NSAIDs and acetaminophen.
- Physical therapy.
- This includes stretching and strength exercises that may reduce pain and other symptoms.
- Steroid shots (injections).
- If other nonsurgical treatments haven't worked, these shots are sometimes tried to help leg pain by reducing inflammation in the nerve root. They may work for some people. But they work for only a short time.
Exercise and changing the way you do your activities may also help you feel better.
Surgery is done to relieve pressure on the nerve roots. The goal is to relieve pain, numbness, or weakness in the legs—not to relieve back pain. People who have surgery only for back pain are less satisfied with the results than people who have surgery for nerve root symptoms and pain in both the back and legs. Also, numbness, weakness, and pain may return after surgery.
Decompressive laminectomy is the most common surgery for relieving spinal stenosis. It's the most common surgery for relieving pressure on the spinal nerve roots.
Most people with lumbar spinal stenosis don't need surgery, but it may be recommended if:
- Your pain, numbness, or weakness is so bad that it gets in the way of normal daily activities and hurts your quality of life.
- You are in good health except for your lumbar spinal stenosis.
- Alternative therapies.
Alternative and complementary medicine therapies, such as acupuncture, are used by some people to relieve pain from spinal stenosis.
- Interspinous process devices.
These are small metal devices that can be inserted between the bones of the spine, near where the nerve roots leave the spinal cord. The idea is to create more space between the bones, to take pressure off the nerve roots. This procedure may be an option for some people.
Back Surgery for Spinal Stenosis
Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.