Neck Stenosis | Trusted Bournemouth Chiropractors | Charminster Chiropractic Clinic
Neck Stenosis: Pain Management With Chiropractic Treatment | Charminster Chiropractic Clinic
Neck stenosis is a painful condition caused by narrowing of the tunnels in the neck, also called cervical spinal stenosis. This happens when the space around your spinal cord in the neck gets narrower than normal. In turn, you may experience neck pain, numbness, weakness, and find it harder and more painful to move your neck, shoulders, arms, or hands.
If you have neck stenosis, your symptoms might feel different to others. However, common signs include neck pain, pain behind your shoulder, or down your arms. Some people also feel tingling or numbness in their arms and/or hands and find their arm and/or hand feels weak. The Bournemouth chiropractors will talk you through the aspects around neck stenosis and how to manage the pain and symptoms.
What is neck stenosis?
Neck stenosis is a condition where the spinal canal in your neck (cervical region) becomes narrowed, which can press on the spinal cord and surrounding nerves. This narrowing can be something you’re born with (congenital) or happens over time due to natural aging of wear and tear (acquired).
The spinal canal houses and protects the spinal cord. When it narrows, it can compress the spinal cord and nerve roots, leading to a variety of symptoms. Not everyone with a narrowed spinal canal will have symptoms, but those who do can experience anything from mild discomfort to serious neurological issues.
Congenital neck stenosis
This form of stenosis is present from birth due to a naturally narrow spinal canal. People with congenital neck stenosis may not have symptoms in the first part of their life. However, they can get symptoms later in life, especially if other spinal issues are present.
Acquired neck stenosis
This type develops due to degenerative changes as you age. There are various reasons for wear and tear and each individual may have different reasons.
Osteoarthritis
Neck osteoarthritis, or wear and tear, in the neck can lead to either more bone formation or bony spurs (osteophytes) in the bones of your neck pressing on the local nerves.
Herniated discs
Herniated discs are bulging discs between vertebrae that either bulge or rupture, pressing on the spinal canal or nerve roots. This in turn can lead to more bone growth around the nerves and thus press on them.
Thickening of ligaments
Ligaments in the spine can thicken and harden over time, contributing to narrowing of the space for the nerve to exit the spinal cord.
Common symptoms of neck stenosis
Symptoms of neck stenosis are due to the compression of the spinal cord and nerve roots. They can vary widely depending on the degree of narrowing and which nerves are affected. Here are the common symptoms in more detail.
Neck pain
Neck pain is a frequent symptom and can range from a mild, dull ache to a sharp and stabbing pain. The pain might spread to the shoulders and arms. It can come on and off, become constant or may worsen with certain movements or activities such as turning your head or looking up.
Radiculopathy
Radiculopathy describes symptoms such as pain, numbness, sharp, burning or weakness that can radiate from the neck and cause shoulder pain, arm, and hands. The pain can be caused from a herniated disc or local inflammation pressing on the nerve that can cause these symptoms. The pain and symptoms can follow the affected nerve and where it exits the spinal cord, similar to a train station. From the train station, it will travel along the train line (nerve) to a station further away that could be the shoulder, arm, hand or fingers.
Myelopathy
In severe cases, neck stenosis can compress more on the spinal cord itself, leading to more severe symptoms.
- Weakness in your arms or hands can make it harder for you to do fine motor tasks such as gripping objects, writing and buttoning a shirt.
- Loss of balance, scuffing your toes or issues with coordination.
- A heavy feeling in the legs or a sensation of walking on cotton.
Sensory changes
You might experience less sensation and symptoms such as numbness, tingling, or pins-and-needles in your arms and hands. This can worsen your ability to feel temperature, texture, and pressure, potentially leading to injuries such as burning from something hot because of reduced sensation.
Motor dysfunction
Weakness in the arms and legs is common and can lead to muscle wasting over time. This weakness can affect your ability to perform everyday tasks such as decreased grip strength and difficulty lifting objects.
When to seek urgent help with neck stenosis
Neck stenosis often progresses slowly, but certain symptoms require immediate medical attention.
Severe or worsening symptoms
If you notice a rapid progression of pain, weakness, or numbness, particularly if these symptoms become severe and disabling, you need prompt medical evaluation. Sudden changes in your ability to walk or perform daily activities are also concerning.
Bladder or bowel dysfunction
Loss of control over bladder or bowel functions is a serious sign indicating significant spinal cord compression. This condition is known as cauda equina syndrome when it occurs in the spine in the low back, but similar urgency can apply to the neck – this is a medical emergency and requires instant help.
Sudden onset of symptoms
If you experience acute neurological symptoms after a trauma or injury to the neck, seek immediate medical attention. Trauma can cause injury to structures and if stenosis is already present it could make the stenosis worse and lead to rapid deterioration.
Signs of myelopathy
Symptoms such as difficulty walking, loss of balance, coordination problems, and very reduced hand movements indicate spinal cord compression and require medical assessment.
Risk factors for neck stenosis
Several factors can increase the risk of developing neck stenosis.
Age
Wear and tear (degenerative changes) in the spine, such as neck osteoarthritis and disc degeneration. They are more common in older adults, making age a key risk factor.
Genetics
A family history of spinal conditions or a naturally narrow spinal canal can predispose individuals to neck stenosis. Genetic factors have a lot to say to the structural development of the spine. It will increase the risk a lot more.
Occupational hazards
Jobs involving repetitive neck movements, heavy lifting, or long periods of sitting can contribute to degenerative spinal conditions. Stress on the neck in the workspace can accelerate wear and tear on the neck.
Previous spinal injuries
Trauma or injury to the spine, such as fractures or dislocations, can lead to changes in the bones, ligaments and muscles in the neck. In turn, over time, this could potentially narrow the spinal canal. These injuries can also make degenerative conditions that are already there even worse.
Congenital conditions
Some individuals are born with a naturally narrow spinal canal, increasing their risk of having symptoms later in life. Congenital stenosis may not cause symptoms until more wear and tear has been happening over time.
Examination and diagnosis of neck stenosis
Diagnosing neck stenosis involves a detailed clinical evaluation from the chiropractor and confirming the condition using diagnostic tools and imaging.
Physical Examination
The first step is a thorough physical exam where the chiropractor looks at your range of motion, muscle strength, reflexes, and sensory function. The goal is to assess the neurology and discover if parts are not functioning properly, or any signs of spinal cord compression.
Imaging studies
MRI (Magnetic Resonance Imaging)
MRI is the best (gold standard) for diagnosing neck stenosis. It provides detailed images of the spinal cord, nerve roots, intervertebral discs, and surrounding soft tissues. It is very precise to tell the degree of spinal canal narrowing and showing the areas that are being compressed.
CT (Computed Tomography) myelogram
CT is the test involves injecting a substance into the spinal canal that will make the spinal canal even more obvious (contrast dye). The things that will be more obvious are the spinal cord and nerve roots. It’s particularly useful in complex cases or when MRI is not the best one suited for the patients. It is very good at showing detailed images of the bones of the spine.
X-rays
Plain x-rays can help show anything wrong with the bones such as bony spurs (osteophytes), low height between each vertebrae (disc space narrowing), and if a vertebrae is not in the angle or place that it normally should be (alignment issues). They are often used as the first imaging tool but do not show as details of the nerves as MRI or CT scans.
Chiropractic pain management for neck stenosis
Chiropractic care offers pain management to help patients with neck stenosis using manual therapy. More often in mild to moderate cases, chiropractors focus on trigger point therapy, soft tissue work and traction therapy to decrease symptoms and provide pain relief.
Traction therapy
Spinal traction can be described as the word says; chiropractors use their hands to very gently stretch the spine. This helps to open the spine to ease off the stress on the nerves. Additionally, it stretches the ligaments and muscles to relieve pressure and can relieve symptoms.
Physical rehabilitation
Chiropractors often also use rehabilitation and exercises to strengthen the neck muscles, gain more flexibility and more stability. Strengthening exercises can help support the spine and reduce the risk of further wear and tear (degeneration).
Lifestyle modifications
Chiropractors may recommend changing the workspace environments, bending or sitting habits and also lifestyle changes to reduce strain on the neck. This can include advice on better posture control, how the workstation is set up, and tips on how to lower repetitive neck movements.
Prognosis for neck stenosis
The prognosis for patients with neck stenosis varies based on how developed the condition is and response to treatment. Things that influence the prognosis can be how much the spinal cord is compressed, the patient’s overall health, and the effectiveness of the treatment.
Mild cases
Patients with mild neck stenosis can respond well to chiropractic care and lifestyle changes can be helpful in managing their symptoms.
Moderate cases
Patients with moderate neck stenosis may experience symptoms on and off and are more likely to need ongoing management. Treatment may include a combination of chiropractic care and, in some cases, minimally invasive procedures to take the pressure off of the nerves or spinal cord. Surgery may be considered if symptoms are getting worse or they do not respond to non-surgical treatments.
Severe cases
Severe neck stenosis, especially patients with myelopathy, often needs surgical intervention to take the pressure off of the spinal cord and stabilise the spine. Surgery options can be laminectomy, discectomy, and spinal fusion. The response to surgery can vary but patients tend to see improvement in their symptoms and function. However, some patients may have symptoms that won’t go away, or require other interventions or treatment in the future.
The Bournemouth chiropractors at Charminster Chiropractic Clinic are pleased to help you with symptom management using chiropractic treatment for neck stenosis and reduce pain. Book your chiropractic appointment here today!
References
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2696878
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10427602
https://pubmed.ncbi.nlm.nih.gov/28723018
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7170349
