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Overview
Cervical spinal stenosis is a condition in which the canal in the neck region, through which the spinal cord and nerves pass, narrows for various reasons. When the canal narrows, the spinal cord and nerve roots come under pressure; this leads to complaints radiating to the neck, shoulder, arm and hands.
The narrowing is most often the result of an age-related wear process. Thinning of the discs, bone outgrowths (osteophytes) and thickening of the ligaments reduce the volume of the canal and cause the narrowing. Because the process advances slowly, the complaints often increase over time.
Causes
- Age-related wear — disc thinning and degeneration narrow the canal.
- Bone outgrowths (osteophytes) — new bone tissue forming on the spine can grow into the canal.
- Thickening of the ligaments — the ligaments supporting the spine thickening over time.
- Disc herniation — protruding disc material can narrow the space within the canal.
- Congenitally narrow canal — in some people the canal is narrow from birth.
- Weakness of the lower back and neck muscles — increases the load on the spine and accelerates wear.
Symptoms
- Neck pain and stiffness
- Pain, numbness and tingling radiating to the shoulder, arm and hands
- Weakness in the arms and hands and reduced hand dexterity
- Loss of dexterity in the hands and fingers (difficulty buttoning, writing)
- Balance and walking problems in advanced cases
- Changes in the reflexes
Diagnosis
Physical examination is essential in assessing cervical spinal stenosis. Our physician examines muscle strength, reflexes, the distribution of numbness and tingling, and the state of balance and walking. The stenosis is most clearly revealed by MRI; when required, the bony structures are assessed with CT and X-ray.
A narrowing detected on imaging may not always be the direct cause of the complaints. For this reason we always evaluate imaging findings together with the physical examination and make the treatment decision within this whole picture.
Treatment
A significant proportion of cervical spinal stenosis cases can be relieved with conservative methods, without the need for surgery. We regard surgery as a last resort only in advanced cases where neurological loss has become pronounced. The main methods are as follows:
- Physical therapy — pain-reducing agents and appropriate exercises.
- Manual therapy and mobilization — to increase mobility and relax tense muscles.
- Dry needling and, when required, injections — to relieve painful areas.
- Personalized exercise — strengthening the neck and upper back muscles to provide natural support for the spine.
What We Do
When a client comes to us with cervical spinal stenosis, our doctor first performs a detailed examination, assesses their neurological status and draws up the treatment protocol. Because we regard surgery as a last resort, we first try a holistic and personalized conservative approach.
In cases where it is needed, our doctor applies dry needling to tense and painful trigger points, and gives injections when deemed suitable. We then refer our client to our specialist physiotherapists.
Our physiotherapists relax tense muscles with mobilization, clinical massage, cupping therapy and Graston; in suitable and carefully assessed cases they support spinal alignment with chiropractic application. In such cases we determine our applications with great care, according to the patient's neurological status.
Once relief is achieved, we apply fully personalized, three-dimensional exercise programs to strengthen the muscles surrounding the neck and upper back. Our aim is to give the spine strong and natural support. We reinforce the sessions with kinesiology taping. At the end of the process we see our client off with satisfaction and continue with remote follow-up. Our principle is clear: we treat the person, not just the condition.