Neck pain, also know as cervicalgia resulting from nerve compression may be due to spinal stenosis cervicalgia where the spinal canal has narrowed and is pinching the nerves or nerve roots in the neck. Cervical spondylosis is a common degenerative condition affecting the section of the spine in the neck and this form of osteoarthritis may involve changes in the intervertebral discs, the bones, or the connective tissues in the spine. Neck pain may be accompanied by shoulder pain, radicular pain, and headaches at the base of the skull (suboccipital pain). Where severe spinal stenosis cervicalgia occurs it may lead to cervical spondylotic myelopathy where the spinal cord itself is put under pressure.
Spinal Stenosis Cervicalgia Causes
There are a number of causes of spinal stenosis which can lead to cervicalgia. Disc degeneration is a major factor and is quite common in the neck due to its relative mobility compared to the rest of the spine. Mechanical stresses and strains applied to the neck on a daily basis may lead to disc bulging, disc herniation, or a loss of intervertebral disc height as the disc becomes dry and brittle. The body often compensates for the loss of cushioning provided by the spinal discs by building osteophytes (new bone spur growth) to try to stabilize the spine. Unfortunately, these bone spurs can impinge on the other structures of the spine and may cause ischaemia, nerve compression, spinal cord compression, or damage to ligaments resulting in cervicalgia (neck pain).
Those who have experienced whiplash or other form of neck trauma may be more likely to develop spinal stenosis cervicalgia, or develop it earlier than normal. Changes to the facet joints, abnormal calcium deposition in the ligaments supporting the spine, inflammatory conditions such as rheumatoid arthritis, and abnormalities in posture or spinal structure lower down in the thoracic or lumbar spine are all potential accelerators of spinal stenosis cervicalgia. Certain professions may increase the risk of neck pain from spinal stenosis as they can involve persistent pressure on the neck, such as manual labor, flying fighter jets, gymnastics, and even surfing. Years of working hunched over at a desk, and then going home to slouch on the couch all night can also increase the risk of spinal stenosis cervicalgia.
Spinal Stenosis Cervicalgia Diagnosis
Cervicalgia (neck pain) can be an early warning sign that spinal stenosis is developing causing intermittent nerve pinching upon certain movements or posture. Where numbness and weakness of the shoulders, arms, or hands starts to occur this is often a sign that the nerves in the neck are suffering serious damage and that this damage may cause permanent dysfunction. Ignoring spinal stenosis cervicalgia and simply putting the neck pain down to stress or tension is, therefore, not to be recommended. Patients with other medical conditions, such as fibromyalgia may be told that their neck pain is simply a symptom of their currently diagnosed condition but all new incidences of pain should be investigated on their own merit. Nerve pain will usually not respond to NSAIDs or other anti-inflammatories when it is caused by a mechanical issue, such as the nerve compression from spinal stenosis. This may help to encourage sufferers to seek medical attention.
Diagnostic imaging such as X-Rays, MRI or CT scans may be used to identify areas of narrowing in the spine (spinal stenosis) whether due to degenerative disc disease, osteophyte growth, inflammation, spinal fracture, spinal slippage (spondylolisthesis), or other cause. However, some people who show signs of spinal stenosis suffer no symptoms such as cervicalgia, whereas others may not have identifiable areas of cervical spinal stenosis may suffer symptoms of cervicalgia with no other obvious cause.
Spinal Stenosis Cervicalgia Treatment
Treatment for spinal stenosis cervicalgia will depend largely on the cause or form that the spinal canal narrowing takes. Where degenerative disc disease is present a patient may be advised to take NSAIDs to reduce the inflammatory action of herniated disc material on the cervical nerve roots. Non-surgical traction may be possible to encourage a bulging disc to move back into its correct position between the vertebrae, or back surgery to remove a herniated disc might be necessary in some patients. Techniques such as the X-stop procedure, commonly used in lumbar spinal stenosis treatment, are not usually considered appropriate for the more mobile neck portion of the spine. Spinal fusion following laminectomy is also a potential treatment for spinal stenosis cervicalgia but is considered a last resort as it can simply defer problems to a later date as the tissues and spinal structures above and below the area of spinal fusion can suffer from adjacent segment syndrome.
Conservative Treatment for Spinal Stenosis Cervicalgia
Many patients will simply be able to address spinal stenosis cervicalgia using physical therapy, anti-inflammatory drugs, and lifestyle modifications. Where a patients smokes this should be a warning sign to stop smoking immediately as bone health and the health of the intervertebral discs are significantly affected by the chemical constituents of tobacco (such as nicotine). Patients who smoke are not good surgical candidates and will usually be required to cease smoking prior to such treatment being offered for spinal stenosis. Disc degeneration is also exacerbated by dehydration and poor diet as discs that are poorly nourished and dry are less supple, more brittle, and liable to bulge or herniate causing spinal stenosis cervicalgia.
Stretching and strengthening neck exercises can help relieve neck pain from spinal stenosis but should only be done with supervision from a trained physical therapist as certain exercises may be inadvisable and actually worsen symptoms. Yoga or pilates can also help, as can the Alexander Technique, in correcting postural problems that may be contributing to spinal stenosis cervicalgia. An ergonomic assessment of a patient’s workspace can also be helpful in removing triggers for neck pain such as uncomfortable screen or keyboard elevation, unsupportive seating, or a lack of physical activity during working hours resulting in stiffness and poor mobility. Where spinal stenosis cervicalgia is accompanied by signs of cervical myelopathy surgical treatment is more likely, but in general neck pain will be treated with conservative therapy for as long as possible due to the risks of back surgery. Spinal stenosis cervicalgia is just one cause of neck pain however, and other causes such as rheumatoid arthritis, and fibromyalgia should also be investigated.