Neck Pain

Cervical central stenosis is caused by narrowing of the cervical canal which squeezes the spinal cord.

Pressure on the spinal cord could cause damage and can manifest as balance problems, bowel and bladder problems,  numbness in the groin, and/or problems with fine motor control of the hands. Severe cervical stenosis needs medical attention as these symptoms may become permanent if not addressed in a timely manner. 

Narrowing in the canal can be caused by disc herniation, bone spurs and degeneration, excessive motion or shearing in the neck,  thickened ligaments, as well as being born with a narrow spine. 

Cervical foraminal stenosis occurs when nerves branching off of the spinal cord become compressed, irritated and inflamed as it exits the spinal canal. These spinal nerves have to pass through bony openings that can sometimes be narrowed or occulded. 

Causes of compression can include bone spurs, excessive motion or shearing in the neck, thickened ligaments, disc herniations, or disc degeneration. 

Symptoms of cervical foraminal stenosis can include pain, tingling, numbness, and weakness. These symptoms can be focal to the neck or it can radiate down the arm. The symptoms can be mild to severe. 

Severe persistent numbness or weakness need to be addressed in a timely manner as they may become permanent. 

Cervical discs are located between the bones in your neck. They serve as shock absorbers as well as spacers. They also allow your neck to bend and twist. The disc has an inner gel like substance surrounded by an outer layer of cartilage. The discs develop cracks and tears with wear and tear which allow the inner gel like substance to migrate to the outer portion of the disc. This creates a bulge on the edge of the disc and the inner disc material may extrude out into the surrounding space causing pain , inflammation, and dysfunction. 

This cervical disc may cause spinal cord compression, spinal nerve compression as well as decreased overall stability of the neck as the disc is “deflated”. 

The weight of an adult human head can vary between 10-12 lbs, about the weight of a bowling ball. The neck needs to be able to support this weight under stress with static postures, such as prolonged sitting behind a computer as well as dynamic motions, like running. This is accomplished by bony architecture, cervical discs, joints, ligaments, muscles, and the neural system that controls the muscles. If any one of these control systems fail, shear and excess wear and tear can occur at the neck leading to pain and dysfunction. Instability can be the result of trauma, inflammatory diseases, and congenital collagen diseases. Varying degrees of instability may also be associated with disc herniations and cervical arthritis as these conditions  cause compromise of structural integrity of the neck. 

Symptoms of cervical instability include needing frequent position changes for comfort, frequent need for self manipulation, neck fatigue, neck juddering or shaking with motions, sharp pain with movements, head feels heavy, locking or catching with movement, trivial movements can cause an exacerbation of symptoms, and fear or apprehension with movement.

Cervical radiculopathy results from irritation or compression of nerves as they branch from the spinal cord and exit the spinal canal. This can cause pain, sensation changes such as numbness or tingling, weakness and sometime lack of coordination in the hands. This can result from degenerative disc disease, degenerative joint disease, disc herniation, instability, and trauma.