Is it a Cervical Spinal Stenosis or a Pinched Nerve?

Cervical Spinal Stenosis or Pinched Nerve: What Are the Symptoms?

Cervical spinal stenosis is a common spinal condition. According to research, degenerative spinal changes affect up to 95% of people by the age of 50—and spinal stenosis falls into this category. It’s important to understand the symptoms of the condition so individuals can intervene in a timely manner.

If you are experiencing any of the below symptoms, it’s worth a consultation to understand exactly what you’re dealing with.

Cervical Spinal Stenosis Symptoms

Often dubbed a “pinched nerve,” cervical spinal stenosis primarily results from a narrowing of the spinal canal that encases the spinal cord and nerve roots, causing a wide range of symptoms. One of the key hallmarks of cervical spinal stenosis is pain in the neck, shoulders, and arms—often coupled with weakness or numbness. This discomfort often extends to the hands and can be accompanied by tingling sensations or loss of fine motor skills. In advanced cases, individuals may experience a loss of balance and coordination, including difficulty walking or executing refined tasks such as buttoning a shirt. 

Symptoms can vary widely, depending on the degree and location of the stenosis. For some, the symptoms might be intermittent, exacerbated by certain movements or positions. For others, they might be continuous, escalating over time as the stenosis worsens.

Cervical Spinal Stenosis Causes

Cervical spinal stenosis typically develops over time and is most commonly seen in adults over 50 years of age. It’s frequently the result of age-related changes in the size and shaping of the spinal canal.

For example, degenerative disc disease is one primary culprit. Over time, the discs between vertebrae dehydrate and harden, narrowing the spinal canal. Similarly, osteoarthritis can lead to the formation of bone spurs that intrude into the spinal canal, causing stenosis.

Other causes include herniated discs, injuries, tumors, or certain bone diseases such as Paget’s disease. These are considered “acquired” causes. In some cases, individuals may be born with a naturally smaller spinal canal, predisposing them to stenosis—classified as a congenital cause.

Other Types of Spinal Stenosis: Lumbar and Thoracic

Cervical spinal stenosis is just one type of stenosis. Another common type is lumbar spinal stenosis. Less common is thoracic stenosis.

Lumbar Stenosis

Lumbar spinal stenosis results from the narrowing of the spinal canal in the lower back and is the most common form of spinal stenosis. As the canal narrows, it can compress the nerves traveling through the lower part of your spine, often leading to symptoms of pain, numbness, and weakness in your legs.

Symptoms of lumbar stenosis typically vary depending on the severity and location of the stenosis, but commonly include:

• Pain or cramping in the legs (also known as claudication), particularly when standing or walking for long periods. This is often relieved by bending forward or sitting down.
• Numbness, weakness, or tingling in the foot or leg.
• In severe cases, loss of bladder or bowel control may occur.

Thoracic Stenosis

Thoracic spinal stenosis occurs in the mid-back region. It is the least common type of spinal stenosis due to the fact that the thoracic spine is more stable and less mobile than the cervical and lumbar regions, reducing the wear and tear that contributes to stenosis.

However, when thoracic stenosis does occur, it can be quite serious. The thoracic part of the spinal canal is narrower than the cervical and lumbar parts, leaving less room for the spinal cord.

Symptoms of thoracic stenosis can include:

• Pain in the rib cage or abdomen. Because the thoracic spine is connected to the ribs, compression here can cause this type of pain.
• Numbness, weakness, or tingling in one or both legs.
• Difficulty walking or maintaining balance.
• In severe cases, paralysis from the waist down may occur.

Spinal Stenosis Treatment

Fortunately, a myriad of treatments exist for cervical spinal stenosis. These can range from conservative methods like physical therapy, pain medication, and corticosteroid injections, to more advanced treatments such as surgical procedures.

• Physical therapy helps strengthen the neck and shoulder muscles, enhancing balance and making it easier to walk. 
• Pain medications can help manage symptoms when used appropriately. 
• Corticosteroid injections reduce inflammation around the nerve roots, offering temporary relief.

When conservative treatments fail or symptoms are severe or worsening, surgery might be necessary. The choice of surgery generally depends on the location and severity of the stenosis, the patient’s overall health, and their specific symptoms. The following represent the most common types of surgical procedures to address cervical spinal stenosis.

Anterior Cervical Discectomy and Fusion (ACDF): This procedure is often used when cervical stenosis is caused by a herniated disc or bone spur. The surgeon will make an incision in the front of the neck, remove the offending disc or bone, and then stabilize the spine by fusing two or more vertebrae together using a graft.

Cervical Laminectomy: During a laminectomy, the surgeon removes part or all of the lamina (the back part of the vertebra), creating more space for the nerves and relieving pressure.

Cervical Laminoplasty: In this procedure, the surgeon creates a hinge on the lamina and props it open, effectively widening the spinal canal. This surgery maintains more spinal mobility than a laminectomy, but isn’t suitable for all cases.

Cervical Foraminotomy: If a nerve root is compressed as it exits the spinal column (in the intervertebral foramen), a foraminotomy can be performed. The surgeon removes bone and tissue to widen the nerve pathway.

Artificial Disc Replacement (ADR): In some cases, the problematic disc may be replaced entirely with an artificial one. This procedure is intended to maintain the normal motion of the spine, unlike a fusion procedure.

Each of these surgical procedures has its own risks and benefits, and the best approach depends on the patient’s specific situation. Importantly, surgery is usually only considered when conservative treatments have been ineffective, or if the stenosis is causing severe or worsening symptoms.

When to Seek a Neurosurgeon’s Expertise

Early recognition of cervical spinal stenosis symptoms is essential in ensuring effective management of the condition. Individuals experiencing persistent neck or arm pain, difficulty with balance, or other unusual neurological symptoms should seek medical attention sooner rather than later—from an experienced neurosurgical professional. With appropriate treatment, the majority of people with cervical spinal stenosis can lead active, fulfilling lives.

New Jersey Brain and Spine has the most experienced neurosurgical professionals in the area. If you or a loved one is concerned about any spinal issue, please don’t wait to address it. There are many solutions we can implement to avoid the worst-case scenario. Connect with our physicians to learn more.