WHAT YOU NEED TO KNOW:

What is cervical spinal stenosis? Cervical spinal stenosis (CSS) is narrowing of the spinal canal in your neck. Your spinal canal holds your spinal cord. Your spinal cord controls your ability to move. When your spinal canal narrows, it may put pressure on your spinal cord. CSS is a chronic (long-term) condition.

What causes cervical spinal stenosis? CSS is usually caused by the breakdown of discs in your cervical spine. Discs are tough, spongy cushions between your vertebrae (bones) that help move your neck. You may acquire CSS as you age, or you may be born with the condition. CSS also may be caused by the following:

• Musculoskeletal problems: These are problems that occur with the muscles or bones in your neck. The vertebrae in your spine may weaken and slip out of place. The ligaments in your neck may harden. Ligaments are tissues that connect your bones.
  
  
• Neck mass: This can be a tumor or an abscess (pus pocket).
  
  
• Trauma: This includes accidents or sports injuries. Trauma may damage your vertebrae and narrow your spinal canal.

What are the signs and symptoms of cervical spinal stenosis? You may have no signs or symptoms. If your spinal canal is very narrow, your signs and symptoms may be worse. You may have any of the following:

• Neck pain and headaches
  
  
• Burning pain that shoots from your shoulder down your arm
  
  
• Weakness, numbness, or tingling in your arm or hand, which may spread to your legs
  
  
• Trouble urinating or having a bowel movement
  
  
• Trouble with balance and walking, or trouble holding your neck up or standing up straight

How is cervical spinal stenosis diagnosed? You may learn you have CSS after an injury. Your healthcare provider will ask about your medical history and examine you. He will ask you where you hurt and how bad your pain is. This may include checking the feeling, strength, and movement of your arms and legs. You also may need the following:

• X-rays: These are pictures of your neck that are taken to check for broken bones or other damage.
  
  
• CT scan: This test is also called a CAT scan. An x-ray uses a computer to take pictures of your neck and head. The pictures may show there is damage to the bones and tissues in your neck. You may be given dye before the pictures are taken to help healthcare providers see the pictures better. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye.
  
  
• MRI: This scan uses powerful magnets and a computer to take pictures of your head and neck. An MRI may show problems with your tissues, spine, and spinal cord. You may be given dye to help the pictures show up better. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell healthcare providers if you have any metal in or on your body.
  
  
• An electromyography (EMG) test measures the electrical activity of your muscles at rest and with movement.

What medicines may be used to treat cervical spinal stenosis?

• NSAIDs: These medicines decrease swelling, pain, and fever. NSAIDs are available without a doctor's order. Ask your healthcare provider which medicine is right for you and how much to take. Take as directed. NSAIDs can cause stomach bleeding or kidney problems if not taken correctly.
  
  
• Acetaminophen: This medicine decreases pain and lowers a fever. It is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage. Ask your healthcare provider before taking over-the-counter medicine if you are also taking pain medicine ordered for you.
  
  
• Pain medicine: You may be given a prescription medicine to decrease severe pain if other pain medicines do not work. Take the medicine as directed. Do not wait until the pain is severe before you take your medicine.
  
  
• Muscle relaxers help decrease pain and muscle spasms.
  
  
• Steroid medicine: This medicine is given as a shot into your neck to decrease pain and swelling.
  
  
• Nerve block: A nerve block is a shot of numbing medicine that makes you lose feeling in an area of your body. You may need a nerve block if your pain is not going away, or is getting worse.

What treatments may be needed for cervical spinal stenosis?

• Physical and occupational therapy: You may need to see a physical therapist to teach you special exercises. These exercises help improve movement and decrease pain. Physical therapy can also help improve strength and decrease your risk for loss of function. Occupational therapy (OT) uses work, self-care, and other normal daily activities to help you function better in your daily life. OT helps you develop skills to improve your ability to bathe, dress, cook, eat, and drive. You may learn to use special tools to help you with your daily activities. You may also learn new ways to keep your home or workplace safe.
  
  
• Radiofrequency: This treatment uses electrodes (wires) to send signals to different parts of your body. These electrodes send electrical heat signals to your nerves. The heat of radiofrequency helps to ease your pain.
  
  
• Spinal cord stimulation: This treatment is also called SCS. With SCS, a small device is placed near your spine during surgery. The device sends electrical pulses to a certain area of the spinal cord. SCS may help relieve your pain and help you function better.
  
  
• Surgery: You may need surgery to widen your spinal canal or to decrease pressure on your spinal cord. Surgery also may be done to fix damaged or injured vertebrae in your neck.

What are the risks of cervical spinal stenosis?

• Steroid injections may cause you to have a headache. They also may damage your spinal cord. This may cause worse weakness, shooting pain, or muscle spasms in your arms or legs. Surgery on your spine may cause neck pain. You also may have a hard time swallowing. Your nerves and spinal cord may become damaged, and you may lose some ability to move. Your surgery may not open your spinal canal fully. Surgery may not relieve all the pressure on your spinal cord. Surgery may be life-threatening.
  
  
• Without treatment, you may have worsening signs and symptoms, such as burning neck pain, numbness, and weakness. It may be hard for you to do your normal daily activities. The pain may make it hard for you to sleep, or it may change your mood. You also may have trouble working or doing chores, such as lifting or carrying things. Cervical myelopathy may develop over time. This is when your spinal canal is pinched, causing the nerve cells to be damaged. You may not be able to control when you urinate or have a bowel movement. In rare cases, you may become paralyzed.

How can I manage my cervical spinal stenosis?

• Exercise as suggested by your healthcare provider: Exercise may help keep your condition from getting worse. Exercise can decrease your blood pressure and improve your health. Safe exercise includes walking and using a stationary (not moving) bicycle. It is best to start exercising slowly and do more as you get stronger. Talk to your healthcare provider about the best exercise plan for you.
  
  
• Use ice or heat as directed: Ice or heat packs on your neck may help decrease your pain. Ask your healthcare provider for instructions about how to use ice and heat.
  
  
• Avoid certain activities: Some activities may worsen your condition. Do not ride motorcycles or horses, climb ladders, or play football or other contact sports. Avoid bending your neck back too far, such as when you work on a computer, swim, or stretch. Ask your healthcare provider about these and other activities to avoid.

When should I contact my healthcare provider?

• You have a fever.
  
  
• Your pain does not get better or gets worse, even after you take medicines.
  
  
• You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

• You injure your neck, and your pain and symptoms worsen.
  
  
• You have new or increased trouble walking.
  
  
• You cannot control when you urinate or have a bowel movement.
  
  
• You have more numbness, tingling, or weakness than before.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.