Diagnosis and symptoms6 min read
What is cervical spinal stenosis and what are its symptoms?
Cervical spinal stenosis is narrowing of the bony canal through which the spinal cord passes. Unlike stenosis in the lower back, narrowing here can affect not only nerve roots but the cord itself, which makes recognising the symptoms important.
How it develops
The most common cause is age-related degenerative change. Reduced disc height, enlargement of the facet joints and bony spurs at the vertebral margins narrow the canal gradually.
In some people the canal is congenitally narrow. In this group the same degree of degenerative change produces symptoms far earlier than in someone with a wide canal.
Thickening of the ligaments also contributes. As the process advances slowly, symptoms usually establish over months or years.
Symptoms
Where the narrowing affects nerve roots, radiating arm pain and finger numbness appear. This follows the same course as cervical radiculopathy.
When the cord is affected the picture changes: loss of fine hand dexterity, unsteady walking and stiffness in the legs come to the fore. This is called cervical myelopathy.
In myelopathy pain can be mild or absent. Little pain therefore does not mean a mild picture; what matters is functional loss.
How the diagnosis is made
Assessment begins with history and neurological examination. Gait, balance, hand dexterity and reflexes are examined in detail.
MRI is the only method showing canal width and the state of the cord. X-ray shows bone structure but not whether the cord is compressed.
Narrowing on an image does not diagnose on its own. Many people with a narrow canal have no symptoms; the decision comes from interpreting imaging and examination together.
Key points
- Cervical stenosis is narrowing of the canal carrying the spinal cord.
- The most common cause is age-related degenerative change.
- Symptoms appear earlier in those with a congenitally narrow canal.
- When the cord is affected, hand dexterity and balance deteriorate.
- In myelopathy pain can be mild; functional loss is what matters.
Frequently asked questions
Does stenosis always progress?
The structural narrowing progresses slowly with age. Symptoms do not follow it in parallel, however, and the picture stays stable for years in many patients.
How does it differ from a herniated disc?
In a herniation, compression is usually at a single level and from the disc. In stenosis, narrowing occurs at multiple levels from multiple structures, so its course is slower and more diffuse.
Can I exercise?
Absent signs of myelopathy, controlled exercise is safe and recommended. Forcing the neck backward is avoided, and the programme is built after assessment.
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This content is for information only and does not replace medical diagnosis or treatment. Response to treatment varies between individuals. Please consult a healthcare professional about your symptoms.