What Is Cervical Stenosis?

Are you dealing with neck problems, and have you had your neck checked out and been told by a doctor that you’ve got cervical stenosis or stenosis in your neck, you might have had an X ray or an MRI that showed that you had cervical stenosis. Or you might just think that you might have cervical stenosis because maybe your dad or your mom had it or some other relative, and it could run in the family.

Oftentimes, when we see clients here in the clinic that had been diagnosed with cervical cervical stenosis, they are terrified by those words. And when they look at their MRI report, and they see a bunch of other huge medical terms like degeneration and arthritis, it just freaks him out. And oftentimes doctors are kind of quick to throw the surgery word out there.

They say something like people with cervical stenosis might end up having surgery someday. But the truth is, cervical stenosis is very manageable in most cases, and it does not have to be scary.

In this video. Today, I’m going to explain to you exactly what it is the different types of cervical stenosis and why it happens in people. And so that that way, you can learn how it’s possible to begin to fix your cervical stenosis problem naturally without surgeries. My name is Dr. David Middaugh. And I’m a specialist physical therapist at El Paso Manual Physical Therapy. And this channel specializes in helping people stay healthy, active and mobile while avoiding unnecessary surgery, injections and pain medications. Be sure to subscribe to our channel so that you don’t miss out on any of the helpful videos that we put out every single week.

Now let’s get to it. There are two types of cervical stenosis. One is called central stenosis. And the other one is called a pyramidal or also lateral stenosis, you have foraminal stenosis or lateral stenosis, same thing, they just have different words for the same thing as the medical field for you. So let me explain the difference here is central stenosis.

The first one, let me get a picture to show you what I mean here. So I’ve written out this nice little fantastic drawing, appreciate my arts midship. It’s terrible. But here’s a side view of the head and the neck and you have seven neck bones right here. And then in green, here you have the brain and the spinal cord coming down. Same thing over here, but we’re looking at a zoomed in top to bottom view of one level of the spine in the neck.

So here’s the disc, here’s the part of the bone in the back that comes to the point. And then here in the middle, you’ve got your spinal cord and you have nerve roots that go out to the side. In Central stenosis, the problem is here in the middle of the spinal cord, he gets some compression is coming from the bones or the disk or some something over there. stenosis just means that an opening is getting closed or pinched off.

So in central stenosis, the central part of the nerves here are getting pinched of a cord, the spinal cord itself is getting pinched. So that’s central stenosis for you. Now in lateral are also known as a pyramidal stenosis, what they’re talking about is the pinching happening out to the side. So lateral means sides for pyramidal just means that the holes in the sides of the spine where the nerve roots come out, so you get some pinching out here.

On a particular side, they might tell you you have more on the left or more on the right are some cases both. So here in the spinal cord, you might get that like a red dot right there is an example of some pressure on the spinal cord or on the nerve root that comes out to the side. Now, you might be thinking Well, which one is worse, they can both be bad.

I mean, if for central stenosis, the big concern is that if there’s enough pressure on the spinal cord, it can begin to affect the legs, it can begin to affect your bowel and bladder function meaning your ability to hold it in you know holding pee or poop. And if the nerves get compressed enough, then you can start having accidents.

And that’s a big concern. By the way, if you’re watching this video, and you think you might have cervical stenosis or you’ve been diagnosed with cervical stenosis, what you need to know is that if you’re having accidents, like you’re not making it to the bathroom in time and you’re dirtying yourself or wetting yourself or it’s this is if it’s changed because you might say oh, well that’s been happening for a while actually before my neck pain came on.

But if you’ve had an increase in neck pain that and also simultaneously had an increase in accidents are you’ve been hurting yourself, then that’s a serious concern. And you need to stop this video right now and call an ambulance.

I’m not even joking. Put your phone down or switch to your phone app if you’re on your phone and call 911 and get yourself to a hospital if you haven’t already been checked out and if you have and they said it wasn’t that bad and you started getting this these accidents happening.

You need to go to the hospital and you very well might need a surgery which is it’s good to catch it sooner rather than later. Because you can have some permanent damage. But that being said, that situation is rare, it is super rare.

What’s more likely to happen is you get some numbness and tingling, some pain, some weakness that might happen in your arms or legs. Because of the cervical stenosis that happens them the most. That’s what we see here the most here in the clinic whenever there’s a central stenosis issue.

Now when you have a lateral or pyramidal stenosis, the nerve root is being pinched. And it typically shows up on individual as pain in the neck, of course, then it might go down in arm, you might get some numbness in some fingers or part of your head, you may be a weakness, like you’re dropping things, dropping your keys, having trouble turning knobs, opening jars, or it could even affect the leg in some cases, depending on situation.

But if you’re talking the neck, it’s most often going to affect an arm on one side, and it’s usually one sided. Sometimes, with all these diagnoses there, there’s multiple diagnoses that overlap. So they might also say that you have cervical radiculopathy, big words for the nerve root is getting pinched.

Now if we’re talking about the stenosis, we’re talking about several reasons that it could occur. So let me go into that. Next, there’s four reasons why you could get stenosis. The most common one is definitely a disc herniation in your neck. So between every single level of the spine starting with the neck bones up top, that’s part of your spine, you have discs, which are squish your cartilage based structures, that allows for some movement between the bones.

If you’ve got some long standing muscle imbalances, or other issues, or maybe you know, accidents have accumulated over the years over the decades, you might end up having a disc herniation. And truth be told this herniations happen anyway as we age and it doesn’t mean that it’s a bad thing. It’s part of aging, it’s kind of like getting gray hairs and wrinkles.

So if you’ve ever had an X ray, really an MRI, and they’ve looked at your discs and told you have disc herniations it’s not the end of the world. If it gets bad enough that it’s pressing on a nerve, then we have to do something about that so that it doesn’t get worse and you don’t end up in a situation where you have to have a surgery salvageable most of the time.

The second most common reason is arthritis in your neck, if you’ve got joints in your neck that are starting to get stuck and not moving too well. And that happens for weeks, months and years. The chain that the surface is within the joints, there’s cartilage, there’s movement that’s supposed to be happening there, it gets kind of rough in the movement doesn’t happen, as it should.

And because those joints are right next door to where the holes where the nerves come out, it can start to affect the position of the joint which starts to compress the hole a bit which pinches the nerve and can cause the central center this this lateral stenosis, the frameless stenosis problem.

The third most common reason for getting stenosis is chronic bad posture. I mean, if you’re in your 40s 50s 60s 70s or beyond, and you can admit that you’ve probably had bad posture that whole time, then there’s a good chance that that posture whenever especially if you’re this slumped forward posture with your head kind of tipped up, it closes the holes, the more you look up, even if it’s just subtle, you suddenly close the holes on the sides of your neck bones, where the nerves come out, those are called the furama.

Those frame and are fragmented, start to close. And if you have arthritis on top of that, and you’ve got a discrimination on top of that, you’re going to get some stenosis on those frame and on those holes in the sides and you might pin some nerves. The fourth most common reason and really the biggest one, in my opinion.

You know, being a specialist physical therapist, and this is one that the MRI won’t find is is something that an expert might find or, or somebody who’s knowledgeable about this, like if you’ve been keeping up with our videos, you probably know about this muscle imbalances.

Anytime you move, if you turn your head, if you look up, look down, if you tip your head, you know that everyday movements that you have to go through where your head moves, those holes on the sides of your spine and the hole in the inside of the spine of your spinal cord goes through.

They also move and they slightly open and slightly close and they grow in size and they shift in order for you to do your everyday movements. And so the nerves that are within those holes have to have adequate space to move around that if you’ve got muscle imbalances, and one of the most common ones in the neck area is where these muscles appear to weak the upper traps. When they’re very weak, the shoulders start to slump down.

And if this goes on for months, years and decades, because of their attachment to the neck bones, they can start to compress the neck bones on top of each other that starts to yank them down. And on the side where the holes are, those holes can start getting smaller the foramen and over time you can get that arthritis the stenosis that pensioners that Ridiculous apathy, all those different diagnosis that somebody gets stared at when they’re looking at their MRI. And all that needs to happen is getting those muscles stronger.

So that we take pressure off the bones, joints, discs, and the nerves. And the, you know, even though your diagnosis of stenosis is there, you get better. We have patients all the time that get better, despite having that diagnosis of stenosis, and the doctor told them, they might need surgery, simply by fixing the muscle imbalances in freeing up the joints and talking a bit about posture and calming down that arthritis problem that dealing with.

Now if you’re looking for how to begin to fix a stenosis problem, I’ve got a video for you linked here in the description. And it’s called the top five ways to keep a cervical stenosis problem from getting worse and avoiding surgery, go check that video out. There’s some exercises and tips in there for you this video here today is intended to show you just what it is explain it so that you have an understanding and so that you’re not afraid of it.

Because that’s the biggest problem that I see with patients here in the clinic is they get that diagnosis and just scared that they’re going to have to have a surgery someday, not the case, I want you to have confidence that it can get better naturally without surgery occasionally need to be on some medications shortly so that you can get through exercise. But a lot of our patients don’t even need that.

They don’t need to be getting injections on a regular basis. It’s possible to fix this and move on with your life, be healthy, active and mobile. And never be relying on any medical interventions or medications.

Hey, if you thought this video was helpful, please give us a like don’t forget to subscribe and turn on your notifications so that you can get notified whenever we release our weekly videos. And drop a comment let us know if you’ve had cervical stenosis for a while and have been able to avoid surgery because I know you’re out there. Leave us a comment.

There are people that are going to watch this video that are that they had that diagnosis, they had the MRI and they’re scared and prove it to them guys, drop a comment on here and let us know that you have not had a surgery. And now there’s a lot of people that have listened to doctors advice way too quick and you know, gotten into the surgical room and have had surgery for stenosis. And you know, some have had good results.

It’s been very important for them. There are definitely situations where since we’re surgery is indicated, you know, if your arm is just constantly asleep in pain, you have some massive weakness, yeah, go get surgery, please, you probably need it. But if you don’t have that, if it’s more of an occasional pain, it can come and go it can be influenced by motion, there are things that make it better than you’ve got a great chance at getting better.

And chances are you might not need the surgery. And there’s people out there that have had this surgery, they’ve had a surgery where they wrote a router the spine, essentially, they clean out the edges of the of the hole to make it bigger to allow more space for the nerve where they go in and clip the disc. That’s another one I diskectomy and they end up worse sometimes and it’s really an unnecessary surgery in many cases.

So just be careful, get a second opinion, do your due diligence and make sure that a surgery is right for you before you pull the trigger because this particular diagnosis can get better without surgery. Hey guys, I hope this video was helpful and I will talk to you next time. Be safe. Stay healthy.