Neck pain What is Spinal Stenosis
The cervical spinal canal narrows due to cervical stenosis. This spinal canal constriction may cause compression of the spinal cord and/or nerve roots, impair the function of the spinal cord or nerve, and result in cervical radiculopathy or cervical myelopathy symptoms.
Spinal stenosis can originate from degenerative changes in the cervical spine known as spondylosis, but it can also be brought on by trauma (fractures and instability), inflammatory diseases, herniated discs, or tumours.
Neural components often have enough area in the cervical spinal canal. With height and between individuals, the spinal canal's sagittal diameter varies. The spinal column's first cervical vertebral body (C 1) measures about 21.8 mm in height.
At all levels, the average anterior-posterior canal diameter is 14.1 +/- 1.6 mm.
With a median diameter of 14.4 mm, the canal diameters range from 9.0 to 20.9 mm.
Men's cervical spinal canals are considerably larger than women's at all levels.
Often, stenosis is the second-order effect. The typical lesions that take up space, for example:
The production of ventral spondylophytes, progressive disc degeneration with disc protrusion, and thickening of the ligaments flavum
increased size of the dorsal facets.
The spinal canal and cord's diameter are influenced by movement:
In flexion and extension, the spinal canal's diameter decreases.
The ligamentum flavum folds during extension, significantly narrowing the spinal canal.
The spinal cord's length is influenced by changes in the spinal canal's size as well. For instance, the spinal cord's shortening in extension is associated with an increase in diameter and can suffer further harm from movement. It is compressed between the lamina or ligamentum flavum of the caudal segment and the pincers of the posteroinferior end of one vertebral body.
Many ideas about the pathophysiology of spinal stenosis propose several interrelated mechanisms:
Osteophytic bones and ligamentous hypertrophy can directly compress the spinal cord.
The spinal cord may become ischemic due to local vascular compression, arterial insufficiency, and venous stasis.
Particularly in the unstable spine with many degrees of subluxations, a herniated disc can cause repeated local trauma to the spinal cord or nerve root during repetitive flexion and extension movements.
Segments C5–6 and C6-7 of the cervical spine are frequently impacted.
Nonoperative treatments, such as physical therapy management, are aimed at reducing pain and increasing the patient's function. Nonoperative treatments do not change the narrowing of the spinal canal but can provide the patient of long-lasting pain control and improved function without surgery. A rehabilitation program may require 3 or more months of supervised treatment.
Programs for physical therapy could include:
Exercises for stretching the muscles of the neck, trunk, arms, and legs are meant to improve their flexibility.
Manual therapy involves adjusting the cervical and thoracic joints to maintain or enhance the range of motion.
Heat therapy can help the muscles and other soft tissues by promoting better blood flow.
Cardiovascular leg and arm workouts will increase the patient's cardiovascular endurance, improve blood flow, and support healthy physical conditioning.
Exercises in the water: to relieve pressure on the spine while moving your body.
The activity of daily living (ADL) and functional mobility training.
Exercises and methods that could ease spinal stenosis symptoms and stop the problem from getting worse include:
For the arm, trunk, and leg muscles, there are specific strengthening exercises.
Stretching
Retraining your posture stabilised scapula;
Ergonomics and regular position changes to prevent prolonged positions that compress the spine;
Make arrangements in advance to take rests between potentially stressful activities for your back, such as walking and yard work;
Appropriate pushing, pulling, and lifting.
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