Cervical Stenosis: Causes, Symptoms, and Exercises to Relieve Pain

When you think of your spine, you might picture your lower back. But your cervical spine, which starts at the base of your skull and works its way down to the top of your back, is important too. “The cervical spine gives your neck its full range of motion and allows you to turn your head, look up or down, and sit and walk comfortably,” points out Mary Kimbrough, PT, DPT, a physical therapist at Hinge Health.

If you have cervical stenosis — a narrowing of your spinal canal — it can be harder to do all of these things. But it’s far from impossible. In fact, neck exercises and stretches, along with physical therapy, can help you regain function and mobility so you can move your neck through its full range of motion again without pain, says Dr. Kimbrough.

Here’s a closer look at cervical stenosis: what it is, what causes it, and exercises recommended by our Hinge Health physical therapists so that you can find relief.

What Is Cervical Stenosis?

Cervical stenosis refers to changes in your cervical spine. “It happens when your neck vertebrae — the bones that protect your spinal canal — narrow, which compresses the nerve roots of your spinal cord,” explains Dr. Kimbrough. While stenosis can happen anywhere in the spine, the two most common areas are your neck (cervical stenosis) and lower back (lumbar stenosis), she adds.

You can have cervical stenosis and not know it. In fact, research suggests it’s present in almost 20% of people, most of whom don’t have any symptoms. “It’s very common in people over the age of 50,” Dr. Kimbrough adds. But as cervical stenosis progresses, it can pinch your spinal cord. Since your spinal cord contains nerves that power your arms and legs, this can make it harder for you to do daily activities like walking and dressing yourself.

Symptoms of Cervical Stenosis

Here are some of the most common cervical stenosis symptoms:

• Neck pain. This is usually the top symptom. But keep in mind that up to 70% of all people experience neck pain at some point, so it can be hard to tease out if yours is due to cervical stenosis.

• Numbness, tingling, or weakness in your neck that may extend into your arms. You may find it more challenging to do tasks like button a shirt, turn a doorknob, or open a jar.

• Problems with walking. It may be hard to keep your balance, and you may start to fall more frequently.

• Bladder or bowel incontinence. 

Causes of Cervical Stenosis

There are a few different reasons you may develop cervical stenosis. Here are some common causes of it:

• Disc changes. As you get older, it’s normal for the discs between the vertebrae of your cervical spine to become less spongy and lose some water content, explains Dr. Kimbrough. As a result, they can bulge into your spinal canal a bit more and irritate a nerve or sensitive structure.

• Bone spurs. Arthritis, such as osteoarthritis or rheumatoid arthritis, may cause extra bone to grow on your spine. While this doesn’t always cause symptoms, that extra bone may push into your spinal canal and cause irritation.  

• Thick ligaments. Ligaments, the connective tissue that holds your spinal bones together, can stiffen and thicken over time and push into your cervical spinal canal.

• Genetics. Some people are just born with shorter than average pedicles — the bones that make up both sides of your spinal canal, says Dr. Kimbrough. As a result, they’re more prone to cervical stenosis.

• Past injury. If you’ve had a cervical spine injury in the past — for example, you hurt your neck in a car accident — you may be more prone to stenosis later in life.

The above cervical stenosis exercises are recommended by Hinge Health physical therapists to help relieve pain and stiffness.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Cervical Stenosis Treatment Options

If you learn that you have cervical stenosis, you might automatically assume that you need to be rushed into surgery. But the truth is, mild cases can often be managed effectively at home with conservative treatment. Here’s how: 

• Physical therapy. Movement is medicine, which is why physical therapy is an effective treatment for cervical stenosis as it helps in managing pain and improving function without the need for surgery. Through targeted exercises, a physical therapist can help you strengthen your neck muscles, enhance flexibility, and improve range of motion. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

• Stay active. Many people with cervical stenosis avoid activity. “Exercise can help lubricate stiff joints and take pressure off compressed nerves in the area. This will help improve pain and function,” says Dr. Kimbrough. In fact, exercise therapy is the first line treatment recommended for all adults with neck pain. You can start with some of the exercises mentioned above. These will help strengthen and stretch tight muscles in your neck, trunk, and arms. Additionally, low-impact activities like walking, biking, and swimming can keep you fit and improve circulation, which boosts blood supply to your cervical spine and helps reduce pain. 

• Tweak your sitting position. When you sit at a desk, it’s natural to shrug and round your shoulders forward. This can put strain on your cervical spine. Instead, try to sit straight, with your shoulders down and your computer at eye level. Also take movement breaks as much as possible, advises Dr. Kimbrough. “Try to stand up and walk around every 30 minutes or so, or at least do some stretches at your desk,” she recommends.

• Medications. There are several over-the-counter medications you can use to relieve pain, including acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil) or naproxen (Aleve). It’s important to make sure, based on your medical history, that you are safely able to take these medications.

• Hydrate. The discs in your cervical spine require fluid to stay healthy, points out Dr. Kimbrough. Make sure you drink plenty of water to stay hydrated. Aim to drink half your body weight in ounces of water each day. (That means a 150-pound individual would want to drink 75 ounces.) 

• Use ice or heat. Ice can help turn down inflammation, while heat brings nourishing oxygen and other healing nutrients to the area. “Most people with neck pain tend to respond better to heat,” says Dr. Kimbrough, but both ice and heat are effective. Use whichever one feels best for you. 

• Massage. People with chronic neck pain — one of the main symptoms of cervical stenosis — who got a weekly massage for six weeks reported improvements in discomfort, especially when it was combined with exercise therapy, according to a 2020 study published in Musculoskeletal Science & Practice. Acupuncture has been shown to help, too. 

You can often manage mild symptoms of cervical stenosis at home, says Dr. Kimbrough. But if you begin to experience weakness, numbness, or tingling in your arms or legs, loss of bladder or bowel control, or notice a change in balance, see your doctor right away to determine if you need further intervention. 

PT Tip: Try a DIY Neck Roll

A neck roll, sometimes called a cervical pillow, is a supportive pillow designed to maintain the natural curve of your cervical spine while you sleep. Instead of buying one, try making your own. Roll up a hand towel or T-shirt and stick it in the bottom of your pillow case. “The towel roll will support the curve of your neck to help improve pain and discomfort while you sleep,” explains Dr. Kimbrough. You are also more likely to find a better fit at home than with a store-bought version that is too big or stiff.

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program. 

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you. 

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you. 

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here. 

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Dean, C. L., Lee, M. J., & Cassinelli, E. H. (2007). Incidence of Cervical Stenosis: Radiographic and Anatomic. Seminars in Spine Surgery, 19(1), 12–17. doi:10.1053/j.semss.2007.01.003

2. Sinnott, P. L., Dally, S. K., Trafton, J., Goulet, J. L., & Wagner, T. H. (2017). Trends in diagnosis of painful neck and back conditions, 2002 to 2011. Medicine, 96(20), e6691. doi:10.1097/md.0000000000006691

3. Skillgate, E., Pico-Espinosa, O. J., Côté, P., Jensen, I., Viklund, P., Bottai, M., & Holm, L. W. (2020). Effectiveness of deep tissue massage therapy, and supervised strengthening and stretching exercises for subacute or persistent disabling neck pain. The Stockholm Neck (STONE) randomized controlled trial. Musculoskeletal Science and Practice, 45, 102070. doi:10.1016/j.msksp.2019.102070

4. Isaac, Z. (2024, January 12). Management of Non radicular Neck Pain in Adults. UptoDate. Retrieved from https://www.uptodate.com/contents/management-of-nonradicular-neck-pain-in-adults?topicRef=4820&source=see_link 

5. Levin, K. (2024, May 13). Cervical Spondylotic Myelopathy. UptoDate. Retrieved from https://www.uptodate.com/contents/cervical-spondylotic-myelopathy