Living with Cervical Stenosis: Daily Management Tips

Many people with cervical stenosis (narrowing of the spinal canal in the neck) manage day to day with self-care, sensible pacing and a few changes at home and work. Self-care, medicines and physiotherapy can often relieve the symptoms of mild stenosis.

The most important thing to know is whether the narrowing is pressing on your spinal cord. This is called cervical myelopathy. If it is, a few extra precautions matter, especially avoiding falls and forceful neck movements. You should also report any new symptoms quickly.

This page covers daily life. For medical treatment, see non-surgical treatments and surgical treatments.

Easing neck pain at home

For everyday neck pain and stiffness, the NHS suggests:

• Painkillers: paracetamol or ibuprofen, or ibuprofen gel rubbed on the neck. Check with a pharmacist or GP if you have other health conditions or take other medicines.
• Heat or ice: both are options, so use whichever helps you more.
  • For heat, use a hot water bottle wrapped in a towel for 20 minutes, 2 to 3 times a day.
  • For cold, use a pack of frozen peas wrapped in a tea towel for 5 minutes, 3 times a day.
• Gentle movement: neck flexibility exercises keep the neck moving. The NHS advises against wearing a neck collar for ordinary neck pain unless a doctor recommends one.

These measures ease pain. They don't widen the spinal canal or take pressure off the spinal cord. If the pain lasts more than a few weeks, or painkillers don't help, see a GP. In many areas you can also refer yourself to NHS physiotherapy (MSK services).

Sleep

• Use a low, firm pillow, so your head stays level with the rest of your body.
• Choose a firm mattress.
• Avoid sleeping on your front, and avoid twisting your neck in bed.

Posture, desk work and daily tasks

• Sit upright. Gently roll your shoulders back and bring your neck back.
• Don't hold your neck in one position for a long time. This includes long spells at a desk and tasks that keep your head bent down or tipped back.
• Put a computer screen at eye level.
• Change your daily routine around tasks that bring on pain.
• Pace your activities so you don't overdo it on good days.
• Some people with spinal stenosis find that bending the spine slightly forward eases their symptoms.

Driving

The NHS advises not to drive or cycle if you can't move your neck fully, because you need to be able to check around you safely.

Exercise, lifting and sport

Staying active helps. The US National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) suggests exercising at least three times a week for 30 minutes. Talk to your doctor before you start a new exercise programme.

• Physiotherapy-led exercise: physiotherapy aims to keep the spine moving, strengthen muscles and build endurance. Exercises that strengthen the deep neck muscles and keep your range of movement are commonly recommended.
• If your spinal cord is compressed: exercise should be supervised. A clinical review warns that relying too long on physiotherapy can delay surgery that a person needs.
• Contact sports and high-risk activities: avoid these if you have myelopathy. A fall or blow can injure the spinal cord.
• Weights and heavy lifting: ask your specialist or physiotherapist what is safe for you, particularly if you have myelopathy or have had surgery. After surgery, avoid heavy lifting or strenuous activity until you're told it's safe.

Neck manipulation and massage

If the spinal cord is compressed, avoid forceful or rapid neck movements done to you by someone else. Tell anyone who treats your neck that you have cervical stenosis, including chiropractors, osteopaths and massage therapists. Check with your specialist first.

Preventing falls

Cervical myelopathy can affect balance and walking. Untreated, it can make walking unsteady and raise the risk of falls. In someone with a narrowed canal, a fall can injure the spinal cord. To lower the risk:

• Use a walking aid if you feel unsteady.
• Take care on stairs and uneven ground.
• Tell your doctor about any new unsteadiness.

Weight and smoking

Keeping to a healthy weight and stopping smoking are part of NIAMS's self-care advice for spinal stenosis.

Keeping track of your symptoms

Cervical stenosis can get worse over time without treatment. Surgery is usually considered when symptoms steadily worsen, to help prevent lasting nerve damage. It is not usually urgent, so there is time to discuss your options.

Keep your follow-up appointments, and tell your doctor promptly if you notice any of these:

• new clumsiness in your hands, or trouble with buttons, pens or cutlery
• numbness, tingling or weakness in your arms, hands or legs that is new or getting worse
• unsteady walking, loss of balance or falls
• bladder or bowel problems

Pins and needles in the arm, or neck pain that lasts more than a few weeks, are also reasons to see a GP. There's more on emergency warning signs on the symptoms and diagnosis page.

Outlook

Mild cervical myelopathy doesn't affect life expectancy, although symptoms can affect quality of life. Severe or untreated cases can cause permanent nerve damage, so keep up regular follow-up.

Related pages

• Emotional and mental health
• Surgery recovery and aftercare
• Causes and risk factors