Neck Pain Support Blog

What is Stenosis?

Stenosis is basically a closure of a nerve pathway; in other words a hole the nerve travels through.  The central nervous system starts with the brain and spinal cord.  Messages come down from the brain, travel down the spinal cord, and out nerve roots, that branch into smaller and smaller nerves, and communicate to the rest of the body.

The cord travels down the spinal column and gives off nerve roots that exit the spine on each side.  Here's the two different kinds of that closure.

Foraminal stenosis - due to arthritis, bulged or herniated disc, and inflammation, we get a closure of that space where the nerve runs.  We call this for foraminal stenosis.  This could be on one or both sides.  Typically you have degeneration, or a disc more on one side than the other.

Spinal stenosis - the vertebrae have an opening in the back side allowing the spinal cord to travel down. Nerves originate from the cord and exit the cord on either side.  If you cut the cord, everything below will be compromised. A disc that moves straight posterior can create spinal stenosis.  The typical is the disc irritation in combination with inflammation and degeneration.

When stenosis happens, it's usually a severe level of degeneration.  This is the phase IV of degeneration we had talked about in the past.  This breakdown or arthritis doesn't really reverse itself so if the stenosis is primarily due to arthritis then surgical intervention is sometimes needed.  If it's primarily disc or inflammation then there are many other options for relief.

Additional Reading:

• Pain Relief Solutions for Headaches of All Kinds
• What does a C5, C6, C7 or C8 cervical radiculopathy look like?
• Cervical Traction to Help with Stenosis and Neck Pain
• What are the similarities and differences between stenosis and arthritis?
• Painful trigger points and how to deal with them
• Neck and Shoulder Pain Treatment Solutions

 

In Rememberance, 

Success is Liking YourSelf.

Liking What You Do,

and Liking How You Do It.

- Maya Angelou

What Is Cervical Brachial Syndrome?

Cervical Brachial Syndrome is diagnosed when someone has neck and/or arm pain originating from the brachial plexus.  The brachial plexus is a group of nerves located in the in the region between the neck and shoulder on each side.  This group of nerves send signals to the shoulder, arm and hands.  The nerve roots that start this plexus of nerves are C3, C4, C5, C6, C7, and C8 + T1.  Next these roots branch into trunks, divisions, and cords. See the diagram below.

 This area can typically be injured when it gets pushed into a hyper stretched position.  An example would be a fall, car or motorcycle accident, and even the birthing process. To hyper stretch the brachial plexus, the shoulder must be pushed down while the head is tilted away. 

 The radial, ulnar, and median nerve originate from this plexus.  Nerves travel all the way to the hands with the radial nerve innervating your 1st 3 fingers and the ulnar nerve innervating your ring and pinky fingers.  The ulnar nerve is essentially your funny bone.  This nerve travels through a notch in your elbow created by your medial epicondyle.  When you hit you elbow and get pain, we call this the "funny bone".

 Here are the types of injuries to the brachial plexus:

 

1. An Avulsion - this is when the nerve is pulled from the cord
2. A Rupture - this is a stretch to the point of tearing
3. Neurapraxia - this is when it is stretched but not torn (still attached) 4. Axonotemesis - in this case the axon of the nerve is severed
4. Neurotomesis - the nerve is divided or separated
5. Neuroma - this is a tumor in the region

 

 "Okay, so I have a brachial plexus injury; how can I get rid of the neck and arm pain?"

 Really what we need to do is help facilitate the healing.  At the root of this is to reduce inflammation and take pressure  off of nerves.  These nerves not only communicate to vital organs of the body but go to the muscles, tendons, and ligaments.

 At the heart of this is to increase motion and align the spine.  Allowing motion helps for inflammation to dissipate.  It is inflammation that puts pressure on the nerves.  Putting the spine back in alignment gives the nerves the best chance for free and clear motion.  To make a long story short, nerves free of pressure, means the body can function like it should...

Additional Reading:

• Best Pillow Recommendation for Neck Pain
• Neck and Arm Pain: Cervical Brachial Syndrome
• Products to Help Improve Posture
• What to do when you have neck and shoulder pain
• Waking up with a stiff neck

Related articles

I Cannot Get Rid of the Tingling in my Last Two Fingers, What Could This Be?

They Told Me I Have Cervical Radiculopathy. What Is That, It Sounds Really Bad?

Which Doctor Do I See for My Neck Pain?

Here's a list of the doctors you might consider when dealing with your neck pain:

First, you want to lean toward the more natural treatments.  These might include seeing your Chiropractor or Acupuncturist.  Most of the ones who do acupuncture seem to be doctors.  Seeing a massage therapist isn't a bad idea either and the typically are not doctors.

 Most of us will often try the over the counter remedies as well.  If you do, pair that with some all natural remedies to... Maybe using some ice or heat at home.  A massage gel or spay (they even have a roll-on now), can give relief also.  A neck pillow can be another great pain reliever.

 After you've tried natural remedies and there was little to no relief, call the doctor.  Typically, you first will see your primary care doctor.  Or, if you feel this is truly a musculoskeletal issue (involves muscles or the bones), you should contact your Chiropractor.  This is also a more natural treatment because prescription medicine will not be used.

 Your primary care doctor may give you a short term prescription but may also refer you to an orthopedic doctor, neurologist, osteopath, rheumatologist, physiatrist, pediatrician, chiropractor (if you haven’t gone already), or the physical therapist (not a doctor but are often utilized in these cases).

 Let’s talk about the above doctors.  Of course if you have an issue that you are worried could be more serious such as a heart attack, stroke, cancer, or something of the like – call 911 or go to the E.R. (Emergency Room).

 

• Orthopedist – these specialists of deal with spine or bone issues.  Not everyone does surgery (orthopedic surgeon), but may use more specific medications such as injectable medication for pain relief and reducing inflammation to a specific area.
• Neurologist – these doctors are focused more on the nervous system; so if the source of your pain seems to be here more then you’ll want to see the neurologist.  Same thing goes as above; the neurosurgeon may do surgery but your neurologist may treat with medication your primary doctor doesn’t use.
• Osteopath – similar to the Chiropractor but he may mainly treat with medication.  Your primary care doctor may even be an osteopath.  Some may do a certain amount of manipulations but many solely use prescriptions.    
• You may get sent or go to your rheumatologist – this is mainly because you either have an inflammatory arthritic condition or one is suspected.
• The physiatrist is much like the physical therapist but is a doctor and can prescribe.  Their  focus will be on musculoskeletal conditions, rehabilitation, and pain medicine.
• Pediatrician – is typically the doctor one takes their children until adolescence.  Children should not suffer neck pain for an extended period of time.  Please see a doctor right away if your child is suffering pain.  Things like a recent car accident or sports injury can be a culprit.
• The Chiropractor does adjustments to the spine (specific movements to restore movement and free nerves from pressure.  Just like any other doctor on the list, he or she will refer you to another on the list if progress is not seen in a reasonable matter of time.
• I mentioned the physical therapist because many of the above doctors above may work with and/or commonly refer out to one.

 

There you have it, your short list of doctors to help you with neck pain.  Any combination of these docs helps as well. Also don't forget using some natural home relievers like an hot/cold pack,  neck pillow, or pain relief gel, or maybe a home neck stretcher.

Additional Reading:

1. I am not sure what type of pillow I need. Everyone tells me I walk like an old person...
2. Treatment for a Straightened Neck Curve
3. Phases on Degeneration in the Cervical Spine
4. Doing deep tissue massage and trigger point therapy as part of your exercise routine
5. Ouchy...I have a pinched nerve in my neck and shoulders...