Neck pain that won’t quit?
Tingling in your arms or hands?
Feeling off balance or stiff in your legs?
Cervical Spinal Stenosis: Causes, Symptoms & Treatments in London
These may be signs of cervical spinal stenosis — a condition I see frequently at my spine clinic in London.
The good news?
Most cases can be managed without surgery — when diagnosed early and treated right
In this guide, I’ll walk you through what cervical stenosis is, how to identify it, how we Your spine is made of bones stacked on top of each other — these are your vertebrae.
Running through the center of this stack is a hollow space, like a tunnel — this is called the spinal canal. Inside that tunnel runs your spinal cord, which connects your brain to your body.diagnose it, and most importantly — how we treat it.
What Is Cervical Spinal Stenosis?
In a healthy spine, the canal is wide enough for the spinal cord to pass through freely.
But sometimes, especially with age or wear and tear, the space inside that canal gets smaller.
Bone can overgrow, discs can bulge, and ligaments can thicken — all of which start to press on your the spinal cord.
When this happens in your neck (the cervical spine), it’s called cervical spinal stenosis.
Imagine threading a thick rope through a wide pipe. Now slowly squeeze the pipe.
The rope doesn’t move as freely — and anything it connects to starts to feel off.
That’s what happens when your spinal cord gets compressed in the neck.
As a result, you might feel:
- Stiffness or pain in your neck
- Tingling or weakness in your hands
- Trouble walking or balancing
- Not able to use your hands and fingers
- Dropping things or items falling off your hand
Common Symptoms of Cervical Stenosis
Many patients don’t realise their neck pain is just the tip of the iceberg.
Here’s what most of them report:
- Neck stiffness or pain that feels worse when looking down or up
- Tingling or numbness in arms, hands, or fingers
- Weak grip or difficulty doing fine motor tasks (e.g. buttoning a shirt)
- Imbalance while walking — sometimes subtle at first
- Heavy legs or difficulty walking long distances
- In severe cases: trouble with bladder or bowel control (a red flag)
Note: Cervical stenosis often starts slow and builds up gradually. It’s not always painful — but the nerve symptoms can become disabling over time.
Why Cervical Spinal Stenosis Affects the Legs Too?
This surprises many patients — but here’s why:
Your cervical spine houses the spinal cord, which sends signals to your entire body below your neck.
So when the spinal cord itself is compressed (not just the nerve roots), it can affect:
- Your arms and hands (first to show symptoms)
- Your trunk and legs — leading to heaviness, stiffness, or walking problems
💡 Think of the spinal cord like a central cable. If it’s pinched high up, everything it connects below that point can be disrupted.
What Causes Cervical Spinal Stenosis?
Most cases are degenerative — meaning they develop as we age:
- Disc wear and tear (degenerative disc disease)
- Bone overgrowth (osteophytes) that crowd the spinal canal
- Thickened ligaments (ligamentum flavum hypertrophy)
- Ligaments that connect the spine turn into bone as age advances
- Previous neck injuries or disc herniation in the neck that leads to scar formation
- In rare cases: tumours or congenital narrowing of the canal
How I Diagnose Cervical Stenosis in My London Clinic?
Mangattil Rajesh
I am one of the best spinal surgeons in London and the Head of the Department of Complex Spine Surgery at The Royal London Hospital. With 3 advanced Fellowships in Complex Spine Surgery, I’ve dedicated my life to helping those who suffer from Back pain and Neck pain.
Your health and well-being are at the heart of everything I do. Together, we’ll find the best path to recovery.
I understand the need for flexible consultation options and urgent professional advice. Whether you prefer an online session from the comfort of your home or an in-person visit at the clinic, I accommodate your needs, ensuring you receive the best possible care.
As a spine surgeon, I rely on your detailed history , clinical examination, and imaging.
1. Detailed History
We’ll discuss your:
- Neck and Arm Pain
- Walking pattern
- Hand weakness
- Coordination
- How it’s affecting your daily life
2. Clinical Examination
I’ll assess your:
- Walking pattern
- Assess your Balance
- Test your Tendon Reflexes
- Muscle strength in your arms and legs
- Grip control
- Analyse your Gait
- Sensory response in hands and legs
3. MRI Scan for Cervical Stenosis
MRI is the gold standard. It shows:
- The extent narrowing of the spinal canal
- Whether the spinal cord or nerves are compressed
- Any signs of myelopathy (cord damage)
In some cases, I may order X-rays to check spine alignment or CT scans if we need to assess the bony structure more clearly.
Can Cervical Stenosis Be Treated Without Surgery?
Yes — especially in mild to moderate cases.
Here’s what usually works:
- 🧘 Physiotherapy: To improve posture, strengthen neck and back muscles
- 💊 Medications: Anti-inflammatories, neuropathic agents, short-term muscle relaxants
- 💉 Spine Injections: Cervical epidural steroid injections can reduce inflammation and create more space for the spinal cord
- 🧠 Lifestyle Adjustments: Ergonomic desk setup, posture retraining, neck positioning tips
Most patients feel relief within 4–6 weeks when treatments are consistent and well directed.
It is the combination of the Spine steroid injection and physiotherapy that offers lasting pain relief and rapid return of function
When Is Surgery for Cervical Stenosis the Right Option?
I typically recommend surgery if:
- Failure of Conservative management – Physiotherapy and Steroid injections
- Neck and Arm Pain lasts more than 6-8 weeks
- Worsening Arm pain and Numbness
- There is progressive weakness or loss of function
- MRI shows clear disc herniation causing pressure on the nerve
- Pain significantly affects sleep or quality of life
Surgical Options I Offer in London
I typically recommend surgery if:
- Failure of Conservative management – Physiotherapy and Steroid injections
- Neck and Arm Pain lasts more than 6-8 weeks
- Worsening Arm pain and Numbness
- There is progressive weakness or loss of function
- MRI shows clear disc herniation causing pressure on the nerve
- Pain significantly affects sleep or quality of life
Common Surgical Procedures for Cervical Stenosis
1. ACDF (Anterior Cervical Discectomy & Fusion)
- Single or Multiple levels as required
- Removes Bone or disc pressing in the spinal cord
- Relieves pressure on the nerve
- Then the two bones are fused together
2. Posterior Cervical Decompression and Fusion
- Single or Multiple levels as required
- Removes Bone pressing in the spinal cord from the back of the neck
- Relieves pressure on the nerve
- Then the two bones are fused together with rods and screws
All surgeries are minimally invasive whenever possible — allowing faster recovery and better long-term outcomes.
Most patients go home in 2 days and return to work within 8–10 weeks
Cervical Stenosis Treatment Recovery Timeline
My Advice to You:
Cervical spinal stenosis can be scary — especially when your arms feel weak or your walk feels off.
But with early diagnosis and the right care, you can avoid long-term damage and reclaim your mobility.
Whether you’re just noticing symptoms or have been dealing with them for months, the right step now can prevent surgery later.
📞 Book a Consultation
- 📞 WhatsApp available 24/7
- 📅 Book online in less than 60 seconds
- 🩺 In-person or online consultations available
…… and don’t wait for it to “go away.”
5 Star Patient Reviews
JolitaV
Mr Rajesh was excellent and I count myself very fortunate that he is my consultant surgeon. I could not have asked for a more courteous and professional experience. I could not fault anything. Mr Rajesh was very professional he explained everything in detail on all my visits. From initial consultation to post op Mr Rajesh took care of everything.
Eloise Morse
Mr Rajesh is the best spine surgeon I have seen and I wouldn’t hesitate to recommend him. I have had chronic issues with my pelvis and lumbar spine for years but was referred to Mr Rajesh for a disc herniation in my neck. His care was faultless. He is technically excellent with brilliant, practical advice beyond just surgical solutions. Read more…
Terri Spires
When it became necessary to have a discectomy decompression in my lower spine Mr Rajesh explained the procedure very clearly and in a way I understood, he is very good at putting your mind and nerves at ease. Mr Rajesh is an excellent surgeon who cares for his patients and goes the extra mile. I wouldn’t hesitate to recommend him to anyone.
Cervical Stenosis FAQs – Answered by Dr. Rajesh
- If untreated, it can lead to spinal cord damage (myelopathy).
- This can lead to weakness of your legs and arms reducing your mobility and independence.
- Early treatment is key.
- Not always. Many mild cases improve with:
- Posture correction
- Regular physiotherapy
- Medications as required
Yes. Compression of the spinal cord can affect walking and coordination.
Symptoms may worsen over time and become irreversible.
The sooner it’s treated, the better your outcomes.