Some degree of spinal stenosis (narrowing) occurs with age, with all of the structures of the spine changing over time. Whether or not these changes will result in symptoms from pinched nerves, spinal cord compression, or blood vessel occlusion or damage depends on the anatomy of each individual.
Those born with an initially narrow spine, short pedicles, narrow foramina or shallow vertebra, for example, may be more likely to experience neck pain, back pain and other symptoms with relatively little additional age-related spinal narrowing. Others, blessed with more room in the spinal canal may have a lot of spinal stenosis before this impacts the nerves and triggers symptoms.
Indeed, some people have spinal stenosis in the neck, thoracic spine, or lumbar spine without even knowing it because they remain asymptomatic their whole lives. This stenosis may show up in routine scans for another condition but unless the narrowing of the spine becomes problematic there is usually no need to intervene.
Reduced Vertebral Height in Older Adults
The most common site of spinal stenosis is in the lumbar spine at segments L4/5 as this is a highly mobile area of the spinal column. The least likely area for spinal stenosis is the T5/6 junction as this has the lowest mobility and, thus, the least degree of degeneration through wear and tear. In one study, those in their 70’s old had significantly reduced vertebral height compared to those in their 40’s but, interestingly, spinal canal diameter did not change signficantly with age, suggesting a vertical stenosis rather than a lateral/horizontal stenosis caused by age.
Preventing Neck Pain
As the neck is a highly mobile area of the spine it is important to keep an eye on posture, general health, bone health, and safety as concerns the spinal structures. The neck is subject to whiplash effects, stress and tension in the shoulders, mechanical injury through intensive labor, and chronic stress from simply having your computer screen at an angle that is less than ideal.
Of course, there are a number of things that can help reduce the degree of degeneration in the spine as we age, such as quitting smoking, staying hydrated, eating well (including foods that can lower inflammation) and getting regular, load-bearing exercise to keep bones, ligaments, and the spinal discs healthy. Certain drugs can affect bone turnover and the health of connective tissue and these may have cumulative effects over a lifetime of use, leading to increased spinal stenosis. Steroids, for example, affect the healing of bone and natural bone turnover, while some non-steroidal anti-inflammatories also affect bone growth (which is why they are often ill-advised after spinal fusion procedures).
Most neck pain is short-lived and unproblematic but where neck pain becomes a daily issue it is important to figure out the cause and take preventative and corrective action. Not only will this help in the short-term, it may also slow down age-related cervical spinal stenosis and stave off future problems.
Kim KH, Park JY, Kuh SU, Chin DK, Kim KS, Cho YE. (2013). Changes in spinal canal diameter and vertebral body height with age. Yonsei Med J. 2013 Nov 1;54(6):1498-504.