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Foraminal Stenosis — What is It?

Author:  
Deuk Spine Web Team
An expert in all things spine, Dr. Deukmedjain is a board certified neurosurgeon who has performed thousands of minimally invasive surgeries and procedures including the revolutionary Deuk Laser Disc Repair and the Deuk Spinal Fusion. 

Foraminal StenosisForaminal stenosis refers to the narrowing or tightening of the spaces between your spine bones. These tiny openings are known as the foramen. Foraminal stenosis is a particular type of spinal.

If you or someone you love is experiencing any of the following symptoms outlined in this article, it’s time to get a FREE Consultation and MRI Review with the Deuk Spine Institute. We can help relieve your pain and get you back to living life without limitations!

The foramen is where nerves travel from your spinal cord to the rest. Pinching nerve roots can occur when the foramen is too close to the body. A pinched nerve could lead to Radiculopathy, which is pain, numbness, and weakness in the area the nerve serves.

Pinched nerves and foraminal stenosis are very common. In fact, almost half of all middle-aged and older people suffer from spinal stenosis or pinched nerves. Not everyone suffering from foraminal stenosis will have symptoms. There may be symptoms that change over time.

While you can’t prevent foraminal stenosis from happening, staying active and maintaining a healthy body weight can reduce your chances. Your back can be protected by using good posture and technique while sitting, moving around, lifting heavy objects, or playing sports. Injury can cause stenosis or pinched nerves.

Tips to identify

Foraminal stenosis can cause pinched nerves in different parts of the spine.

Cervical stasis occurs when the foramen of the neck is narrow. Pinched nerves can lead to a sharp, burning sensation in the neck that travels down your arm and shoulder. You may feel numb and weak in your arm or hand due to “pins and needles.”

Thoracic Stenosis occurs when the foramen in the upper part of your back narrows. This can lead to pain and numbness radiating to your front. This is the most common area that can be affected by foraminal stenosis.

Lumbar Stenosis occurs when your foramen at the low back narrows. Foraminal stenosis is most likely to affect the lower back section. You may feel tingling, numbness, and pain in your buttock, leg, and foot. Sciatica may be a term that you might have heard to describe this type of pain.

What’s the cause? Who are you at risk?

As you get older, your chances of developing foraminal stenosis or pinched nerves are higher. Your spine can become narrower due to arthritis and daily wear and tear. Stenosis can also be caused by injury, particularly in younger people.

A bulging or herniated disc is one example of foraminal stasis. These cushioning discs between your spine bones can become loose or damaged. The foramen and nerve roots are pressed by the bulging disk. This is most likely to occur in your lower back.

Your nerves can be pinched by bone growths around and in your foramen. Bone spurs can form from injury or degenerative conditions such as osteoarthritis.

There are also other causes, less commonly known as foraminal stenosis.

  • An increase in the size of the ligaments around your spine
  • spondylolisthesis
  • Cysts and tumors
  • Paget’s Disease is a bone disease
  • Genetic conditions such as dwarfism

How can it be diagnosed?

Your doctor should be consulted if you feel pain radiating down your arm or leg, or if you experience numbness lasting several days.

Your doctor will begin with a physical exam at your appointment. Your movement, muscle strength, and level of pain, as well as your reflexes, will be checked by the doctor at your appointment.

To confirm your diagnosis, your doctor might order imaging scans or other tests.

  • X Rays are used to determine the alignment of your spine bones and the narrowing of your foramen.
  • MRI scans are able to detect soft tissue damage, such as disks and ligaments.
  • CT scans are more detailed than X-rays and allow your doctor to see bone spurs around the foramen.
  • Electromyography is combined with nerve conduction Studies to determine if your nerves are functioning properly. These tests will help your doctor determine if your symptoms may be caused by pressure on the spinal nerve roots, or another condition.
  • Bone scans are able to detect arthritis, fractures, and infections.

Grading

Your doctor or the radiologist reading your MRIs can gradeTrusted Source your foramen’s narrowing.

  • Grade 0 = No foraminal Stenosis
  • Grade 1 = Mild stenosis without any evidence of physical changes in nerve root
  • Grade 2 = Moderate stenosis without any physical changes in the nerve roots
  • Grade 3 = Foraminal Stenosis with nerve root collapse

What treatment options do you have?

There are many treatments that can be used to relieve your pain, depending on the severity and cause of your foraminal stasis or pinched nerves.

In many cases, pinched nerves, especially in the neck, will heal with no other treatment than stretching, activity modification, and pain-relieving medications.

Modification of activity

You may need to rest for a few more days if you feel radiating pain, numbness, or weakness caused by a pinched nerve. You should not be idle for too long as your symptoms could worsen. Sharp pain should be avoided, but it is important to not remain motionless. You may find that cold packs are helpful for pain relief in the beginning, and then warm packs or a heating pad can be used to ease it over time.

Physical therapy

Stretches and specific exercises can help stabilize your spine and increase your range of motion. They also open up space for your nerve roots. To prevent further damage, strengthen the muscles that support your spine. Weight loss can reduce pressure on your spine and nerve roots.

Orthotics

Your doctor might recommend that you wear a neck brace, or soft cervical collar if you have a pinched nerve. This will restrain your movements and allow your neck muscles to rest.

You should only wear it for a brief time as too much can cause damage to your neck muscles. You will be provided with details by your doctor about when and how long to wear it. Doctors generally do not recommend wearing any type of back brace for pinched nerves in your low back.

Medications

There are many types of medicine that can be used to relieve your pain.

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) — Medicines such as Aspirin (Bufferin), Ibuprofen, and naproxen may help to reduce inflammation and provide pain relief.
  • Steroids — Oral corticosteroids like Prednisone (Deltasone) may ease pain by decreasing inflammation around the nerve. To relieve pain and inflammation, steroid injections can be made near the nerve.
  • Narcotics — If you are experiencing severe pain and have tried all other options, your doctor might prescribe narcotic pain relief. These drugs are usually only used for a brief time.

Surgery

Your doctor and you may decide to have surgery if conservative treatments fail to alleviate your symptoms. The exact type of surgery you choose will depend on where the stenosis is located and the cause. Surgery to remove a bulging disk that has herniated may be an option if it is pinching your nerve roots.

Another option is foraminotomy, which is a minimally invasive procedure. This procedure expands the area through which the nerve flows by removing any obstructions like bone spurs from the foramen.

Are complications possible?

Sometimes foraminal stenosis may be accompanied by stenosis in the spinal column. The symptoms of spinal cord compression can be worse than those caused by pinched nerve roots.

These symptoms could include:

  • Clumsiness
  • Trouble using your hands
  • Walking is difficult
  • Weakness

What’s the outlook?

At-home treatment will provide relief for the majority of people suffering from foraminal stenosis. Surgery is not always necessary. Sometimes your symptoms may return even after they have been gone for weeks or years. Your pinched nerve pain should be gone if you follow your doctor’s recommendations for physical therapy and activity modification.

 

The Deuk Spine Institute encourages and welcomes you to contact us today regarding any questions or concerns you may have about your current situation… 

​​If you or someone you love is experiencing any of the preceding symptoms outlined in this article, it’s time to get a FREE Consultation and MRI Review with the Deuk Spine Institute. We can help relieve your pain and get you back to living life without limitations!

 

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