At each level of the spine, a pair of nerve roots run through the spinal column through two openings called the foramina. The foraminal canal is the exit for nerves that leave the spine and travel to the extremities. Foraminal narrowing or foraminal stenosis occurs when the nerve roots have a reduced space to function within. If a nerve root is disturbed or compressed by this narrowing, it can cause pain, tingling, numbness, or weakness in the muscle group activated by the nerve that is being compressed.
What is Foraminal Stenosis?
Foraminal narrowing is a spine condition where the spinal nerve is compressed. Age is the most frequent cause of foraminal stenosis because the vertebrae and the intervertebral discs that separate them break down after years of continued use. The different forms that this degeneration takes affects one or both sides of a vertebral segment. When a disc that slips out of the place it normally occupies (bulging disc), or the disc tears or breaks and the inner disc fluid leaks into the spinal canal (herniated disc), or bones develop projections in response to joint damage (bone spurs), foraminal narrowing can occur as a result. Spinal injury and degenerative disc disease are also known to produce stenosis in the foraminal canals, along with arthritis, ligament thickening, and facet joint enlargement. Spinal injuries that result from trauma can hasten this process, i.e. injury resulting from repetitive movements over time, or carrying too much excess body weight.
Symptoms of Foraminal Stenosis
The pain and symptoms associated with foraminal stenosis can be localized around the nerve root affected, or the pain may travel through the nervous system along the path of an affected nerve root. Stenosis of the cervical (neck) spine causes pain, tingling, muscle weakness and numbness in the neck, shoulders, arms and hands; compression in the lumbar (lower back) spine causes the same pain, weakness, and numbness in the lower back, hips, buttocks, legs, and feet. This lower back pain is the most common traveling pain in the body and is usually attributed to the sciatic nerve being compressed. This compression leads to a set of symptoms know as sciatica: pain, tingling, weakness and numbness radiating along the sciatic nerve (running down the buttocks, along the back of the thighs and calves and into the feet).
Treating Foraminal Stenosis
To diagnose your foraminal stenosis, your doctor will ask you about your complete medical history. A physical exam will help them determine which nerve roots are under duress (and with what severity). They will check your spine and neck motion, muscle strength, painful areas, sensory changes, reflex changes, motor skills, and certain red flags that could indicate something other than a spinal problem. Diagnostic imaging tests such as X-Rays and MRI’s may be administered.
Muscle weakness, pain, spasms, and cramping, along with numbness or pins-and-needles sensation, will vary in location depending on the position of the affected foramen (paths that hold the nerve roots in the spine). Treatment typical starts with intermittent rest, medications for the pain, physical therapy, moderate exercise, stretching, hot/cold compress therapy, and alternatives like restorative yoga, acupuncture, and massage. Visiting a chiropractor is also known to provide intermittent relief from symptoms.
Make sure you ask a physician for guidance on which is best for you. If conservative treatment provides little relief, or if the pain worsens, surgery may be utilized.
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