Foraminal stenosis is a condition that occurs when passageways between the spinal vertebrae narrow, sometimes causing pain.
The spinal nerve roots must travel through these small passageways, called foramen, in order to reach the rest of the body. When the foramen become narrowed, the nerves can be compressed. As a result, patients may suffer pain, tingling, numbness and muscle weakness at the pinched nerve site and all the way down the associated arm or leg.
Though this condition is commonly seen in both men and women over the age of 50, truck drivers and women who regularly wear high heels are at particular risk.
Although this condition is similar to spinal stenosis, it is regarded as a unique condition in that it affects one or more specific vertebral foramen.
Causes of Foraminal Stenosis
Some people are born with unusually small foraminal openings, putting them at increased risk of developing this condition. In most cases, however, foraminal stenosis is a result of the natural aging process.
Over time, the gradual deterioration of the spinal column can lead to a variety of degenerative conditions, including arthritis, herniated discs and bone spurs.
These types of degenerative disc diseases can limit the space within a foramen, constricting the nerves. Spinal injuries — from trauma or repetitive movement — also can cause the foramen to narrow.
Foraminal Stenosis Diagnosis
A medical history is the first step in diagnosing foraminal stenosis. Then the spinal surgeon will perform a physical examination, looking for pain, limitations on mobility and other symptoms as the patient moves.
X-rays or a CT scan may be ordered to rule out abnormalities or injuries to the bony areas of the spine. To see damage and disease in the soft tissues, an MRI likely will be ordered. If a confirmation of the diagnosis is needed, or if the surgeon wants a clearer picture of the patient’s condition, other tests, such diagnostics injections, may be considered.
Treatments for Foraminal Stenosis
Conservative treatments are recommended as a first course of action for most patients with this condition. Hot or cold therapy, along with non-steroidal anti-inflammatory drugs (NSAIDs) like naproxen or ibuprofen can help relieve pain and swelling.
If pain is severe, corticosteroid injections may be given and physical therapy may be advised. Some patients also can benefit from a manual manipulation of the spine.
If conservative treatments fail to provide symptomatic relief, spinal surgery may be an option. A foraminotomy can relieve the pressure on the nerves by removing the bone or tissue that is compressing the spinal nerve root. This spinal surgery can be performed as part of an open procedure that aims to address a larger spinal issue or as a single procedure, involving only a small incision.
If you are suffering from symptoms you think may be related to foraminal stenosis, make an appointment today with the physicians at Steward Health Care: Centers of Orthopedics and Sports Medicine.