Foraminal stenosis
Stenosis, in general, is a narrowing of a normally large opening; just as spinal stenosis is a narrowing of the spinal column, foraminal stenosis is a narrowing of the spinal foramen, or the hole through which a spinal nerve passes as it exits the spine. In a normal spine, there is enough space, as there very well should be, for the nerves to exit. However, when there isn’t enough room, serious pain and problems can be a result. Most commonly, compression of the nerve or nerves and the discomfort that goes along with that is experienced. This can affect one or more of the vertebral foramen. Not all cases of foraminal stenosis put an individual in critical condition, but at the very least, function loss can happen if it is not treated in a timely manner.
Location
The spine is split into five regions: the cervical are the first 7 vertebrae (located in the neck); the next 12 vertebra are thoracic; the lumbar region has 5 larger vertebrae; the sacrum has 4 or 5 vertebrae that are fused into a triangular bone; lastly, the very bottom of the spine is called the coccyx or tailbone. The most common location for foraminal stenosis is in the cervical region; however, it can occur in the lumbar region, too.
Causes
Constriction of the nerve or nerve roots in the opening is due to either the gradual degeneration of the spinal column with age or from another medical condition. Such medical conditions include bone spurs, a herniated or bulging disc, arthritis, ligament thickening, or the enlargement of a joint. One specific type of foraminal stenosis, called lateral stenosis, occurs when the nerve root leaves the lateral foramen (side foramen), unnatural things can compress on the nerve root, such as a bone spur, disc herniation, cartilage fragment, or scar tissue. When the pain is felt on both sides of the body, it is known as bilateral stenosis.
Symptoms
Symptoms of foraminal stenosis are only present when it gets to the point that a nerve is compressed. Nevertheless, they are certainly uncomfortable and can include: weakness; numbness; sensations of burning or tingling in the arms or legs; pain that radiates into the lower extremities along the course of a specific spinal route; and loss of specific reflexes.
Diagnosis
In order to diagnose foraminal stenosis, the doctor must get a complete medical history, and he or she will probably ask you questions regarding the type of pain and location of the pain. To get a visual look at the narrowing, either in the neck or in the lower back, and MRI or x-ray will be recommended.
Treatment
There are treatments available for foraminal stenosis that may or may not be of benefit to you. These treatments can either relieve the symptoms or attempt to correct the problem.
Medication
Some medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), can help relieve the pain and inflammation (if present) due to foraminal stenosis. NSAIDs are medications like ibuprofen, Motrin, and Aspirin.
Chiropractic
Having work done on your back by a chiropractor can provide temporary relief of your symptoms. A chiropractor is knowledgeable in the spine and spinal conditions and is qualified to do this.
Massage therapy
Massage therapy, like chiropractic care, can relieve the symptoms of foraminal stenosis temporarily. A massage therapist can work directly on the area of pain and discomfort.
Spinal decompression
Back surgery can be quite risky, and so it is important to look at the benefits and compare them to the risks. Some people, however, don’t have much of a choice, especially if non-surgical options are not working and the problem becomes worse. Open back surgery may be one choice of surgery. It would entail cutting into the back in the affected area, and removing the object that is causing the decompression. Sometimes a spinal fusion is required after this if too much of the spine structure has to be removed. This surgery requires overnight hospitalization and general anesthesia.
Foraminotomy
This is another surgical option for foraminal stenosis. It is a less invasive and less risky procedure. A small incision is placed around the foramen that needs fixing, and the bone and tissue causing the compression are removed, with little discomfort to the patient. This surgery requires only local anesthesia, no overnight hospital stay, and results in little scar tissue.
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