Foraminal Stenosis or Foraminal Narrowing – All You Need to Know

Did you know, about half of the middle and old-aged population has some kind of spinal stenosis? And the occurrence of foraminal stenosis is just as common!

In fact, foraminal stenosis is itself a type of spinal stenosis, as it occurs in the part of the spinal vertebra. And foraminal stenosis is then further classified into cervical, thoracic, and lumbar stenosis.

Note: Foraminal narrowing most commonly occurs in the lumbar region leading to sciatica.

This foraminal narrowing results in pinching of the nerves passing through that foramen causing pain, numbness, and weakness in the limbs, a condition known as radiculopathy.

Not to ado further, let’s talk about foraminal stenosis and narrowing in detail!

Foraminal Stenosis or Foraminal Narrowing

The term ‘foraminal’ arises from foramen. But what’s a foramen?

Simply put, foramen means a small opening (like a small hole), through which passes the vessels or nerves. A foramen is usually found in bony structures but can also be seen in many other parts of the body.

In the case of foraminal stenosis, there is a foraminal narrowing of the vertebral foramen, specifically. Hence, it is also known as neural foraminal narrowing, hinting towards the compression of nerves.

How and why does it happen? What is foraminal stenosis definition? What are foraminal stenosis causes, symptoms, and treatment?

Let’s dive into the details!

Foraminal Stenosis Definition

The easy way to learn the foraminal stenosis definition is to divide the two terms and learn about each of them separately.

• Foramen means a narrow canal or passageway in the body for nerves and vessels.
• Stenosis means abnormal narrowing of a tubular canal or vessel.

Note: Emphasize the word ‘abnormal’.

A normal spine has one long spinal canal in the center, stenosis of which is called spinal stenosis.

And on sides of vertebrae lie foramen for the passage of spinal nerves. These spinal nerves exit through the spinal foramen to supply different parts of the body.

In simple words, foraminal stenosis means there is an abnormal foraminal narrowing of the vertebra leading to compressed nerve roots.

This will then result in pain associated with numbness and tingling sensation in the area affected by the foraminal narrowing. And this occurs due to a decrease or total lack of nerve supply in that region.

Moreover, the most common form of foraminal stenosis is unilateral foraminal narrowing, which affects only one side of the vertebrae. However, some patients experience bilateral foraminal narrowing as well, but it is rare.

Let’s see what bilateral foraminal stenosis means.

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Bilateral Foraminal Narrowing

Bilateral foraminal narrowing, as the name suggests, refers to the abnormal narrowing of the vertebral foramen on both sides of the spinal canal.

The commonest causes of bilateral foraminal stenosis are; disc prolapse, enlarged joints, or spinal injuries, affecting the nerve roots of both sides.

Even though bilateral foraminal narrowing is uncommon, it usually affects the upper back (cervical region) or lower back (lumbar region).

Its symptoms are more or less similar to unilateral foraminal narrowing symptoms. However, in bilateral foraminal narrowing, since both sides of the spine are affected, the symptoms occur on both (right and left) sides of the body.

Hence, the symptoms will be vast. And in most cases, the doctors recommend foraminal stenosis surgery as the best treatment option.

Foraminal Stenosis Symptoms

Before we proceed, know that foraminal stenosis is a slowly progressing disorder of the foramina. This means that the foraminal narrowing symptoms develop over time.

Plus, the patient might start experiencing back pain years before the diagnosis and wouldn’t know that he/she has foraminal stenosis.

However, the following are the symptoms of foraminal stenosis that you should be aware of;

• Pain in the upper back (cervical region)
• Neck and shoulder pain
• Tingling or numbness in arms and legs. The patient will describe it as a ‘pins and needle-like feeling in the affected organ).
• Weakness and burning sensation in arms and legs
• Muscle spasms
• Bladder and urinary incontinence

Note: The Foraminal narrowing symptoms, especially, pain radiate to the other regions supplied by the affected nerve. For instance, if there is foraminal Stenosis of the cervical region, you might as well experience pain in the neck, arms, and shoulders along with upper back pain.

Now the presenting symptoms of foraminal narrowing may vary from patient to patient. Some might experience mild to moderate pain, but some patients complain of severe back pain causing resistance in daily activities.

Does it sound like a common problem in almost every other person you know? Well, it’s time that you learn the foraminal stenosis causes to avoid incorrect diagnosis.

Foraminal Stenosis Causes

Note: Most commonly, foraminal stenosis or foraminal narrowing is caused by advancing age and joint disorders, like arthritis.

However, these are the multiple foraminal stenosis causes resulting in pain and other associated symptoms;

• Bony spur formation
• Bulging disc
• Disc herniation
• Swollen joints
• Degenerative disc disorder
• Spondylolisthesis
• Spinal injuries and trauma
• Wear and tear of surrounding bones

So, these were the most common foraminal stenosis causes. Usually, the risk of foraminal stenosis increases with age. And it is less commonly seen in children or adolescents.

However, the good news is that the condition is treatable. Let’s highlight the various foraminal stenosis treatment options.

Foraminal Stenosis Treatment

The treatment preference for foraminal stenosis is variable. Meaning, some patients might opt for physical therapy. Whereas, many patients choose to stick with the pain-reducing medicines. And some patients with foraminal stenosis go for spine surgery.

The following are the ideal foraminal stenosis treatment options;

• Painkillers like, aspirin and ibuprofen
• Corticosteroids
• Reduced activity
• Spinal Mobilization
• Back brace
• Maintain diet and a healthy weight
• Sustain a good posture

Note: Your doctor will tell you the correct foraminal stenosis treatment option. Perhaps, it depends on how severe your symptoms are. Or how severe your condition is. This will then change your treatment plan.

Therefore, not everyone has to go through spinal stenosis surgery. It’s an option reserved for severe cases.

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Foraminal Stenosis Surgery

Does foraminal stenosis require surgery?

Yes, it does! But thankfully, the mild cases of foraminal stenosis resolve without the need for surgical intrusion. This surgical procedure is called a foraminotomy.

The term Foramino is derived from foramen. And Otomy means to open that part.

So, foraminotomy is decompression surgery in which the surgeons open the foramina to relieve the pressure on the nerves.

Following is the step-by-step procedure for foraminal stenosis surgery;

• First, general anesthesia is given to the patient.
• There is a posterior approach, that is, the surgeons make an incision from the backside.
• Then to assess the affected part, the surgeon cuts through the skin, fat, and muscle.
• If there is a bulging disc only, a discectomy is performed.
• And laminectomy is done to remove the bony spurs if any.
• The last step is to decompress the nerve by widening the narrowed foramen.

This will eventually relieve pressure, reduce pain and other symptoms of foraminal stenosis.

FAQs

Conclusion

So to sum it up, foraminal stenosis refers to the foraminal narrowing that puts stress on the exiting nerve roots.

Sometimes the patients take at-home treatment and recover on their own. And it’s very rare for anyone to have foraminal stenosis surgery.

However, this does not mean that you neglect the need of having surgery as it can have severe complications. So, we suggest you contact your doctor if you have constant or intermittent back pain with other symptoms but there is no sign of improvement.

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