What is Foraminal Narrowing?

Neural foraminal narrowing is also known as neural foraminal stenosis, a type of spinal condition that occurs when the spinal canal housing the nerves becomes narrowed.

Nerves connecting the spinal cord to the organs and other extremities of the body use the neural foramina. These openings need to remain wide enough to thread the nerves freely through without pressure. When these openings become too narrow, the nerves become compressed or pinched, leading to localized or widespread pain in the back and throughout the body

A variety of conditions and degenerative diseases may cause the neural foramina to narrow. Depending on the conditions causing neural foraminal narrowing, you may be able to fix the problem through exercise, various physical therapies, or surgical procedures.

Causes of Foraminal Narrowing

Neural foraminal narrowing may be caused by many different conditions. These include:

  • Osteoarthritis

  • Rheumatoid arthritis

  • Degenerative disc disease

  • Herniated discs

  • Bone spurs

  • Facet hypertrophy

  • Age

  • Obesity


Age remains the most common cause of neural foraminal narrowing. As the body ages, the spinal joints start to wear away, leaving debris and buildup around the neural foramina. Conditions such as obesity, poor posture, traumatic injury and lack of exercise may exacerbate the problem over the years. The best way to prevent neural foraminal stenosis is to live a healthy, active lifestyle and to avoid serious injury.

Symptoms of Foraminal Narrowing

Common symptoms of foraminal narrowing include:

 

  • Shooting pain

  • Chronic, burning pain

  • Numbness

  • Acute muscle fatigue

  • "Pins and needles" sensation

  • Increased body heat

  • Loss of bowel, bladder or sexual control

These symptoms may occur in the back or anywhere throughout the body. All of the nerves pass through the spinal cord on the way to the brain, and if a particular nerve is pinched at the neural foramen, it may manifest as pain to the extremeties.

Diagnosis and Treatment

To diagnose foraminal narrowing, you will need to first visit a doctor's office. Your doctor will conduct a physical examination, ask you about your medical history and if needed, conduct various imaging tests such as an MRI or X-ray. This is done to determine if the pain in your body stems from stress and muscle fatigue or if nerves are really being pinched. The imaging scans will allow the doctor to see if the spinal canal or neural foramina are too narrow.

Following the examination, your doctor will give you several choices. If the narrowing is not severe, you may be able to use alternative therapies to treat the pain or put the spine back into alignment. Common alternative therapies for foraminal narrowing include:

  • Physical therapy - By developing an exercise routine and moving under the guidance of a physical therapist, you can gradually reduce the pressure on your nerves.

  • Chiropractic - A chiropractor will manually adjust your spinal column and may be able to open up the neural foramina using massaging and stretching techniques.

  • Ultrasound therapy - Ultrasound treats the pain of foraminal narrowing, but it may not solve the root cause.

  • Ice and Heat therapy - Like ultrasound, ice and heat therapy treats pain, but does not reduce the pressure on the nerve.

You may also need to consider surgical options. These include:

 

  • Foraminotomy - A surgeon uses high-powered precision lasers to cut away blockages in the neural foramina.

  • Laminotomy - With a laser, irrigation and suction tools, the surgeon cuts away part of the laminae, or the crests of the vertebrae, that may be causing pressure on the nerve.

  • Laminectomy - A surgeon opens up the back and removes the affected lamina from the vertebral column. This is highly invasive and only used for the most serious cases of neural foraminal narrowing.

All surgical procedures have risks. Consult with your doctor before deciding on surgery to treat your neural foraminal narrowing to see if it is the right choice for you.

 
  

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