What is foraminal stenosis? Foraminal stenosis, also referred to as neural foraminal stenosis, is a narrowing of the foramen. The foramen, put simply, is the area between the vertebrae – the hole - from which nerve roots from the spinal cord pass through. The nerves branch off from the spinal cord to go to other parts of the body. When this opening is too small, the associated nerve does not have enough room, so it becomes “pinched,” or compressed.

Symptoms of foraminal stenosis

When a nerve is impinged, it can cause numerous symptoms. These might include numbness, tingling, pain, weakness, or strange sensations in the affected area. I have this condition in both my upper and lower back, and sometimes it feels like ants crawling on my skin. Sometimes it causes a maddening itch that doesn’t stop when scratched. Once in a while, I feel as if water is trickling down my right leg. At other times, I experience sharp pains shooting down my left arm. The best way I can think of to describe the pain is that it’s like an electric toothache.

Any part of the spine can be affected by foraminal stenosis. If nerves in the upper back are involved, it’s called cervical foraminal stenosis. If the middle back is affected, it’s thoracic foraminal stenosis, and if the lower back’s nerves are trapped, it’s called lumbar foraminal stenosis.

Cervical stenosis will affect the neck, shoulders, and/or the arms. Thoracic stenosis will affect the mid back, and lumbar stenosis will affect the lower back, buttocks, and/or legs.

Causes

Foraminal stenosis is often caused by degenerative disc disease. The discs may be bulging or herniated. They "poke out," taking up room meant for the nerves. Osteophytes or “bone spurs” can cause foraminal stenosis for the same reason. Sometimes the uncinate processes on the sides of the vertebrae grow where they shouldn’t, like in the way of a nerve. Foraminal stenosis can also be caused by congenital defects.

Diagnosis

Foraminal stenosis is sometimes difficult to diagnose and pinpoint. According to my orthopedic surgeon, the best way to diagnose the problem is with an MRI. Even then, the results are not 100% accurate. I had an MRI in response to my neck, shoulder, and arm pain, and the radiologist reading the MRI said he didn’t see anything serious. I knew he just had to be wrong, so I asked for my discs and took them to a specialist to read. He went over them frame by frame with me, and showed me the nerve damage. I got a third and fourth opinion, and all the subsequent doctors agreed with the specialist after they viewed the MRI discs for themselves. If you’re having the above symptoms but have been told by a radiology report that you don’t have any nerve damage or compressed nerves, get a second opinion!

Treatment options

If you have foraminal stenosis, you have several treatment options available to you. Most doctors will begin with conservative treatments and use surgery only as a last resort. Some of your options include:

· Over-the-counter and prescription oral anti-inflammatories

· Physical therapy and exercises to stabilize the spinal column

· Acupuncture

· Chiropractic

· Cox decompression (a table that stretches your spine, making more room for the nerves)

· Therapeutic massage to stretch the affected area

· Cortisone injections into the affected are (you can get only 3 of these a year)

· Surgery

Pain relief at home

With foraminal stenosis, it’s likely that you won’t have pain every day – at least not severe pain. I have found several treatments that I can do at home to help relieve my pain. These include:

· TENS unit (a device that sends electrical impulses to block pain pathways)

· Hot tub – position the painful area directly in front of a jet

· Heat or cold therapy (heat works better for me)

· Stretching exercises, especially in a swimming pool

· Aspirin and tramadol (a synthetic narcotic – used as a last resort)

· Pelvic tilt exercises (get on all fours and arch your back to open the spaces between your vertebrae)

· Toe touches – I just “hang” over to stretch the vertebrae in my lower back

· Leg stretches – lie on your back and have someone push your legs, one at a time, toward your head while you keep your leg straight. If your stenosis is advanced, you probably won’t be able to endure this.