Foraminal stenosis is a condition in which the vertebral foramen become narrowed. This typically happens only with the foramen on one side of the vertebrae (unilateral foraminal stenosis). Get to know what causes Bilateral Foraminal Stenosis, its symptoms and available treatment options.
What is Bilateral Foraminal Stenosis?
However, in some cases, both foramina are narrowed, causing bilateral foraminal stenosis. Bilateral foraminal stenosis is where both foramina have become narrow and the nerve roots on both the right and left sides of the spine are compressed. This condition is commonly seen when the spinal nerve root is compressed on both sides due to narrowing of the foramen that may be caused by a collapsed disc space, an enlarged joint or a foraminal herniated disc.
Bilateral foraminal stenosis symptoms
The symptoms of Bilateral foraminal stenosis vary with the severity of the pressure on your spinal cord or the nerves. Here are some common symptoms of the disease.
- Numbness– There will be times when some parts of the body (feet, thighs) and will be difficult to move or cannot be felt at all.
- Tingling Sensation– people feel tingling (prickling or stinging) sensation in both lower limbs.
- Certain Pain– Sometimes, people feel pain in the back, buttocks, thighs, or calves.
- Loss of bowl and Bladder Movements– Some people have Problem with controlling urine or bowel movements.
- Muscular Weakness– This is one of the symptoms that will catch the attention of people easily because activities become restrained once the condition becomes severe.
Diagnosis of Bilateral foraminal stenosis
The doctor asks the patient to give their recent information and also ask about the person’s medical history. Few tests will also have to be done including diagnostic imaging to diagnose Bilateral foraminal stenosis.
- An X-ray of the spine to diagnose narrowing of the spinal canal, OA, and bone spurs
- A CT (computed tomography) scan: This takes more detailed images of the back and spinal canal
- An MRI scan (magnetic resonance imaging): this scan helps to take pictures of the spinal cord and nerves to find out cause of the disease
- An EMG (electromyogram): to evaluate nerves and muscle problems
- X-rays of the hips, blood tests, as well as some diagnostic tests, to check the circulation in your limbs and to rule out other conditions with similar symptoms.
Bilateral foraminal stenosis – Treatment Options
For people who are suffering from Bilateral foraminal stenosis, the obvious choice is to search for possible treatment options so that they can get better. Some of the possible treatment options such as:
Over-the-counter medicines for pain relief
While you wait to see your doctor, you can take over-the-counter anti-inflammatory medicines like acetaminophen (Tylenol), or simple pain relievers like ibuprofen (Advil) or naproxen (Aleve). Follow the package directions for how much and how often to take these drugs.
Consult with your health specialist before taking over-the-counter medication together with your normal medication. Don’t take extra doses; several products that contain pain relievers, including medicines for colds or menstrual cramps.
Physiotherapy
People who are diagnosed with bilateral foraminal stenosis may have symptoms such as pain, numbness, or weakness in both lower limbs (legs & feet) can come on gradually or more suddenly, depending on the cause. Physical therapy is prescribed to improve the condition of spinal muscles and strength of the spinal column.
Heat and ice therapy
This is the type of treatment done to treat the pain brought about by the condition. Do remember it is a temporary solution, but the condition will still worsen as long as it is not addressed.
Lifestyle modification
Having a strong & healthy spine and good muscles strength plays an important role in preventing spine conditions from diminishing your quality of life. Practicing regular exercises and stretching, maintaining proper body mechanics helps you to decrease your chances of bilateral foraminal stenosis.
Minimally invasive surgery
Minimally invasive surgery recommended for those patients who have mild bilateral foraminal stenosis. Some small surgeries can be done to decrease compression on spinal nerves.
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Spinal decompression surgery
When all the conservative treatments have been tried have not done anything to change patients condition, this is the recommended to discharge pressure of the spinal nerves.
Role of physiotherapy in Bilateral foraminal stenosis
The purpose of physical therapy is to relieve pain and allow you to return gradually to your daily activities. In Bilateral foraminal stenosis, physiotherapy involves treatment with physical or mechanical means, such as through exercise or heat. Physical therapy may reduce pain in the soft tissues (such as the muscles, tendons, and ligaments), improve function, and build muscle strength. A physiotherapist provides these treatments and also provides education, instruction, and support for recovery.
Physiotherapy techniques may include:
- Stretching, to reduce stress on joints
- Exercise, to strengthen muscles
- Ice therapy or cryotherapy to help relieve pain
- Heat therapy, to improve blood flow to the muscles and other soft tissues
- Manual therapy, including soft tissue manipulation or massage, to improve or keep range of motion
- Cycling and limited walking, to promote good physical conditioning
- Swimming or Aquatic exercises, to allow your body to exercise without pressure on the spine and improve the muscle strength
- Education, to help you improve and maintain good posture
Exercises and techniques that may help ease the symptoms of spinal stenosis and prevent progression of the condition include:
- Lower limb strengthening, which may help to avoid falls
- Stretching
- Get active and eat a balanced diet
- Frequent changes of position, to prevent sustained postures that compress the spine
- Planning ahead so that you take breaks in between potentially back-stressing activities such as walking and yard work
- Proper lifting, pushing and pulling
Your doctor or a physical therapist design a program specific to your normal level of activity, physical fitness, and severity of pain.
Conclusion
Bilateral foraminal stenosis is a common cause of low back pain and neck pain affecting some of our young adults and many of our elderly. The diagnosis is made by history and physical examination with radiographic confirmation. Treatment goals include pain management and improvement in function, mobility, and overall quality of life. It can treat effectively in most cases non-operatively. In some cases, surgery may be an effective option.
If for some reason an experienced doctor is not available around you, then you can contact us here.
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Dr. Kaleem Mohammed graduated as a Bachelor of Physiotherapy in 2014 from Deccan College of Physiotherapy, affiliated to Dr. N.T.R. University of Health Sciences, Vijayawada, India. Dr. Kaleem is an expert at handling physiotherapy needs of patients suffering from orthopedic and spinal conditions and post-surgery rehabilitation. Dr. Kaleem is associated with HealthClues since its inception where he facilitates diagnosis and advanced consultation with senior doctors. He is also a medical researcher and prolific writer who loves sharing insightful commentaries and useful tips to educate the patient community about fitness, treatment options, and post-treatment recovery.
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