What is Neural foraminal stenosis?
The term “Neural” refers to the nervous system, while “Stenosis” pertains to the act of narrowing. Neural foramen stenosis, also known as foraminal narrowing, is a condition that occurs when the roots of the spinal nerves are compressed. These spinal nerve roots run through small openings at each level of the spine, called foramina. When these foramina (opening) are stenotic or narrowed, they can compress the nerve roots causing symptoms such as pain, numbness, tingling or weakness and along the areas served by the nerve. Neural foramen stenosis can be very frustrating because of the pain and discomfort that may cause to enter certain positions or perform certain activities.
Neural foraminal stenosis may occur in either the lumbar area (lower back) or the cervical spine (neck), and be caused by an osteophyte, a foraminal herniated disc, or collapse of the disc space.
Neural foramen stenosis often develops with the natural aging process of the spine. By understanding the causes and symptoms of this condition, you can be prepared to discuss treatment options with your doctor.
Causes of neural foraminal stenosis
This condition can not be acquired because of the weather or because of the different things that people do. Neural foraminal stenosis is caused by common degenerative conditions such as:
- Congenital – People do not realize that they have neural foraminal stenosis until such time passageway (foramen) gets too narrow for the spinal nerves to pass through.
- Aging – It is natural that as people age, the spinal cord begins to weaken and start to become narrower. This is the most common cause for people who are diagnosed with this condition are over 40 years old.
- Bone spurs – There are certain conditions where new bones begin to grow. There are also certain conditions that can change the rate of bone growth. This can greatly affect the spinal cord.
- Degenerative diseases of the spine – The most common causes of neural foraminal stenosis are disc degeneration (natural wear and tear of aging). Foraminal stenosis may also be due to RA (rheumatoid arthritis), osteoarthritis (OA), tumors in the vertebral column, less often the condition is present at birth.
- Overweight – There is a good reason why people are supposed to maintain their normal weight. It is not just because they are required to look good, but because if your weight is normal, you can be sure that you can be safe from different possible diseases that overweight can bring.
- Repetitive activities – There are times when people develop this condition because doing a certain activity all over and over again.
Neural foraminal stenosis symptoms
The symptoms of neural 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 the upper and lower limbs.
- Certain Pain – Sometimes, people feel pain in the back, buttocks, thighs, or calves, or in the neck, shoulders, or arms.
- 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 neural foraminal stenosis
The doctor asks the patient to give their recent information and also ask about the person’s medical history. Some tests will also have to be done including diagnostic imaging to diagnose this condition.
- 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.
Treatment options for neural foraminal stenosis
For people who have neural foraminal stenosis, the obvious choice is to search for possible treatment options so that they can get better. Following are just some of the possible treatments options:
- Non-Surgical Treatments – Usually, this type of treatment recommended for those whose condition is subacute. This means that the condition has just begun and can still be improved. This involves the intake of some medications to relieve pain and other symptoms.
- Physiotherapy – Some individuals who are diagnosed with neural foramen may have symptoms such as pain, numbness, or weakness in the upper limbs, legs, or feet can come on gradually or more suddenly, depending on the cause. Physical therapy is prescribed to improve the condition of muscles and bones.
- 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 – Practicing regular exercises and stretching, maintaining proper body mechanics helps you to decrease your chances of many other spinal deformities. Having a healthy spine and strong muscles strength plays a big part in preventing spine conditions from diminishing your quality of life.
- Minimally invasive surgery – This type of surgery is recommended for those who have mild neural foraminal stenosis. Some small surgeries can be done to decrease compression on spinal nerves.
- Spinal decompression surgery – When all the conservative treatments have been tried have not done anything to change patients condition, this surgery recommended for release pressure of the spinal nerves.
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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.