Foraminal Stenosis
What is Foraminal Stenosis?
Our spine is the most important structural feature of our body. It is a major stabilizer and shock absorber; bearer of weight; and it holds the rest of the skeleton together. We use our spine in bending, twisting, picking things up, and turning our head. We must have it to walk, dance, or perform any number of daily activities.
Unfortunately, our spine is susceptible to wear and tear as we age. This gradual deterioration includes the degeneration of cartilage that cushions our vertebral joints. When this cartilage starts to erode, bone-on-bone contact can occur. This friction alone can cause irritation; however, constant pressure can also result in the pinching of our foraminal nerves.
The foramina are openings between our vertebrae that allow for spinal nerves to branch out to the rest of our body. When degeneration occurs, these openings get smaller, leaving far less room for the nerves to exit from each opening in our vertebrae. This degeneration eventually leads to these nerves being pinched by the vertebral bones, causing a variety of irritating, painful, or debilitating symptoms.
Common causes of foraminal stenosis include:
- Age-Related Degeneration: One of the main causes of foraminal stenosis; both gravity and age can act as natural forces to promote vertebral erosion.
- Arthritis: A progressive and chronic set of diseases that accelerate the spine’s natural degradation over time.
- Bone Spurs: Bone growths that develop on the edges of existing bones; these outcroppings of bone are most commonly attributed to osteoarthritis.
- Chronic Strain or Repetitive Use: Continuous wear and tear on the spine from occupations such as nursing or construction can lead to spinal degeneration and foraminal narrowing.
- Injury: Injury from an accident or fall can lead to herniated or bulging discs, which can also promote the development of foraminal stenosis.
- Excessive Weight or Obesity: Like gravity over time, excessive weight can lead to degenerative wear on the intervertebral discs, resulting in foraminal stenosis
Worried that you might have foraminal stenosis? With over 20 years of surgical excellence in Redefining Relief, Dr. Daveed Frazier uses the latest advancements in minimally invasive techniques to resolve chronic neck & back pain.
What are the Symptoms of Foraminal Stenosis?
As with most spinal conditions, the symptoms of foraminal stenosis will fluctuate from person to person. The most typical differences to consider are the spinal origin of the stenosis and the severity of a patient’s discomfort. For example, foraminal stenosis is most commonly experienced in the cervical (neck) region of the spine; but for some patients, foraminal stenosis occurs in the lumbar spine (or lower back).
Although individual symptoms will vary significantly as a result of differences such as these, general warning signs of foraminal stenosis may include:
- Localized Pain: Dull to striking pain at the site of foraminal narrowing. This pain tends to intensify as the months and years go by.
- Radiating Pain: Pain may originate at the source and radiate into the limbs, shoulders, or buttocks regions. Cervical stenosis will often be accompanied by radiating pain to regions of the upper body such as the neck, shoulders, and arms; lumbar stenosis may involve shooting pains to the legs, buttocks, and hips.
- Muscular Weakness: Adjacent muscles often overcompensate to support the compromised spine. If the foraminal stenosis is severe enough, the muscles may even become cut off from the blood supply or nerve impulses, resulting in tingling or progressive muscle weakness.
- Tingling or Heat: Prickling sensations or heat may be felt at the site of the stenosis, or radiate outward, into adjacent areas of the body.
- Sciatica: Sciatica is a condition that occurs when the sciatic nerve of the lower back is compressed by foraminal stenosis or a related condition of the spine. This is often manifests as a debilitating pain that radiates down one of the legs.
- Emergency Symptoms: If you are noticing weakness or paralysis in limbs, loss of bowel or bladder control, or excruciating pain, please seek immediate medical attention. Permanent paralysis of the limbs is a rare but serious complication of foraminal stenosis.
Are you concerned that you may be experiencing foraminal stenosis or any of these troubling symptoms? Contact NYC Spine today and our Harvard-trained, board certified surgeon, Dr. Frazier, will help you find relief from chronic pain!
What are the Treatments for Foraminal Stenosis?
The first step in treating foraminal stenosis is to secure a proper diagnosis. Your physician may ask you about your medical history; perform a physical examination of the spine; or ask you to move in certain ways to stimulate the pain that you are experiencing. Other routes to diagnosis include highly accurate technologies such as MRIs, CT scans, and X-rays.
If a diagnosis of foraminal stenosis is determined, any of the following minimally invasive treatments may be suggested or prescribed: physical therapy, chiropractic intervention, massage, acupuncture, exercise, or lifestyle changes (such as smoking cessation or losing excess weight).
Medication is also a common course of treatment. Over-the-counter and prescribed medications can help manage your discomfort or control localized inflammation.
Although these methods are often sufficient to produce lasting pain relief from foraminal stenosis, there are severe cases that may require surgery. For those individuals who do require surgical treatment, NYC Spine’s Dr. Frazier has over 20 years of experience in treating foraminal stenosis and other spine conditions. Dr. Frazier may recommend one of the following minimally invasive surgical procedures:
- Laminotomy & Foraminotomy (Combined): Same-day, minimally invasive surgery that serves to remove any of the structures or bones that may be causing the pinching of the foraminal nerves. This surgery will leave much of the muscle undisturbed, and involves precise imaging of the area before and during the procedure.
- Endoscopic Foraminotomy: A minimally invasive procedure in which the surgeon will access your spine through a small 1 to 3-inch incision in the back or neck. This procedure allows the surgeon to bypass any muscle, resulting in shorter recovery times and less pain. The surgeon will remove part of the foramina (vertebral passageways for nerves), widening it so that pressure can be taken off the nerves causing the pain.
Although these procedures are commonly used, they are not the only surgeries or treatments to address foraminal stenosis. Working closely in collaboration with Dr. Frazier, you will receive one-on-one attention to find the right treatments for your stenosis.
Meet Dr. Daveed Frazier
Dr. Frazier is a Harvard-trained, board certified orthopedic spine surgeon. He’s held an academic appointment at Columbia University College of Physicians and Surgeons and New York’s SUNY Downstate. Dr. Frazier is also a respected lecturer, accomplished researcher, published author on spine disorders and treatment, and a consultant for several international spine companies.
After completing his undergraduate education at Brown University, Dr. Frazier attended Harvard Medical School, where he graduated cum laude. He completed a Harvard internship based at the New England Deaconess Hospital in Boston, MA, followed by a Harvard combined residency before becoming chief resident at Massachusetts General Hospital.