What is Neural Foraminal Stenosis?
Neural foraminal stenosis is a spinal disorder characterized by narrowing of the foramen or the spinal canal through which the nerves are passing through the spinal cord. The condition is due to the constriction in the foramen results in restriction of the spinal cord causing neurological deficit.Pain perceived in people suffering from neural foraminal stenosis is due to the pressure put on the nerve as the foramen is narrowed.
Foramen is an opening in any part of the body that allows the nerves, arteries and muscles to connect from one part of the body to another. The occurrence of disc degeneration or when the disc herniated, the spinal cord cannot pass through.
The condition is common in older people as the quality of bone structures degenerate due to the aging process. The condition of neural foraminal stenosis is common to people over 50 years of age however, stenosis can also be of inherited condition wherein stenosis is related to birth defect of spinal canal smaller than usual.
The symptom of pain may occur although in some cases pain is uncommon. The onset of pain however is gradual or while the condition is progressing.
Symptoms of this condition depend on the location of the stenosis although common symptoms include pain, tingling sensation, weakness and numbness as a result of compression on the nerves.
Neural Foraminal Stenosis Pictures
Mild neural foraminal stenosis
This condition of spinal narrowing is commonly associated with natural aging process. It is not necessarily symptomatic and usually completely relieves undetected.Manifestation of symptoms occur when mild foraminal stenosis is due to impingement and irritation of the nerves in the foramen, an individual can experience symptoms such as localized pain on the affected side, pain is radiating along the nerves to another part of the body, tingling in the extremities and stiffness.
Muscle weakness or may also occur unexpectedly. Moderate treatment is required in mild foraminal stenosis. Marked pain relief and reduced nerve compression is achieved through therapeutic medications such as anti-inflammatory, muscle relaxant and hot compress.
Moderate neural foraminal stenosis
Moderate neural foraminal stenosis refers to the gradual constriction of the foramina in the spinal column as a result of compression of the nerve. The gradual constriction is a result of collected deteriorated materials from disc, bone and soft tissues that occur over the years.The collected debris clogging the spinal canal can lead to irritation and impingement of the nerve and symptoms may be experienced depending on the location of stenosis. Symptoms may include localized pain, muscle weakness and spasm.
The goal of treating moderate foraminal stenosis is pain relief and decompressing compressed nerve.
Severe neural foraminal stenosis
Severe neural foraminal stenosis is a degenerative spine condition causing significant back pain and neck pain. The constriction of the foramen is a result of natural wear and tear of the spine. The constriction may also be exacerbated by injury, displacement and deterioration.The development of stenosis is gradual but can get worse with injury. Wide variety of symptoms can be experienced such as localized pain, numbness, cramping and travelling pain including numbness and tingling in the extremities.
Treatment of severe foraminal stenosis is difficult as the condition is the result of deterioration over the years. Conservative noninvasive approach is given to remedy or relieve pain usually with pain medication, epidural injections, physical treatment and vertebral manipulation.
Cervical neural foraminal stenosis
Cervical neural foraminal stenosis is one of the two types of stenosis that is more dangerous as the compression involves the spinal cord. This type of stenosis may arise without any disc herniation and the occurrence is due to the enlargement of a joint in the spinal canal.A root on one side is the cause of majority of symptoms of this stenosis. The pain associated with this stenosis develops slowly and may develop over the years. Pain anticipated is not continuous and may be involved with certain activities and position.
Lumbar neural foraminal stenosis
This is the second type of stenosis that is more common and occurs in the lower back. Constriction of this type of stenosis is at the lower back resulting to difficulty in walking as the increased pain is perceived in the legs.Pain is relieved when at rest or in a comfortable position. The symptoms of stenosis develop overtime and patient affected are usually at 50 years of age and over. The symptoms however may come and go. The most common symptoms of lumbar stenosis are sciatica, claudication, tingling, weakness and numbness radiating from lower back to buttocks and legs.
Multilevel neural foraminal stenosis
Multilevel neural foraminal stenosis involves more than one neural foramen. For instance, lower vertebra is followed by stenosis on the upper level. The goal of treatment for this type of stenosis is pain relief through repair of degenerative disc.Surgery is the usual mode of treatment after careful diagnosis of multilevel stenosis if pain relief is not achieved through noninvasive measures.
Causes
The common cause of neural foraminal stenosis is disc degeneration as a result of natural aging process. Aging process causes the discs to become herniated or bulge narrowing the foramen.Rheumatoid arthritis and osteoarthritis are factors in causing stenosis. Foramen narrowing may also arise as congenital result that is inherited or through environmental factors. Different types of trauma may also cause stenosis as a result of collected materials or debris from injury.
Treatment
Treating neural foraminal stenosis depends on symptoms and noninvasive measure is the common approach. Pain relief is the goal of treatment including repair of degenerative disease. Noninvasive measures may include:- Physical therapy – therapy program is designed in restoring the flexibility of neck and back to improve strength, flexibility and good posture to relieve the symptoms.
- Medication – anti-inflammatory drugs and muscle relaxants is often the first step in managing symptoms depending on the severity of the condition.
- Epidural steroid injection – is given depending on the severity of the condition.
