Foraminal narrowing, or foraminal stenosis, is a condition of the spine that can cause pain and other symptoms resulting from spinal nerve compression. At every level of the spine, a pair of nerve roots exit the spinal cord through small openings called foramina (singular: foramen). Narrowing, or stenosis, occurs when the space available for the nerve roots to pass is reduced. While narrowing of the foraminal canals does not necessarily produce symptoms, if a nerve root is irritated or compressed, it can cause pain that radiates along the length of the nerve, as well as tingling, numbness, or weakness within the muscle group innervated by the affected nerve.


Causes of Foraminal Narrowing

Most cases of foraminal stenosis are related to gradual anatomical deterioration that is associated with the aging process. The vertebrae, intervertebral discs, and other spinal components break down after years of wear and tear, especially within the cervical (neck) and lumbar (lower back) regions of the spine. Most of the time, this anatomical degeneration affects one side of a vertebral segment, producing unilateral foraminal narrowing. Sometimes, degeneration affects both sides of a vertebral segment, and this is known as bilateral foraminal stenosis. Conditions that can produce stenosis within the foraminal canals include:

  • Degenerative disc disease – deterioration of an intervertebral disc can lower the disc’s height, reducing space available for nerve roots to pass.
  • Herniated disc – extruded disc nucleus material through a tear in the disc’s outer wall can leak into the foraminal opening.
  • Bulging disc – a portion of the outer disc wall can protrude into foraminal space.
  • Bone spurs – osteophytes resulting from arthritis of the spine can grow along the edges of the foramina, constricting available space.
  • Spondylolisthesis – slippage of one vertebra over another can reduce foraminal space significantly.
  • Spinal injury – a fracture or compression injury can displace the vertebrae, thereby reducing space available for nerve roots to exit the spinal cord.


Treatment for Foraminal Narrowing

An attempt to manage symptoms associated with foraminal narrowing typically begins with pain medication, exercise, and/or corticosteroid injections. If symptoms persist after several weeks of conservative treatment,  a minimally invasive, outpatient procedure known as a foraminotomy may be able to help you rediscover your life without back or neck pain.


What is foraminal stenosis?

Foraminal stenosis, or neural foraminal stenosis, refers to the narrowing of the foramen, a small hole through which the nerve exits the spine (neural is defined as having to do with nerve cells or relating to a nerve and is often added to the condition’s name).


What are the symptoms associated with foraminal stenosis?

Common signs of foraminal stenosis include numbness, burning, tingling, and a sensation of “pins and needles” locally and/or in the extremities. Since foraminal narrowing hinders the nerve’s ability to function correctly, symptoms of foraminal stenosis can be quite painful.


What causes foraminal stenosis?

Aging-related disc degeneration is one of the primary causes of foraminal stenosis. As we age, our discs gradually lose their flexibility and can easily become bulged or herniated. The herniations may narrow the spaces in the spine and press on the nerves. Other common foraminal stenosis causes include bone spurs (osteophytes), arthritis, and ligament thickening.


Are there foraminal stenosis exercises I can perform to relieve some of my symptoms?

If you suffer from foraminal stenosis, certain exercises can help you feel better. Foraminal stenosis exercises are generally able to be performed anywhere, and they are recommended as long as they don’t cause increased pain. For more information see foraminal stenosis exercises.


Should I be in physical therapy for foraminal stenosis?

It’s generally a good idea to include therapy for foraminal stenosis in your treatment plan. In fact, physical therapy for foraminal stenosis is often the best way to help regain the strength and stability that your spine needs to stay healthy. And a healthy spine can help you prevent future injuries.