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Between each vertebra in the spine are small openings, called foramina, where nerves split from the spinal cord and travel to other parts of the body. Foraminal stenosis is a condition in which one or more foramina are narrowed to the point that nerves are pinched or severed, leading to numbness, tingling, or loss of feeling in the back or legs. Many different factors can contribute to foraminal stenosis, but the most common causes are arthritis, bulging disks, and congenital deformities. Anti-inflammatory drugs and physical therapy can often remedy mild cases of stenosis, though a severe problem may require surgery to prevent permanent complications.
Foraminal stenosis can occur in a person of any age, though the condition is most common among adults older than 60 due to natural bone and cartilage degeneration. Primary stenosis, the congenital form of the condition, is usually detected in early childhood in patients who have chronic back pain or difficulty with motor movements. Foraminal stenosis can also occur if a person suffers a herniated disk due to excessive pressure on his or her back, as when trying to lift a heavy object. The condition can affect any of several dozen foramina in the spine, though most cases appear in the lowest section of vertebrae called the lumbar region.
The symptoms of foraminal stenosis depend on the location and severity of the problem. Mild stenosis is often the most painful variety, since nerves are not fully compressed and can still transmit pain signals to the brain. A person with mild stenosis is likely to experience radiating pain throughout their lower backs, buttocks, and down through one or both legs. Severe foraminal stenosis can cause the back and legs to feel numb or tingly, especially when sitting or standing for extended periods of time. Any abnormal numbness or pain should be reported to a physician as soon as possible so that appropriate measures can be taken to relieve symptoms.
A doctor can pinpoint foraminal stenosis by conducting a physical exam and taking x-rays of the spine. Diagnostic imaging tests can reveal the presence of a herniated disk, bone deformity, or age-related deterioration. Once the doctor knows the extent of the problem, he or she can prescribe the best treatment option. Mild cases are often relieved by reducing inflammation and swelling in the spine with medications. A patient with a herniated disk or arthritis may be scheduled for physical therapy sessions to regain strength and flexibility.
Congenital deformities and cases of severe compression typically necessitate surgery. A skilled surgeon can make an incision in the back, rearrange or cut away excess bone tissue, and fuse vertebrae together to prevent further narrowing. If possible, nerve, cartilage, and ligament tissue are repaired. The outlook for patients who undergo stenosis surgery varies, but most people eventually recover some or all of their mobility following months of intensive physical therapy.