Each of the 33 bones of the spine has a large central opening for the spinal cord. Additional openings called foramen allow the nerves branching from the spinal cord to travel to the arms, legs and other parts of the body.
Normally nerve roots have enough room to easily slip through the foramen. However, with age and conditions like arthritis, the foramen may become clogged. Bony spurs can develop inside and press on the nerves. When the passage through which the spinal cord runs becomes clogged, the condition is called spinal stenosis.
The symptoms may include numbness, weakness, burning sensations, tingling and "pins and needles" in the arms and legs.
Causes and Risk Factors
The risk of the foramen narrowing increases with age and with other musculoskeletal conditions, such as arthritis.
To diagnose foraminal stenosis, the consultation begins with a medical history. During a physical exam, the doctor looks for limitations on movement, pain, loss of reflexes or other symptoms when the patient moves his or her spine.
Other procedures that can help confirm the diagnosis include:
- X-rays, which can help rule out tumors, injuries or abnormalities
- Magnetic resonance imaging (MRI), which can be helpful in detecting damage or disease in the soft tissues, such as the discs between vertebrae or ligaments
- Computerized tomography (CT scan), which can show the shape, size and nearby structures of the spinal canal
- Myelogram, in which an opaque dye is injected into the spinal column followed by an MRI or CT scan, can show pressure on the spinal cord or nerves from herniated discs, bone spurs or tumors
- Bone scan, which can detect fractures, tumors, infections and arthritis
Conservative treatment can include:
- Pain-relieving drugs without steroids, such as aspirin or ibuprofen
- Corticosteroid shots
- Restricted activity
- Physical therapy or exercises
If these are unsuccessful, a surgical procedure called a foraminotomy is an option.