Types of foraminal narrowing, or stenosis, include bilateral, unilateral, and far lateral. The foramina (singular: foramen) are openings on either side of the vertebrae that allow for the passage of nerve roots that branch off the spinal cord. Bilateral foraminal narrowing means both foramina become narrow. Unilateral means only one foramen (left or right) is affected. Far lateral stenosis refers to a restriction or narrowing of the area surrounding a nerve root after it has exited the foramen. All of these conditions can be caused by injury or by a degenerative spine condition, such as a herniated disc, that is associated with the aging process. Foraminal narrowing only becomes symptomatic if the restricted space leads to nerve compression, which can produce symptoms such as pain, tingling, numbness, or muscle weakness.
Types of Foraminal Narrowing by Location
Foraminal narrowing can occur at any level of the spine, but is most common in the cervical (neck) and lumbar (lower back) regions. The relative stability of the thoracic (middle back) region gives it some protection against age-related deterioration. The same cannot be said of the neck and lower back, which are subjected to years of stress-inducing movement and support the weight of the head and upper body, respectively. The site of the foraminal narrowing determines the location of the symptoms, as described below:
- Cervical foraminal narrowing – head, shoulders, upper back, arms, hands
- Thoracic foraminal narrowing – ribcage, shoulders, arms, internal organs
- Lumbar foraminal narrowing – lower back, buttocks, legs, feet, toes
Treatment Options for Foraminal Narrowing
If you experience symptoms associated with different types of foraminal narrowing, talk to your doctor about treatment. Generally, mild to moderate symptoms can be managed using pain medication, exercise, corticosteroid injections, or other conservative methods. However, if symptoms are severe or chronic (persist after several weeks or months of conservative treatment), contact Laser Spine Institute for a complimentary review of an MRI or CT scan. Our orthopedic specialists have used minimally invasive, outpatient procedures to help tens of thousands of patients rediscover their lives without back and neck pain.