Foraminal Narrowing Treatment
Neural foraminal narrowing or foraminal stenosis arises when the vertebral foramen, which is the opening in the vertebra through which spinal nerves pass, becomes narrowed. This can result from many foraminal narrowing causes, including degenerative disc disease or a buildup of debris in the foramen over time.
This condition can present at any level of the spine but is most common in the lumbar or cervical area. As the foramen narrows, it results in nerve compression, leading to uncomfortable and painful symptoms.
Treating Foraminal Narrowing Symptoms
Treatment to manage foraminal narrowing symptoms typically starts with exercise, pain medications and/or corticosteroid injections. Depending on the severity of the symptoms, managing foraminal narrowing via a non-surgical treatment plan is quite common.
The following are some of the non-surgical treatment options for foraminal narrowing that people usually undergo before coming to The Bonati Spine Institute:
Medication for foraminal narrowing along with rest, hot and cold therapy, and physical therapy may be the first treatment course your doctor suggests. Here are some of the usual medications included in treatments plans for foraminal narrowing:
Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
These common drugs like ibuprofen or naproxen, help diminish inflammation and are usually used to treat mild or moderate pain. NSAIDs provide analgesia at low doses and quell inflammation at high doses, both key agents to treat foraminal narrowing syndrome and relieve pain.
Epidural steroid injections provide an aggressive conservative treatment for foraminal narrowing syndrome. Common steroids, such as cortisone, are used if tissue inflammation adjacent to the foraminal narrowing is noticeable. Steroids help reduce inflammation while sedatives control the nerve pain.
Opioids are a type of prescription narcotics, usually used for severe cases. When combined with NSAIDs, opioids can reduce inflammation and pain. Opioids such as oxycodone, codeine, and morphine are stronger narcotic drugs and highly addictive, which is why they are usually prescribed on short-term treatments on those who experience moderate to acute pain. The use of opioids is controversial and not recommended by the surgeons of The Bonati Spine Institute.
Under proper supervision, exercises like yoga and Pilates can provide relief from foraminal stenosis. Focusing on exercises that elongate the spine and stretch ligaments and muscles can help relieve the pressure on a compressed spinal nerve as well as reduce neck and back pain.
Physical therapy for foraminal narrowing can show promising results. Physical therapy programs to treat this condition are designed to help restore flexibility and strength in the neck or back. The overall improved posture and increased flexibility help reduce the symptoms.
Chiropractors focus on subluxation of the spine, which is when a vertebra doesn’t move as well, so as a result the bone and surrounding tissue structures add pressure on the nerves and spinal cord. With a chiropractic adjustment, they can balance out the nervous system, get the joints moving again properly, and release pressure from the spinal cord.
Acupuncture is usually used in conjunction with other treatments to provide a holistic approach to well-being. For foraminal narrowing, acupuncture needles are placed on the points that affect the area of the body in which the patient is experiencing symptoms.
Acupuncture is often combined with epidural injections, stretching exercises, physical therapy, and over-the-counter medication.
Since some symptoms of foraminal narrowing include muscle spasms, numbness, muscle weakness, and tingling, massage therapy can treat these specific symptoms. After pinpointing the location of symptoms a massage therapist can use direct pressure and stretch your muscles to release tension and decompress the nerves.
Some lifestyle changes are important to reduce pain and maintain your spine as healthy as possible. Some changes that can help your quality of life with this condition are:
- Quit smoking and keep consumption of alcohol to a minimum
- Maintain a healthy diet high in calcium and omega-3 fatty acids
- Practice a low-impact exercise like yoga
- Avoid lifting heavy objects
Surgery for Foraminal Narrowing
For the more severe cases and when conservative treatment has failed to provide relief, a surgical intervention may be necessary to reduce pain and the symptoms from foraminal narrowing. The Bonati Spine Institute offers an array of highly effective procedures to treat foraminal narrowing. These procedures may include:
- Foraminotomy – This procedure increases the space for nerve roots to exit the spinal canal
- Laminectomy/Laminotomy – This surgery removes part of the lamina of a vertebra and relieves the pressure on a nerve affected by foraminal narrowing
- Discectomy – Removes part of a herniated disc compressing a nerve root