Foraminal Stenosis Treatment in Kalimpong

Your spine is made up of 33 bones or vertebrae which have a narrow opening to let the nerves pass through. Foraminal stenosis occurs when the foramina or the openings within the spinal canal (the hollow cavity that runs through each vertebra) narrow or tighten. This can compress the spinal nerves eventually affecting the signals traveling through them. 

Foraminal stenosis can lead to pain, weakness, and numbness in the regions where the particular nerves supply. So, what causes foraminal stenosis? how is it treated? & how can this be prevented? This article will give you a better insight into these facets. 

The vertebrae or bones that make up your spine consist of small openings called the foramina through which nerves pass to the rest of your body. Foraminal stenosis is a condition when these tiny openings tighten/narrow pinching the nerves passing through them. This leads to pain, weakness, and numbness in parts of the body the nerve serves.

Most cases of foraminal stenosis do not show any symptoms and in cases that are symptomatic, it can cause pain, numbness, or tingling sensation in certain areas. Here, let’s take a detailed look at the signs and symptoms of foraminal stenosis. 

Cervical Stenosis

This happens when the tiny opening in your neck or cervical spine bone tightens or narrows. This causes sharp and burning pain in the neck, shoulders, and arms. You may experience mild numbness and weakness in your arms and hands. 

Thoracic Stenosis

This type of foraminal stenosis develops in the thoracic vertebrae or the upper portion of your spine. The pinched nerves in your back can cause pain and numbness that may be felt in the front of your body. In fact, this is the most common type of foraminal stenosis.

Lumbar Stenosis

Spinal stenosis is the most commonly found type and it develops in the lumbar vertebrae or the lower back. People with lumbar stenosis experience pain, numbness, tingling, and weakness in the buttocks, legs, and foot region. Your pain may worsen while bending, twisting, reaching, coughing, or sneezing.

Common causes of foraminal stenosis include:

• Advancing age: As you age your spine may undergo degenerative changes due to wear and tear.
• Back injuries: Certain injuries to your back can lead to the formation of scar tissue or cause structural changes that can increase the risk of developing foraminal stenosis.
• Inflammatory conditions: Certain conditions such as degenerative disc diseases can affect the spinal bones and the surrounding tissues. 
• Previous surgery: Foraminal stenosis can be the result of an unsuccessful surgery that was done to treat back problems.
• Abnormal spine structure: Anatomic defects in the spine can also result in foraminal stenosis.

Apart from these, here are some less common causes of foraminal stenosis:

• Paget’s Disease: It is a chronic condition that affects the bones, resulting in abnormal bone remodeling and growth.
• Spondylolisthesis: Here one vertebra in the spine slips out of its proper position and onto the vertebra below it. 
• Cysts or Tumors: Cancerous & benign growths can narrow the gaps between the spinal cord and add pressure on the spinal nerves. 
• Genetic Conditions: Individuals with genetic conditions such as dwarfism (height 4ft 10 or below) are more at risk of developing foraminal stenosis due to abnormal spine formation.

What is the first sign that could indicate having spinal stenosis? Well, if you have pain that begins from your spine and radiates to your arms and legs accompanied by numbness or tingling, then you need to consult an orthopedist immediately. For a doctor to identify the extent of your foraminal stenosis, he/she would conduct the following tests: 

• Physical Examination: A doctor will check your movement, muscle strength, reflexes, and the severity of pain and numbness. 
• X-Ray: They help understand the alignment of spinal bones and the narrowing of the spaces between them. 
• MRI Scan: This scan detects damage in soft tissues i.e., ligament & discs. 
• CT Scan: This scan helps identify extra bone growth over an existing bone (bone spurs).
• Electromyography: This is a nerve-conducting test to understand if the nerves in the spinal gaps are functioning properly. It also helps your doctor understand if this is caused due to some sort of pressure on the spinal nerves or another existing condition that needs to be studied further.

Grading: 

Based on the above-listed test results, your healthcare provider will determine the severity of the narrowed gaps between your spinal bones. This can be understood as Grading: 

• Grade 0: No Signs of foraminal stenosis
• Grade I: Mild stenosis. No damage to the spinal nerves
• Grade II: Moderate stenosis. No damage to the spinal nerves.
• Grade III: Severe foraminal spinal stenosis. Damage to the spinal nerves. Spinal nerves are pinched due to tightened gaps between the spinal bones.

The treatment for foraminal stenosis depends on the severity of its symptoms. Here’s how a doctor will initiate a treatment plan in Kalimpong for spinal stenosis. 

1. Medications:

Your Orthopedic doctor will prescribe the following the relieve pain and ease symptoms with medication. These medications include: 

• Nonsteroidal Anti-Inflammatory Drugs: These medications may help relieve mild to moderate pain associated with foraminal stenosis.
• Antidepressants: Some antidepressant medications, such as amitriptyline or duloxetine, can be used to help manage chronic pain 
• Anti-Seizure Drugs: Medications used to treat seizures, such as gabapentin or pregabalin, can also be used to treat nerve pain associated with foraminal stenosis.

2. Physical Therapy:

Physical therapy is a group of exercises that help relieve pain and manage spinal stenosis on a daily basis. Here are some of the benefits of physical therapy for foraminal stenosis: 

• Builds spinal flexibility and stability
• Strengthens spine
• Improves body posture and balance
• Relieves pain

3. Steroid Shots: 

In order to reduce swelling, pain, and inflammation in the affected nerves, your doctor may recommend a steroid shot. During the procedure, a healthcare provider will use a small needle to inject the medication into the epidural space near the affected nerve root. The epidural space is the area that surrounds the spinal cord and nerve roots. The medication then spreads to the surrounding tissues, providing relief from pain and inflammation.

4. Surgery: 

In severe cases where symptoms are not responding to conservative treatment, surgery may be necessary. The goal of surgery is to remove the bone or tissue that is compressing the nerve root, allowing it to heal and reducing pain and other symptoms. The types of surgeries include:

• Laminectomy: It involves the removal of the lamina, a portion of the vertebrae to ease the pressure on the veins and relieve the symptoms. 
• Laminotomy: This surgery refers to a partial or complete removal of the spine laminae (tiny weak bones found on opposite sides of the spinal canal). This will ease the pressure on the spinal nerves.
• Laminoplasty: This surgery is done for people with cervical stenosis (affected bones in the neck/upper region of the spine). This procedure makes more space in the spinal canal for the spinal nerves to pass freely without being compressed. The gaps between the spinal bones are held with metal hardware. This procedure relieves pain and symptoms of foraminal stenosis.

Surgery can be a daunting aspect, and feeling anxious is absolutely normal. The amount of information you get from the internet may confuse you. This is where Medfin can help! Our team of Orthopedic Surgeons in Kalimpong has 15+ years of surgical expertise in treating and has foraminal  (spinal) stenosis for over a decade. Advanced surgeries that are painless and scarless are aimed to boost recovery. Think Surgery! Think Medfin!