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Foraminal Narrowing

Foraminal Narrowing


Spinal stenosis develops when the open spaces within the spine narrow. Foraminal narrowing is a specific type of spinal stenosis that affects the bony passageways between vertebrae, called the intervertebral foramina. Spinal nerves pass through the foramina when they branch off the spinal cord and exit the spine. Narrowing of the passageways can cause nerve roots to become trapped or pinched as they make their exit. The resulting nerve compression causes pain and symptoms along the pathway the nerve innervates.

While foraminal narrowing can occur anywhere along the spine, it commonly develops in the cervical or lumbar spine.


Age-related changes are the primary cause of foraminal stenosis, as the vertebrae, spinal discs and other spinal structures begin to degenerate after years of wear and tear. Components that contribute to spinal narrowing include:

  • Osteoarthritis. Degenerative arthritis causes cartilage erosion, inflammation and swelling in and around the facet joints between vertebrae. Spinal arthritis can also cause bony overgrowths called bone spurs to develop in and around the foramina, narrowing the space nerves have to pass through. 
  • Degenerative disc disease. Spinal discs degenerate naturally with age, wear and tear. They may start to flatten, bulge or collapse, all of which can narrow the open spaces between vertebrae.
  • Herniated disc. Disc herniation develops when age-related wear and tear or an acute injury causes a spinal disc to tear. A tear can leak the inner, jelly-like fluid of the disc into the open spaces of the spine, where it irritates and compresses nearby nerves.
  • Thickened ligaments. With age, the ligaments that support vertebrae start to thicken and bulge or collapse into the spinal canal, narrowing the space nerves have to pass through.

Age is the primary risk factor for developing foraminal stenosis.


Mild foraminal narrowing may not cause any pain or symptoms. Symptoms occur when the bony passageways narrow or tighten enough to trap or compress nerve roots traveling through on their way out the spine. If nerve compression occurs, you might have the following symptoms:

  • Cervical spine. If foraminal narrowing happens in the cervical spine, you may develop pain, weakness, numbness and tingling in the neck, shoulder, arm and hand. You might also experience stiffness and loss of range of motion in the neck.
  • Lumbar spine. If foraminal narrowing happens in the lumbar spine, you may develop a set of symptoms known as sciatica: pain, weakness, numbness and tingling in the low back, hip, buttock, thigh, calf and foot.

Foraminal stenosis symptoms usually worsen with activities and movements that place increased stress and pressure on the spine, like bending over, twisting, coughing, sneezing or laughing. Additionally, in the lumbar spine, sciatic symptoms may flare up from prolonged periods of sitting up straight, standing and walking.


Unfortunately, spinal narrowing can’t be reversed. Instead, treatment is focused on reducing pain and symptoms, maintaining spinal mobility and slowing down the progression of damage. Luckily, the nerve compression that’s causing your pain and symptoms has a good chance at resolving with a few weeks of non-surgical treatments. To begin, your doctor may prescribe some or all of the following:

  • Rest and activity modifications. Try to avoid activities that cause severe pain and symptom flare-ups, like playing high-impact sports or heavy lifting. But don’t spend too much time resting and avoiding activities. Prolonged immobilization can cause even more weakness and pain, so resume your activities as soon as you can.
  • Medications. Over-the-counter pain relievers (acetaminophen) or NSAIDs (naproxen, ibuprofen, aspirin) can help reduce mild to moderate pain, swelling and inflammation.
  • Physical therapy. Physical therapy can help you improve strength in the back, leg and core muscles that support your back and spine. A therapist will work with you to improve your strength, flexibility, range of motion, balance and endurance. Additionally, your therapist will show you exercises and stretches that relieve pressure on the spine and pinched nerves.
  • Injections. A corticosteroid injection directly into the spine can temporarily reduce pain, inflammation and swelling around irritated nerve roots. While the effects of an injection are short term, the weeks or months of pain relief will give you time to get stronger and more mobile.

Once your symptoms resolve, maintaining an active lifestyle is key to managing your condition. Regular exercise improves your strength and mobility and allows you to perform activities for longer and with less pain. 


If several weeks of conservative treatments aren’t effective, surgery may be an option. A spinal decompression procedure can create more space in the spine and relieve pressure on compressed nerve roots. 


At Integrity Spine and Orthopedics, we specialize in identifying, diagnosing and treating a wide range of acute and chronic back, spine and joint conditions. Our board-certified orthopedic surgeons specialize in performing minimally invasive spine surgeries to reduce pain and improve mobility for patients diagnosed with spinal arthritis, degenerative disc disease, bulging or herniated discs, a pinched nerve, spinal stenosis and more. 

Some of the primary benefits of minimally invasive surgery include:

  • Smaller incisions
  • Fewer complications and bloss loss during surgery
  • Less damage to surrounding muscle and soft tissues
  • Lower risk of infection
  • Less post-op pain and less reliance on strong pain medications during recovery
  • Faster recovery and rehabilitation
  • Better cosmetic results with minimal scarring 

If you’re experiencing back or joint pain, weakness, or a loss of mobility, reach out to us today to schedule a consultation with our team. We provide compassionate and comprehensive care to help you find relief from pain and get back to doing the activities you love. 

Call us at 904-456-0017 or contact us online to request an appointment.