Neuralforaminal Stenosis Symptoms

How Neuralforaminal Stenosis Causes Pain

Neuralforaminal stenosis is a type of stenosis that narrows the holes through which spinal nerves pass on their way out to all parts of the body from the spinal cord. These holes, known as foramen, are located on the sides of your vertebral column at every level, or segment of the spine. (One segment is demarcated above and below by intervertebral joints.)

When you have neuralforamenal stenosis, bony growths or malformations – which are often due to age-related and/or degenerative changes that take place in the spine — encroach on the space normally provided by the foramen. This encroachment, in turn, decreases the amount of space available for contents, such as the spinal nerve (as well as other things), to comfortably fit.

Common Symptoms 

So what does all that mean to your symptoms? How does encroachment affect the way you feel when you have neuroforamenal stenosis?

The first thing to keep in mind is that the nerves that are affected by your neuroformainal stenosis are just that — nerves. Their job is to convey messages of sensation and action to and from your central nervous system (which consists of your brain and your spinal cord). If, due to stenosis present in your foramen, a nerve root becomes disrupted from performing its job — in other words, if it is pressured or otherwise irritated as it comes into contact with neighboring structures — you'll likely feel symptoms related to aberrations of what that nerve normally does for you.

The main symptom of neuroforamenal stenosis is usually radiculopathy. Radiculopathy may be experienced as pain, numbness, tingling, weakness, burning or electrical sensations that go down one leg or one arm (depending on whether your stenosis is present in your lower back or your neck.)

Neuralforaminal stenosis is not the only medical condition for which radiculopathy is the main symptoms. A herniated disc is another example.

Dr. Allen Wilkins, MD, of Manhattan Physical Medicine and Spine, says that radiculopathy symptoms tend to occur in a specific pattern along the extremity down which the nerve affected by your stenosis travels. The exact pattern is pre-determined and corresponds to zones into which the nerves normally exert their influence. These zones are known as dermatomes.

Dr. Ali Bydon, Associate Professor of Neurosurgery, Director of Spinal Column Biomechanics and Surgical Outcomes Laboratory at Johns Hopkins Medical School and Clinical Director of Spine Surgery at Johns Hopkins Bayview Medical Center clarifies the dermatomes (in the case of neuroforaminal stenosis) as lines of distribution along the arms or legs that when symptoms are present, correlate to the nerve that is being compressed. "The neuroforaminal stenosis symptoms tend to follow along these distribution pathways," he says.

“Compression of the cervical nerves will cause symptoms in the arms; compression of the thoracic nerves cause symptoms in the thorax and compression of the nerves in the lumbar spine will cause symptoms in the buttocks and legs,” he says.

Dr. Robert Bray, a neurosurgeon at the DISC Sports and Spine Center in Marina del Rey, California concurs and explains that “each nerve has a separate function in the arm or leg. For example, he informs me, in the neck, the C-5 nerve moves the shoulder and biceps muscle, while the nerve at the  C-6 level moves the forearm. In the low back, the L-4 nerves control the quadriceps muscle, the L — 5 nerve moves some of the calf and the big toe. In your sacral area, he says, S-1 nerves control other parts of the calf and the small toes.

"The individual nerve that is stenosed in the foramen will exhibit radiculopathy in the specific area it affects or controls. That's why you feel or experience symptoms in a specific pattern,"  Bray explains.

Wilkins adds that depending on a number of things including your particular anatomical structures, the way the neuroforaminal stenosis develops and which spinal segments are affected, symptoms can differ from patient to patient. Generally, though, when the nerve is compressed, Wilkins says that pain is the first thing to show up, then sensory or tingling numbness starts, and finally, motor weakness specific to the affected nerve may result.

Wilkins also reports that people with neural foramina stenosis commonly experience pain, muscle spasms, extremity weakness, extremity numbness and tingling, radiating burning sensation along the extremity. He adds that patients typically describe the sharp pain and tingling or burning sensations in the involved area. Diminished sensation and motor loss, corresponding to be involved nerve root may also be present, he says.

Dr. Bydon confirms that these symptoms can be due to compression of the nerve as it exits the spine. Along with the other symptoms mentioned above, he says, a compressed nerve due to neuralforamenal stenosis may feel like a shooting pain down the extremity.

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Article Sources

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  • Email Interview. Bray,, Robert S. Jr., MD. DISC Sports & Spine Center. Marina del Rey, CA. December 2013.
  • Email Interview. Bydon, A., MD. Associate Professor of Neurosurgery, Co-Director of Neurosurgery Medical Student Education, Director of Neurosurgery Undergraduate Student Education, Director of Spinal Column Biomechanics and Surgical Outcomes Laboratory at Johns Hopkins University, Clinical Director of Spine Surgery at Johns Hopkins Bayview Medical Center. December 2013.
  • Email Interview. Wilkins, A., MD. Manhattan Physical Medicine and Rehabilitation. New York. December 2013.