What Is Bilateral Neural Foraminal Stenosis?

foramenThe spine is made up of a bunch of pieces of bone, called vertebrae, this much we are all aware of.  Bilateral Neural Foraminal Stenosis is what happens when the tiny holes on each side of the canal in the vertebrae (known as foramen) narrow.  So these little holes narrow, which thereby compresses the nerve roots.  BNFS is the most common type of stenosis, with the lowest lumbar being affected in 68% of all cases reported.

You might be asking yourself what the cause of this is, and the answer would be normal degeneration of the disc due to the natural aging process being the most common.  That’s not the only cause though, any of the multitude of degenerative diseases such as rheumatoid arthritis, osteoarthritis, or structural abnormalities can be the culprit.

Symptoms of Bilateral Neural Foraminal Stenosis

In order to tell if you have symptoms of BNFS, you need to pinpoint the location of the narrowing of the foramen.  We have already said that the lumbar region is the most affected area, which would lead to the obvious location of most symptoms, the lower extremities.  The most common symptoms can be any of the following:

Bilateral Neural Foraminal StenosisIf it happens in the area of the sciatic nerve, and affects it, then the symptoms of sciatica are produced.  Pain in the lower back area that spreads to the buttock and lower leg with possible numbness and tingling of the lower extremities.  Even simple tasks as walking can become almost impossible due to the shear pain brought on by exertion.

Occasionally, neurogenic claudication manifests as pain in the leg, accompanied by numbness and weakness during normal walking.  The only thing one has to do to relieve this symptom is to sit down.

These symptoms we have spoken of tend to develop and gradually worse over a period of several years.  The longer the patient walks and stands, given the period of time, the worse the pain becomes.  Bending over backward, bending and stopping sideways, or rotating all make the symptoms worse, but can be relived sitting or getting some rest.

Treatment Of Bilateral Neural Foraminal Stenosis

Nowadays, diagnosing BNFS has become easier than in the past, with the advent of the CT scan and MRI.  Both of these tests can make the diagnosis obvious.

The severity of the symptoms and how much disability is caused are what decide what the treatment will be.  The first step of treatment is of course non-invasive and would involve exercises that stretch areas affected, modifying the activities that might aggravate the situation, and then possibly prescription medicine or epidural injections.  The aim of these treatments is of course to let the patient still lead the same life led before, with less pain, or manageable pain.  That being said, these treatments do not cure the heart of the issue, and pain will be present.
Surgery is a possibility but is saved usually only for those whose daily lives have been affected.  If the quality of life has been lowered due to the bilateral neural foraminal stenosis, then surgery would seem appropriate.

For a more general look at middle back pain and what causes it, click the link.