Symptoms of foraminal stenosis really do not exist, since the narrowing or even closure of a foraminal space does not enact any symptoms unto itself. In fact, the only reason a person will feel anything if the foramen are decreased enough to elicit pain is because there is a nerve running through the space which is being compressed by the shrinking opening.
Therefore, a better name for this page would be pinched nerve symptoms, since it is the nerve which experiences the pain, not the foramen themselves.
Just remember that the
basics of the spinal anatomy need to be understood in order to truly
appreciate what foraminal narrowing or closure looks like. Once you can
conceive a mental picture of the process of neuroforaminal stenosis, understanding how symptoms may result is the easy part.
Symptoms of Foraminal Stenosis / Pinched Nerves
A pinched nerve, also called a compressive neuropathy in medical circles, is an often diagnosed condition which may occur when the foraminal space is partially or completely sealed off.
The theory of the diagnosis states that due to narrowing of the neuroforaminal space, the nerve which passes through the opening is compressed. This idea is completely accurate in some cases of purely structurally-induced pain, but falls short explaining many cases where the nerve still has ample room to exit without compression.
Some patients who are diagnosed with pinched nerves due to foraminal narrowing are obviously misdiagnosed, since the space is still widely open, often virtually completely patent and in most cases, the symptoms do not even match the diagnostic suspicion.
This type of iatrogenic blunder is so widespread that I can’t help but question virtual every pinched nerve diagnosis I examine.
Symptoms of Foraminal Stenosis and Compressive Neuropathy
Spinal nerve roots serve the motor and sensory needs of very specific parts of the anatomy. Nerve innervation is the term which means to provide with nerve energy and the body is incredibly well mapped for the nerve energy patterns.
When a nerve is compressed, it will trigger symptoms in a highly specific area of the body served by the affected nerve and not somewhere not served by the nerve. This makes sense.
Additionally, research shows that continued compression of any nerve will cause the nerve to stop signaling completely in a short time frame. The result is true and lasting objective numbness and weakness in the area served; not the chronic pain and related subjective tingling, weakness and numbness far more commonly reported by patients. These are usually indicators of a more variable process, such as partial impingement or regional ischemia.
Basically, what this all means is that the diagnosis often does not correlate to the actual symptoms. This should be obvious to doctors and in many cases, it is.
However, the diagnosis of a pinched nerve is sometimes made nonetheless, since treatment for said condition is far more profitable than telling the patient the truth, which is:
I do not know what the cause is.
In other cases, the diagnosis is speculative from the start, since no diagnostic imaging is performed to confirm or deny and the causative theory amounts to little more than an educated guess.
might be surprised how many patients are diagnosed without any definite
proof ever offered. A simple exam, a guess and treatment begins. Not good.
Symptoms of Foraminal Stenosis Summary
The reason I advise clinical correlation of symptoms with the working diagnostic theory from more than one neurologist is because these doctors will not assume about the diagnosis, but will look for facts supporting the diagnosis. These facts will be there or they will not. This is almost a universal truth of neurology.
Of course, some of the neurologists may be looking for a fast payday as well, but this is not as common within this specialty as it is with some others.
This is just my opinion here, no solid facts to back it up that last statement. But my decades of suffering and your tens of thousands of stories, emails, treatment stats and symptomatic expressions have reinforced this idea time and time again.
My advice to all who have been pronounced to be suffering from the symptoms of foraminal stenosis is simple:
Do your research and learn what your condition should entail.
Compare this to what is actually hurting you and look for inconsistencies.
This is already far more than many doctors will do. If you find some things which do not make sense, get a second opinion or even a third. There is no harm in that.
Always speak openly with your doctor and voice any concern you might have, particularly before starting any long-term or invasive treatment plan.
5/9/11 Revised 7/3/12