What Is Foraminal Stenosis?

Written by Katie Cameron
Medically Reviewed by Jabeen Begum, MD on May 05, 2025
6 min read

‌Your spine is made up of 33 vertebrae. Each one has openings that let nerves from your spinal cord pass through to other parts of the body. When these openings, called neural foramina, get narrow or blocked, they can press on your nerves. This is called neural foraminal stenosis.

Neural foraminal stenosis can happen anywhere along your spine. It's a type of spinal stenosis. Your spinal cord is a bundle of nerves that runs down the center of your spine. Some of these nerves spread out to your arms, legs, and other body parts.‌

Cervical foraminal stenosis. This occurs in your cervical vertebrae, which are the spinal bones in your neck. Your neck is one of the most mobile parts of your spine and has to support your head, so it's a common place for foraminal narrowing to occur. ‌

Thoracic foraminal stenosis. It is the least common type and happens in your thoracic spine, which is located in your upper back area. Thoracic foraminal stenosis can affect your shoulders and rib cage.‌

Lumbar foraminal stenosis. This is another common type of foraminal stenosis. The lumbar spine is located in your lower back, which is another very mobile area of your spine and has to hold up a lot of weight.

Mild neural foraminal stenosis. Depending on which part of your spine is affected, you may feel some pain, tingling, or numbness if you have mild foraminal stenosis. Some people don't have any symptoms at all.

Severe neural foraminal stenosis. If foraminal stenosis becomes severe, it can cause complications such as the loss of bladder and bowel control, sexual issues like erectile dysfunction or difficulty reaching orgasm, or even partial or full leg paralysis, though this symptom is rare.

Most causes of neural foraminal stenosis are degenerative, which means they happen over time as you age. It can also be caused by injuries. Some causes of foraminal stenosis include:

  • Osteoarthritis, which can cause bone spurs to grow into the foramen
  • Paget's disease, which also causes bone overgrowth
  • Herniated disks, which can leak fluid that presses on your nerves
  • Thickened ligaments, which can bulge into your foramen
  • Tumors, though these are a less common cause
  • Spinal injuries, which can cause the bones to move out of place (dislocations) or break (fractures)

Not everyone has symptoms of foraminal stenosis. Symptoms usually develop slowly over time, and they may come and go. It's most common in people over 50. Your symptoms will vary based on where the neural foraminal stenosis is located.

Cervical foraminal stenosis

Symptoms can include:

  • Neck pain
  • Arm pain
  • Trouble walking
  • Trouble using your hands
  • Numbness or tingling in the hand, arm, foot, or leg
  • Weakness in the hand, arm, leg, or foot

‌Thoracic foraminal stenosis

Symptoms can include:

  • Trouble keeping balance
  • Numbness or tingling at or below the level of the abdomen
  • Weakness or pain at or below the level of the abdomen‌

Lumbar foraminal stenosis

Symptoms can include:

  • Sciatica, or pain that begins in your buttock and extends down the leg, possibly into the foot
  • Weakness in the leg or foot
  • Pain in the lower back that may come and go
  • Numbness or tingling in the buttock, leg, or foot
  • Loss of bowel or bladder control 
  • Pain that worsens when you stand or walk for long periods
  • Pain that gets better when you lean forward, bend forward, or sit

If you think you have foraminal stenosis, talk to your doctor. After looking at your medical history, they'll look for limitations in your movement, ask about any pain or numbness, and check your reflexes.

If your doctor thinks you have it, there are several procedures used for a formal diagnosis:

  • X-rays show your vertebrae to help identify or rule out growths, injuries, and abnormalities.
  • MRI shows damage or disease that affects the cartilage and cushions between your disks.
  • CT scans give outlines of all the structures around your spinal canal and can show if anything is pressing on your nerves.
  • A myelogram is a procedure where your doctor uses a dye to show the movement of fluid between individual disks in your spine. Once they inject the dye, they use a CT or MRI to see pressure points affecting your nerves.‌
  • Bone scans identify fractures, growths, infections, and arthritis that affect your spinal column.

Treatment for your foraminal stenosis will depend on how much your nerves are affected and how severe your symptoms are. Your doctor will likely start with conservative (nonsurgical) treatment. Here is a brief look at some treatment options:

Medicines

This may include prescription or over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), prescription pain medicines, muscle relaxers, and steroids.

Fix your posture

If your spine is not correctly aligned, it can cause stress on your lower back and neck.‌

Modify your activities

Changing your home and work environment to reduce bending, twisting, and stretching can help your symptoms. You may need to learn proper lifting techniques as well.

Physical therapy

A therapist can help you learn exercises to improve your flexibility, strength, and circulation. This can help reduce your pain and inflammation. 

Braces

You may need to wear a brace for support.

Neural foraminal stenosis surgery

If your condition is causing severe pain or affecting your quality of life, your doctor may suggest surgery on the spine. The surgery, called a foraminotomy, may be more or less invasive depending on the degree of damage to your spine.

A neurosurgeon works with specialized nurses to perform a foraminotomy, which usually takes several hours. Here's what you can expect during the surgery:

  • You'll lie on your stomach.
  • You'll be put under anesthesia so you don't feel pain or discomfort during the procedure.
  • Nurses will monitor your vital signs like your heart rate and blood pressure.
  • Your surgeon will make a small incision beside the vertebrae on the side of your body affected by symptoms.
  • Your healthcare team will use X-rays and a microscope to help guide the procedure.
  • Your surgeon will use special tools to move muscles and ligaments blocking the opening, so they have a clear view of the vertebrae.
  • Any blockages will be removed, or bulging discs will be repaired.‌
  • Your doctor may need to remove a portion of your vertebrae to allow more room for your nerves.
  • Your muscles and ligaments will be moved back into place, and the incision will be closed with stitches.

After foraminal stenosis surgery, you can usually resume your normal diet and activity. You may need to rest for a few days and allow the surgical site to heal. Depending on the reason for your surgery, your doctor may suggest physical therapy.

There are some things you can do at home to help with foraminal stenosis. Here are a few suggestions:

Pain relievers. Try using over-the-counter pain relievers , such as NSAIDs, to help relieve pain and inflammation. 

Use ice or heat. You may be able to improve your symptoms with heat or ice. 

Use assistive devices. A walker or a cane can help you avoid falls. They may also help relieve your pain by letting you bend forward while you walk.‌

Exercise. Talk to your doctor or physical therapist about what exercises you can do to improve your balance and strengthen your muscles. 

Maintain a healthy weight. If you are overweight, losing weight can help ease the stress on your spine.

Can I exercise with foraminal stenosis?

Yes, exercise can help ease some of your foraminal stenosis symptoms. Talk with your doctor or physical therapist about exercises that are safe for you to add to your daily routine. They may recommend physical therapy.

What is the best natural treatment for spinal stenosis? 

If your case isn't severe, doing light aerobic exercises, maintaining a healthy weight, and stretching may help ease your spinal stenosis symptoms. Talk with your doctor before you start a new exercise program.