Diagnosing Foraminal Stenosis

Deciding to See a Doctor

You should make an appointment if you have persistent pain, numbness, or weakness in your back, legs, or arms.

If your family doctor suspects that you have foraminal stenosis, he or she may refer you to a doctor who specializes in disorders of the nervous system. Depending on the severity of your symptoms, you may also be told to seek spinal surgery options.

What You Can Do Beforehand

Before the appointment, you might want to prepare a list of answers to the
following questions:

  • When did you first notice this problem?
  • Has it gotten worse over time?
  • Have your parents or siblings ever had similar symptoms?
  • Do you have other medical conditions?
  • What medications or supplements are you taking regularly?

Your doctor may ask some of the
following questions:

  • Do you have pain? Where?
  • Does any position ease the pain or worsen it?
  • Do you have any tingling, numbness or weakness?
  • Do you feel clumsier lately?
  • Have you had any difficulty controlling your bowels or bladder?


How is Foraminal Stenosis Diagnosed?

Diagnosing foraminal stenosis involves a complete evaluation of your spine. This process always begins with a medical history and physical examination.

The doctor will be able to order tests to help rule out other conditions and help you discover whether foraminal stenosis is the cause of your pain. Imaging studies, like the MRI and CT scan, are often used to determine the extent and location of the nerve compression.

Medical History

A thorough medical history is probably the most important aspect of your evaluation, as it will tell your doctor about your individual symptoms, possible causes of foraminal stenosis and other potential causes of back pain.

Physical Examination

During the physical exam, your doctor will try to find the location of the pain and figure out how it affects your movement. You may be asked to:

  • Sit, stand and walk. While you walk, your doctor may ask you to try walking on your toes and then your heels.
  • Bend forward, backward and sideways.
  • Lift your legs straight up while lying down. If the pain is worse when you do this, you might have sciatica, especially if you also feel numbness or tingling in one of your legs.
  • Your doctor will also move your legs in different positions, including bending and straightening your knees. Your doctor will be checking your strength and ability to move.
  • To test nerve function, the doctor will use a rubber hammer to check your reflexes.

The following tests may be done:

  • An x-ray of the spine to check for osteoarthritis, bone spurs and narrowing of the spinal canal
  • X-rays of the hips or knees
  • Tests to check the circulation in your legs and to rule out other diseases with similar symptoms
  • An EMG to check the nerves going to your legs
  • A CT scan takes more detailed images of the back and foraminal canal than an X-ray can. CT scans give your doctor a better view of areas of compression within the foraminal canal and gives the best images of bone.
  • An MRI scan of the spine. MRIs are helpful because they show the soft tissue structures — including discs, nerves, muscles, and ligaments — than seen on X-rays or CT scans. The MRI can show exactly what is causing foraminal nerve compression and is the best tool for diagnosing foraminal stenosis.