From the Research
Neural foraminal stenosis at C5-C6 and C6-C7 levels would likely cause radiating neck pain, numbness, tingling, and weakness in specific arm and hand areas. At C5-C6, symptoms typically affect the shoulder, biceps, and thumb/index finger, while C6-C7 stenosis impacts the triceps and middle fingers. Patients often experience pain that worsens with neck extension or turning, difficulty with fine motor tasks, and possible muscle atrophy in severe cases. These symptoms occur because the narrowed foraminal spaces compress nerve roots exiting the spinal cord, disrupting normal nerve function. The severity of symptoms generally correlates with the degree of stenosis, explaining why more pronounced symptoms might occur from the C6-C7 level described as "severe" 1. Some patients may also experience balance problems, coordination difficulties, or bladder/bowel issues if spinal cord compression develops alongside the foraminal stenosis.
Expected Symptoms
- Radiating neck pain
- Numbness
- Tingling
- Weakness in specific arm and hand areas
- Pain worsening with neck extension or turning
- Difficulty with fine motor tasks
- Possible muscle atrophy in severe cases
- Balance problems
- Coordination difficulties
- Bladder/bowel issues (if spinal cord compression is present)
Severity of Symptoms
The severity of symptoms generally correlates with the degree of stenosis, as shown in a study on the outcome of transforaminal epidural steroid injection according to the severity of cervical foraminal stenosis 1. However, another study found that the treatment outcome of cervical transforaminal epidural steroid injection did not differ according to the severity of cervical foraminal stenosis 1. It is essential to consider the individual patient's condition and the severity of the stenosis when evaluating the expected symptoms and treatment outcomes.
Treatment Options
While the provided studies focus on lumbar radiculopathy and spinal stenosis, the principles of treatment can be applied to cervical foraminal stenosis. A systematic review and meta-analysis found that pregabalin was more effective in reducing pain in lumbar radiculopathy patients compared to gabapentin at short-term follow-up, but there was no difference in the long-term follow-up 2. Another study found that pregabalin and gabapentin had a significant effect on VAS score at 3 months, but no significant differences were observed in ODI scores, and adverse events were higher in the gabapentinoids group 3. These findings can be considered when evaluating treatment options for patients with cervical foraminal stenosis.