‘Serious neck injuries caused in a serious car accident, motorcycle accident, bicycle or pedestrian accident can be brutally debilitating. One of the most common neck injuries that we see on a repetitive basis is called “Foraminal Stenosis”. Below our Hamilton Personal Injury Lawyers explain how foraminal stenosis can occur after an accident and five of it’s most common symptoms.
Foraminal stenosis is a medical condition involving the narrowing of the foramen, which are the openings in the spinal column that allow your nerve roots to exit the spine and extend to other areas of your body. Each spinal nerve travels through these foramina, providing motor and sensory function to specific regions of the body.
A healthy spine is composed of a series of bones, known as vertebrae, stacked on top of each other, from the skull to the lower back. The neck or cervical spine includes the first seven of these vertebrae, labeled C1 through C7, followed by the C8 nerve root which exits the spine below the C7 vertebra. Each vertebra in the cervical spine is separated by intervertebral discs, which act as shock absorbers, preventing the vertebrae from rubbing against each other and providing flexibility for the spine.
Trauma or accidents can lead to foraminal stenosis in several ways. Inflammatory responses to injury, bleeding, or tissue swelling can cause immediate narrowing of the foramen, leading to potential nerve compression. More commonly, however, foraminal stenosis is a delayed response to an injury. Trauma can accelerate the degenerative changes in the spine, leading to conditions such as bulging or herniated discs, bone spurs (osteophytes), or thickening of the ligaments in the spine, all of which can result in foraminal stenosis. These degenerative changes can lead to persistent pain and other neurological symptoms due to the affected nerves’ inability to function properly. Understanding the anatomy of the your spine and how trauma can lead to foraminal stenosis is a crucial first step in the journey toward appropriate treatment and recovery after a serious accident.
Foraminal stenosis in the cervical spine can lead to a variety of symptoms in the upper extremities, which include the shoulders, arms, and hands. The top five symptoms typically include:
Pain: Foraminal stenosis is characterized by a narrowing of the openings or foramina in the spinal column through which nerve roots exit. This can result in nerve root compression and manifest as pain, the most common symptom associated with this condition.
The genesis of this pain can be traced back to the injury and the subsequent bodily responses. When a neck injury occurs, the structures within the neck, including the vertebrae, discs, ligaments, and muscles, can be damaged. In response to this damage, the body initiates an inflammatory process which can cause an immediate swelling and narrowing of the foramina.
Over time, if the injury leads to persistent inflammation or accelerates degenerative changes in the spine, the foramina can become chronically narrowed. This might happen due to conditions such as bulging or herniated discs, development of bone spurs (osteophytes), or thickening of the spinal ligaments, all of which encroach upon the space within the foramina. This leads to compression or pinching of the nerve roots that pass through these openings.
This nerve root compression can cause pain in two primary ways. First, the compression itself can trigger pain signals along the nerve that are interpreted by the brain as coming from the area of the body served by that nerve. This is why pain from foraminal stenosis in the neck can be felt in the arm.
Second, the compressed nerve roots can become inflamed, further intensifying the pain. The inflammatory response can cause the release of chemicals that irritate the nerve root, leading to more pain signals being sent to the brain.
The result is often a pain that starts in the neck and radiates down the arm, following the path of the affected nerve. This can be a sharp, burning, or dull ache, varying in intensity and frequency. It can be constant or intermittent, and may be exacerbated by certain movements or positions.
It’s important to remember that the course and severity of pain can vary widely among accident victims, depending on factors such as the specific nature of the neck injury, the degree of the foraminal stenosis, the nerve roots affected, and the person’s overall health.
Numbness: numbness often arises when the nerve’s ability to transmit sensory signals to the brain is impeded. Sensory signals relay information about sensations such as touch, temperature, and vibration from various parts of the body to the brain. When these signals are interrupted due to nerve compression, the brain may interpret this as numbness in the region of the body that corresponds to the affected nerve.
In the case of foraminal stenosis resulting from a neck injury, the numbness is often experienced in the upper extremities, including the shoulder, arm, or hand, depending on which cervical nerve roots are impacted. This may manifest as areas of decreased or absent sensation, which can be both disconcerting and functionally limiting.
The extent and location of numbness can vary widely among individuals, depending on factors such as the severity of the neck injury, the degree of foraminal stenosis, the specific nerve roots affected, and the person’s overall health. Timely and accurate diagnosis is crucial to manage these symptoms effectively and mitigate the impact of the neck injury on the individual’s quality of life.
Tingling or Parasthesia: tingling or paresthesia in the upper extremities is a common symptom resulting from nerve root compression in foraminal stenosis, particularly in the cervical spine following a neck injury. This symptom is an abnormal sensory experience often described as “pins and needles,” a sensation of crawling skin, or even a chilling or burning sensation. Tingling or parasthesia is a common symptom of a neck injury after an accident.
Nerve roots function as highways for electrical signals traveling between the brain and different parts of the body. Sensory nerve roots carry signals about touch, temperature, and body position from the skin, muscles, and joints to the brain. When these nerve roots are compressed, the normal flow of electrical signals can be disrupted. This can lead to the misfiring of nerve signals or increased spontaneous nerve activity, which the brain interprets as abnormal sensations, such as tingling or paresthesia.
The specific location of tingling or paresthesia often correlates with the area of the body served by the affected nerve root. In the context of foraminal stenosis in the cervical spine, these abnormal sensations are often experienced in the shoulders, arms, hands, or fingers.
The frequency and severity of these sensations can vary widely. They can be intermittent or constant, and can range from mildly annoying to significantly disruptive. In some cases, specific movements or positions of the neck can exacerbate these sensations, reflecting the mechanical nature of nerve root compression. It’s important to recognize that persistent or worsening paresthesia should be evaluated by a healthcare professional to ensure appropriate diagnosis and management.
Muscle weakness is a symptom that can occur when foraminal stenosis in the cervical spine leads to nerve root compression. Nerve roots function as conduits for electrical signals traveling between the brain and different parts of the body. Some nerve roots specifically carry motor signals from the brain to the muscles, instructing them to contract and thus enabling movement.
When these motor nerve roots are compressed, the normal flow of these motor signals can be disrupted. The efficiency of signal transmission from the brain to the muscles is reduced, which can lead to decreased muscle strength. In practical terms, this can manifest as difficulties in performing certain tasks, such as lifting objects or opening jars, which were previously easy. In severe cases, this can even lead to muscle atrophy, or shrinkage, due to decreased use.
The location of muscle weakness often correlates with the area of the body served by the affected nerve root. In the context of foraminal stenosis in the cervical spine, this weakness is often experienced in the upper extremities, including the shoulders, arms, or hands.
The degree of muscle weakness can vary widely, depending on factors such as the severity of the nerve root compression, the specific nerve roots affected, and the duration of the compression. It’s important to note that persistent or worsening muscle weakness warrants evaluation by a healthcare professional, as it may indicate significant nerve compression requiring prompt intervention.
Reduced Reflexes: reduced reflexes are another symptom that can manifest due to foraminal stenosis in the cervical spine leading to nerve root compression. Reflexes are automatic, rapid responses to certain types of stimuli that are mediated by specific neural circuits involving both sensory and motor nerve fibers. Classic examples of these include the bicep reflex, the tricep reflex, and the brachioradialis reflex, all of which involve the upper extremities and are mediated by nerves that originate from the cervical spine.
When a stimulus is applied (like a tap from a reflex hammer), sensory nerve fibers transmit a signal to the spinal cord, which then sends a response signal back to the muscles via motor nerve fibers, causing a reflex contraction. This process occurs without conscious thought and is an important aspect of normal nervous system function.
However, when nerve roots become compressed, the flow of these signals can be disrupted, leading to a diminished or absent reflex response. This is because the compressed nerve root may not transmit the signals effectively, preventing the full strength of the reflex signal from reaching the muscle.
In the context of foraminal stenosis in the cervical spine, this can result in reduced reflexes in the arms, depending on the specific nerve root affected. For example, compression of the nerve root at the C5 or C6 level can result in a diminished bicep reflex, while compression at the C7 level might lead to a diminished tricep reflex.
Reduced reflexes are typically detected during a physical examination by a healthcare provider, and can provide important clues regarding the location and extent of nerve root compression. It’s important to note that while reduced reflexes can be an indication of nerve root compression, they are just one aspect of the overall clinical picture and are considered in conjunction with other symptoms and diagnostic tests.
In a serious accident, such as a high-impact car crash or motorcycle accident, violent forces can be exerted on the neck. These forces can lead to damage of the cervical spine, causing immediate injuries such as fractures or dislocations, or softer tissue injuries to the muscles, ligaments, and intervertebral discs. This trauma can induce an inflammatory response causing swelling and narrowing of the small holes in the spine where nerves exit, called foramina.
Over time, this damage can get worse. The hurt discs might bulge out, or bony growths might form as the body tries to make the neck stable again. This can make the foramina even narrower, a problem called foraminal stenosis.
The long-term effects of foraminal stenosis can vary. Some people might have ongoing symptoms like pain, numbness, a tingling feeling, weakness, or loss of reflexes. If not treated properly, these problems can get worse and seriously affect a person’s life.
In the worst cases, foraminal stenosis can lead to permanent nerve damage. This means chronic pain and possibly unchangeable problems with feeling and muscle strength. This could make it really hard for someone to do normal daily activities.
Doctors can use surgeries to treat foraminal stenosis. These might include removing a disc, removing part of a bone, or joining bones together. These surgeries are designed to give the nerves more space.
However, surgery in the neck area is more risky than in the lower back because the neck is a complex area. It holds the spinal cord, supports the head, and allows a lot of movement. So, any surgery needs to carefully balance making more space for the nerves, while keeping the neck stable and flexible.
Also, the neck is close to important body parts like the food pipe, windpipe, and big blood vessels, which can add to the risks. Although problems are rare, they can include nerve damage, infection, trouble swallowing or talking, and, with joining of bones, the bones not fusing properly. Even with these potential risks, in severe cases, surgery might be the best way to relieve symptoms and improve a person’s life. Decisions about surgery should always be made with the help of a qualified orthopedic surgeon.
For over 20 years our Hamilton Personal Injury Lawyers have helped accident victims who have suffered serious neck injuries recover the compensation they deserve. We understand that a serious neck injury which results in a permanent interruption of function or worse – a neck injury which requires surgery – can alter a person’s life forever – both in a non-economic and economic perspective. A person may be unable to work, or suffer a loss of economic opportunity, causing financial hardship and suffering.
Our Hamilton Personal Injury Lawyers lawyers have a strong record of winning neck injury cases against reckless drivers, and business establishments that have failed to protect the safety and well-being of visitors who visit their premises.
If you or a loved one has suffered a neck injury at the fault of another, our Hamilton Personal Injury Lawyers can help you recover the compensation you need to make a full financial recovery. Don’t wait to learn how much your case is worth. Call us today to schedule a free case evaluation and discuss the details of your case today no matter where you are in Ontario. If you have been involved in a serious accident, call us today, no matter where you are in Ontario at 1-844-LALANDE or local in Hamilton and throughout Southern Ontario at 905-333-8888. Alternatively, you can email us confidentially through our website or chat 24/7 with our live chat operator.