Disclaimer: While the information on this web site has been helpful to many people, you should check with your medical doctor or other health care professional in deciding what is the best course of action to take for your situation. This information is designed to help you be a better partner in your care, and not as a do-it-yourself guide to diagnosing and/or treating your health care issue.
How Nerves Cause Pain
The nervous system is a continuous organ that runs throughout the body, like the extensive roots of a tree. It includes the brain, spinal cord and the nerves that connect almost every structure of the body to the spinal cord. It is a key information transmitting organ; whether the information is instructions to a muscle about when to contract, pain sensations from the body surface to many other information functions. It is commonly injured by compression, tension and friction or chafing on sharp or hard objects outside or inside the body.
Nerves are bundled within connective tissue sheaths for protection from compression and stretch forces. Nerves are wrapped in a protective connective tissue sheath, or epineurium. The bundles of conducting fibers in a nerve are termed fascicles. The fascicles of the nerve are wrapped with their own connective tissue sheaths with looser connective tissue between the fascicles. The number of fascicles in a nerve varies according to the nerve and its location. In areas of increased mechanical stress, the nerve temporarily divides into more fascicles with more connective tissue between them in areas where the nerve is subject to more mechanical force, such as when it pierces a muscle or crosses a bone.
What Types of Sensations are Created by Nerve Injury?
We are all familiar with the aches and pains that occur when muscle tissue is injured. We feel these familiar types of pain; achy, pulling, pressure when the connective tissue around and within a nerve is injured. When the nerve tissue itself is injured we feel a whole different type of pain. Neural pain is tingly, numb, electrical and/or zingy. It is common to feel either type of pain or both together. Sometimes people will feel achy, pulling and pressure which progresses to tingling and numb or zingy pain when the condition worsens.
Nerves are Vulnerable to Compression
Nerves are vulnerable to compression. It doesn’t take much pressure to affect a nerve. Pressures as low as 20- 30 mmHg within the carpal tunnel can collapse the vein that drains blood from the nerve. When this happens, the blood inside the nerve cannot exit the nerve. This prevents new blood from entering. As a result, the neural tissue becomes anoxic (lacks oxygen).
When neural tissue becomes anoxic it tends to create tingling and/or numbness. If blood flow is restored within two hours or so, a normal nerve returns quickly to full function. However, if compression and anoxia are maintained long enough, the endothelial cells lining the blood vessels begin to die and produce a protein-rich edema. If compression is alleviated and circulation restored, this edema will be relieved and the nerve will return to health. However, if the edema is sustained it will gradually create fibrosis, within the nerve and/or between the nerve sheath and adjacent structures within the tunnel.
Many clients have nerves that have suffered from on-again, off-again compression episodes over the years. As a result multiple sites along the nerve are often home to a bit of edema and/or fibrosis.
Nerve Mobilization Techniques
A lot of nerve mobilization interventions focus on decompressing nerves that are compromised by tight muscles and/or connective tissue roofs overlying or adjacent to the nerve. There are also techniques to milk oedema from the areas around nerves to decompress their blood supply so they have better health, as well as milking techniques to the nerve itself to remove oedema within the nerve. Neural flossing techniques are designed to stretch and release adhesions between nerve sheaths and adjacent structures (most of which you just decompressed). Lastly, adhesions within the nerves are resolved through milking of the nerve, and nerve stretching techniques.
Questions, comments, suggestions? Contact Doug Alexander by clicking here.