Nerve Pain

Our nervous system is very complex.  Basically, the nerves that exit between the vertebrae in your neck communicate with the muscles and joints in your arms and the nerves that exit between the vertebrae in your low back communicate with the muscles and joints in your legs.

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The following symptoms are characteristic of some kind of nerve involvement

• Numbness

• Tingling (pins and needles)

• Weakness

• Muscle wasting

• Muscle twitching

• Hypersensitivity

• Tight “ropey” muscles

• Non specific/vague pain that moves around

• Pain at night/rest

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So, imagine your nerves are like an electrical wire transmitting signals (both for movement and for sensation) to your skin, muscles and joints.  These electrical wires travel along path with many branches before they end. Nerves can be affected ANYWHERE along their path causing symptoms ANYWHERE along their path. One of the most common examples of this is sciatic pain where the sciatic nerve is pinched in the low back but pain is felt in the back of the thigh (along the pathway of the nerve).  Everyday repetitive movements or sustained positions can put pressure on a nerve.  

Often a nerve is stressed in more than one spot. So now imagine a long elastic.  If you pinch it in one spot, it can still stretch and move relatively well BUT if you pinch it in two or three spots that elastic loses its ability to stretch and glide from one end to the other.  Our nerves are the same. 

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Nerve pain is complicated and can be frustrating. Treating nerve pain is not the same as treating a strain or sprain because nerves are VERY IRRITABLE. Depending on many variables, they can only withstand so much treatment at any given time. 

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Direct Nerve Pain

• Nerve is compressed along its pathway in one or more places causing symptoms along the pathway

Indirect Nerve Pain

• Faulty nerves can contribute to persistent symptoms down the arms or legs

• If a nerve (think messenger) isn’t working well it’s like a bad game of telephone. A couple things can happen

  • The affected area becomes hypersensitive to touch and pain

  • The muscles innervated by that nerve aren’t getting the full message to contract and relax. Often they just get the message to contract causing perpetually tight, ropey muscles that respond poorly to stretching and rolling (because the source is the nerve not the actual muscle) 

FAQs

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Why did the pain start all of a sudden?  

Unless there was an acute injury (lifting a box --> disc herniation --> nerve pain) there has likely been pressure on the affected nerve over many months or even years. Your body simply reached its threshold and became symptomatic. 

I came in with a sore foot. Why did my physio ask if I had low back pain?

As physios, it is important for us to detect the root cause of the pain so we can treat accordingly. For example, often foot pain that is diagnosed as plantar fasciitis isn’t healing because there is some faulty nerve involvement that originated in the hip or low back.  Very often, once we start to treat the back in these scenarios (even if your back wasn’t sore), the foot pain finally goes away. 

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How can I avoid getting nerve pain?

The two most important preventative measures are​

1. Practice Good Posture

2. Move Frequently

Other things that will help include sleeping well and minimizing mental and physical stress

Will it go away?

Most often, yes! Typically, proper physio treatment in conjunction with a home exercise program can conquer nerve pain.  However, there are always exceptions and occasionally medication and/or surgery is required.

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What can I do at home to alleviate symptoms?

Of course, we are all different.  Because nerves are easily irritated, it is important to check with your physio to see what you should and shouldn’t do at home to alleviate your symptoms.  Sometimes certain movements or stretches that you think are helping could actually be further irritating the nerve.