Structures Around the Nerve
Whether it be a herniated disc, spinal degeneration, or fascial tightness in structures like the carpal tunnel, it is important to treat any physical structure that can compress or ‘pinch’ the nerve. Interventions such as traction, manual therapy, or medical interventions that can range from injections to surgery can reduce the pressure on the nerve and relieve its symptoms.
The Nerve Itself
Even if the mechanical compression is relieved, patients may still have nerve symptoms. The residual symptoms are due to the nerve itself being left untreated. Nerves should be elastic enough – like a bungee cord – to lengthen in order to match your daily motion. However, with inflammation, the nerve becomes less elastic and more irritable with movements that extend it beyond its available motion. It is vitally important to improve the mechanics and physiology of the nerve, so that it is able to perform its intended function. In physical therapy, we utilize nerve mobilizations to improve the mechanics and physiology of the nerve.
Tissue the Nerve Innervates
Lastly, tissue that an inflamed nerve innervates can maintain nerve symptoms. This innervated tissue can manifest itself as fascial restrictions, muscle trigger points, and joint restrictions. It is important to improve the integrity of these structures as they are manifestations of the nerve’s system not working correctly and can perpetuate the dysfunction. Treatments can include, but are not limited to, manual therapy, appropriate exercises, and intramuscular manual therapy.