Peripheral Nerve Entrapment
What is Peripheral Nerve Entrapment?
Peripheral Nerve entrapment (PNE) is a common problem in the adult population. These can affect both the upper body in the arms and fingers and the lower body into the legs and feet. For the upper body, PNE can usually cause common conditions such as carpel tunnel syndrome, cervical disc bulge, and thoracic outlet syndrome whilst lower body entrapment may include lumbar disc bulge, piriformis syndrome, and peroneal nerve entrapment.
What are the symptoms?
The symptoms of PNE are usually similar between the upper and lower extremities with tingling, numbness, and sometimes loss of function which can range from mild to severe weakness. Neural pain can usually be described as burning, sharp, and shooting pain down the arms or legs.
How can peripheral nerves cause pain and dysfunction?
Due to the intricate pathways some nerves take, they can be susceptible to irritation or damage due to compression or friction caused by external sources such as prolonged sitting or direct impact such as hitting the ‘funny bone’ which isn’t an actual bone, but rather an exposed nerve that reacts with impact. Internally these nerves can be affected by compression and friction from various structures that surround the nerve such as bones and muscles. Long-lasting compression or friction can result in compromised blood flow to the nerve as well as inflammation around the nerve.
Difference between muscle referral and Nerve Pain?
Muscle referral or trigger point pain and nerve pain can feel similar with pain usually traveling down to an extremity, except nerve pain will usually accompany an altered sensory (tingling, numbness) or motor (weakness) symptom which is different to a muscle that may feel like more of a dull ache, soreness and may increase symptoms with pressing on the affected area. Neural pain is usually only worsened by putting the nerve on stretch or by sitting or lying in a certain position that may increase the numbness and tingling sensations. Health professionals such as Myotherapist and Physiotherapists use palpation, movements, and orthopaedic tests that help in determining the cause and area of where the nerve may be causing entrapment issues.
How is neural pain treated?
As Myotherapists we firstly use our extensive knowledge of anatomy and structures to identify what nerve is being entrapped and follow that to what spinal level that nerve will originate from. From there we can perform special tests to identify whether the problem is within the spine or elsewhere. These tests can include strength tests, stretch tests, and muscle palpations to identify the type of entrapment and where it may originate from. Once the nerve is identified we can use techniques such as soft tissue muscular massage, dry needling, and Transcutaneous Electrical Neural Stimulation (TENS) work to relieve and free up the nerve from being entrapped. We will then accompany the treatment with some home exercises to assist the entrapped nerve, these may include muscle release work by a spikey ball or foam roller, neural floss techniques, and adjusting positions in sitting and sleeping to ensure symptom management.
Nerve entrapment can be debilitating and cause major disruptions to a person’s day to day life therefore, it is important to try and get the symptoms under control as soon as possible to prevent the symptoms from becoming worse as well as future complications.
Written By Mo Bhatnagar (BHSc. Clinical Myotherapy)
References
- Ulnar Nerve Entrapment at the Elbow (Cubital Tunnel Syndrome) – OrthoInfo – AAOS. (2021). Retrieved 11 May 2021, from https://orthoinfo.aaos.org/en/diseases–conditions/ulnar-nerve-entrapment-at-the-elbow-cubital-tunnel-syndrome
- Nerve entrapment. (2021). Retrieved 11 May 2021, from https://www.physio-pedia.com/Nerve_entrapment
- Nerve Entrapment – Neurosurgical Associates of Central Jersey. (2021). Retrieved 11 May 2021, from https://neurosurgerycnj.com/peripheral-nerve/nerve-entrapment/