Nerves carry impulses of sensation or motion through the body. Nerve pain can often be described as severe toothache.
Bell’s palsy is a condition affecting one of the nerves in the face: Cranial nerve VII, the Facial nerve. There are many reasons for the paralysis and it is often attributed to trauma, viral infection or even pregnancy. Bell’s palsy affects one side of the face. Signs of paralysis or weakness are present and it can be painful. Treatment includes cortisone/anti-inflammatory medication and physiotherapy. Physiotherapy treatment entails assistance with pain management, reducing inflammation, stimulating the nerve and exercises to address the weakness.
Advice: Bell’s palsy should receive immediate intervention from your General Practitioner (GP) and physiotherapist. Home exercises could include active-assisted exercises of the affected side, using your hand to help the movement.
Chronic pain is a complex problem and needs a multi-faceted approach. These conditions need to be assessed and explained on an individual basis, as each person is different. The physiotherapeutic approach to chronic pain involves education, manual therapy, lifestyle changes, cognitive behavioral therapy, exercise prescription, maintenance therapy and working in a multi-disciplinary team. Chronic pain should be tackled with a team approach where the patient is the captain. The importance of attending to the mobility of the nerve is vital. The treatment options for nerve mobilisations are vast and the importance of specific exercise is crucial to success.
Advice: no broad advice can be given for chronic pain; however heat packs tend to sooth pain. This can be used safely if the patient does not experience any decrease in or loss of sensation.
Nerve Root Pain
Nerve root pain is experienced due to the compression or irritation of a nerve in the body at the origin in the spinal cord. This can result in symptoms down the arm or leg, or even patchy symptoms in the extremity. Symptoms vary from pins and needles, pinching, burning, aching or stiffness. The treatment is specific to the level of the nerve affected and origin of the compression or irritation.
Advice: by shortening the length of the nerve, you can get relief from acute pain. This is only a coping mechanism and the cause of the nerve irritation needs to be addressed.
Sciatica is used as a general term for any pain radiating down the leg. Sciatica is a known form of nerve root irritation. This can be at the nerve root level, (at the spine) or along the nerve as a result of compression by surrounding muscles (for example piriformis syndrome). A thorough assessment will indicate the cause of the sciatica, and treatment will be specific to this.
Advice: this is similar to a nerve root, as the structure is the same. By shortening the length of the nerve you can get relief from acute pain. This is only a coping mechanism and the cause of the nerve irritation needs to be addressed. Progression will include nerve mobilisation techniques, for example straight leg raise seen in image above.
Soft Tissue Dysfunction and Nerve Pain
The whole body is made up of connective tissue. We are able to stand up straight or move due to connective tissue that works with muscle, ligaments, joints and nerves. Adaptions or imbalances in this connective tissue due to posture, injuries or compensation can be called a dysfunction. Myofascial release, dry needling, muscle energy techniques and muscle retraining are used as treatment for soft tissue dysfunction.