Alleviating Nerve Pain - The Power of Physiotherapy

Introduction

Many people usually come across mild to severe pain in the nerve, a tingling sensation, or an irritated nerve. It usually affects daily activities and the quality of life. Nerve pain can be of different types, like pin and needles type or numbness and tingling sensations. Nerve pain can occur in any part of the body and commonly involves the legs, arms, feet, and face. Nerve pain in these areas can occur due to stretching, lacerations, or pressure. In case of damage to the peripheral nerves, it is referred to as peripheral neuropathy. Different types of nerve pain sensations that occur are the tingling type, the pricking type, the throbbing type, the burning pain, or the stabbing pain.

What Are the Three Major Variants of Nerve Injury?

The three major types of nerve injury described by Seddon are:

• Neuropraxia: It is a minor compression of the myelin sheath of the nerve resulting in conduction blockade. It usually resolves within three to four weeks. Physiotherapy helps in the early recovery of nerves.

• Axonotmesis: It is characterized by damage to the internal nerve (axons), but the outer nerve is fine. It usually occurs due to a rupture of the nerve tissue. It can be treated with different types of physiotherapy exercises. It is recommended to visit the doctor for proper diagnosis and treatment.

• Neurotmesis: It results in permanent damage to the nerve. It usually requires surgical intervention.

What Are the Goals of Physiotherapy for Nerve Pain?

The main goals of physiotherapy for managing nerve pain are:

• Physiotherapy goals are to reduce nerve pain.

• Physical exercises aim to restore the range of motion.

• Aims to restore the function of affected muscles.

• Physiotherapy exercises goals to repair and heal the damaged nerve.

• Physiotherapy aims to improve functional and sensory deficits.

• Aims to relieve pressure on the nerves (entrapped nerve).

Can Physiotherapy Help With the Nerve Pain?

Different physiotherapy exercises help in getting relief from nerve pain and restoring the normal function of the affected areas. These exercises can be done in a physiotherapy clinic under a trained physiotherapist or at home. Different specifically designed physiotherapy exercises recommended by the professional physiotherapist for addressing nerve pain are:

• Strengthening Exercises: Various strengthening exercises focusing on the muscles of the affected areas can be performed under the guidance of trained therapists to restore the normal position and functions of the muscles.

• Soft Tissue Manipulation: Various exercises can be performed by the physiotherapist using pressure techniques or other soft tissue manipulation techniques targeting the affected muscles. Soft tissue manipulation exercises are mostly recommended in people with muscle sprain, stress injuries, and swelling in the tendons (Tendinitis). The most common exercises used for soft tissue manipulation are dry needling exercises and massaging techniques. These methods help to reduce tension in the muscles and relieve nerve pain.

• Range of Motion Exercises: Different range of motion exercises are taught by the physiotherapist for early recovery of joint movement and to help alleviate nerve pain.

• Traction Exercises: Different types of decompression or traction exercises are taught by the physiotherapist to relieve pressure on the affected areas and the pain associated with it. These exercises use a pulley, weight, and harnesses. Traction or decompression exercises help the individual with nerve pain due to:

1. Facet’s disease (pain in the spine due to arthritis).
2. Foraminal stenosis (narrowing of the foramina from which nerve exits or passes).
3. Sciatica (radiating pain along the sciatic nerve).
4. Pinched nerves.

• Acupuncture Therapy: It is one of the most commonly used techniques and is recognized by the World Health Organization for treating different types of medical problems. It is done by using fine needles and safely inserting it to specific points of the tissue to help in the relief of nerve pain.

• TENS (Transcutaneous electrical nerve stimulation) Therapy: It is one the most trending and current methods used in the management of nerve pain. TENS therapy uses very mild electric currents for the management of pain. TENS therapy machines consist of small devices with batteries that deliver a small electric impulse by the electrodes, which are attached to the pain trigger points of the skin. TENS therapy is given only by trained healthcare professionals based on the diagnosis of the underlying cause of nerve pain.

• Spinal Mobilization: It involves manual therapy exercises to improve the flexibility and mobility of the spine. A few physical therapy exercises help to manage nerve pain by relieving the pressure on the nerve and releasing a trapped nerve.

• Aquatherapy: Hydrotherapy or aqua therapy utilizes warm water to help in the relief of nerve pain and improves the mobility and strength of the muscles.

• Relaxation Exercises: Different relaxation exercises are recommended by the trained physiotherapist to reduce the pain perception and stiffness of the muscles. These exercises can be performed by self or under the supervision of the physiotherapist. Relaxation exercises consist of specific postural exercises that help to manage pinched nerves.

What to Keep In Mind While Undergoing Physiotherapy Exercise Program for Nerve Pain?

There are a few things to keep in mind while performing physiotherapy exercises, such as:

• All these exercises should be performed only if advised by the physiotherapist after the diagnosis of the source of pain.

• Physical therapy exercises should be performed at the same frequency and time as advised by the trained physiotherapist.

• Only the specific exercises recommended by the trained physiotherapist based on the type, intensity, and source of the nerve pain should be performed.

• Patients with underlying neurological disorders should inform the healthcare provider prior to starting any exercise program.

• Pregnant women should inform the physiotherapist about their health status before enrolling in any physiotherapy program, as few postural exercises, TENS therapy, and various other therapies are not indicated in pregnant females.

• At any point in time, if the condition worsens and the pain aggravates, it is advised to inform the healthcare provider immediately for early intervention.

Conclusion

Damage or injury to the nerve can result in different types of pain sensations in the nerve and an irritated nerve in the affected areas. Nerve pain can affect the body’s movements and affect the quality of life. It is advised to visit the healthcare provider for an early diagnosis of the type, source, and nature of the pain, along with the underlying cause of the pain. Based on the diagnosis, specific exercises are recommended by the trained physiotherapist for early restoration of the body's movements and to help alleviate pain