What is nerve pain?
To start, all pain has to first be perceived by the body. Pain cannot be felt or interpreted without the nervous system and the signals they provide. That said, there are two major different types of signals. We could classify a third as “other” that do not fit in this category.
- Nociceptive pain – this type of pain is the typical pain you may think of when you bump, stub, or bruise your arm or shin. This type of pain can often be seen in sprains, strains, arthritis, inflammation, fractures, etc. This can also be known as mechanical pain because typically this pain or discomfort can get better or worse with certain positions, loading (weigh bearing), and movement patterns. Nociceptive pain typically has to deal with irritation or damage to tissues.
- Neuropathic pain – this is also known as nerve pain. Nerve pain occurs when the nervous system itself has sustained injury. This can occur in the Central Nervous System or the Peripheral Nervous System and can be caused by many factors that include compressing or pinching of a nerve (disc herniation, sciatica or nerve impingement aka entrapment). Nerve pain can also come from autoimmune diseases like Multiple Sclerosis & ALS (Lou Gehrig Disease) that actually destroy nerve tissue itself. Additionally, chemotherapy, diabetes, and toxic chemicals can aid in the destruction of nerves that can cause nerve pain.
- Other pain – Pain that does not exhibit neurological or nociceptive can be classified as other. Interestingly, these types of pain patterns do exhibit the firing or use of nerves but there may be a processing error in the way that the body perceives pain. This can be things like Complex Regional Pain Syndrome (CPRS) and Fibromyalgia. Typically, these conditions can have widespread pain throughout (seen with Fibromyalgia) the body and there can be miscommunication and/or over firing of the nervous system or a heightened response by the nervous system.
Sоmе соmmоn examples of nerve раin
- Carpal Tunnel Syndrome
- Disc Herniations
- Injury to the Lumbar or Brachial Plexus
- Damage to nerves via autoimmune diseases
- Damage to nerves via Chemotherapy
- Damage to nerves via exposure to toxins or chemicals
What does nerve pain feel like?
Nerve раin саn tаkе diffеrеnt fоrmѕ but gеnеrаllу thе ѕуmрtоmѕ inсludе burning, ѕtаbbing оr ѕhооting раinѕ, numbnеѕѕ as well as рinѕ аnd needles. It can also be jolting and electric like. Many people suffering from nerve pain often report that they have to move slowly so that they do not trigger the pain. In addition, when the pain is intense active they may feel a constant tightness or pulling sensation. In many cases, patients can have muscle spasms, and fasciculations (involuntary twitches).
In some cases patients may experience increased sensations (hyperalgesia), decreased sensations (hypoalgesia), or increased pain levels from non-painful stimuli (allodynia).
In more severe cases, pain can extend all the way down into the limbs and cause muscle weakness and atrophy.
Location of the pain
The location of your nerve pain is not always clear cut and straight forward. Typically, nerve pain occurs in the arms and legs (extremities). This is because the nerves that come from our spinal cord then branch outwards from our neck and low back extend outwards and run down into the limbs. When tissue is injured it can shoot the pain signal down into the extremity which is why a lot of people have these symptoms. The truth is that it can be very predictable at times but patients do not always follow the pain patterns as described in text books.
Getting Rid of Nerve Pain?
Most painkillers and other medications typically do not help nerve pain. That said, there are also medications that exist on the market that can aid in neuropathic pain. Please consult your medical doctor if you are considering medication as an option.
What are some natural ways to help nerve pain?
In my opinion its always best to first start with natural ways to sooth and heal nerve pain. While nerve pain is often associated with chronic injuries, it can still be alleviated with treatment and managed well. This is especially true of there are impingements (entrapments) and/or herniations. Listed below are some ways to help nerve pain but they are not a “cure to the pain.”
What are some natural ways to help nerve pain at home?
- Topical analgesics
- B Vitamin Complex (B12)
- Omega 3 Oils
- Increase vegetable intake
- Juicing & Blending
- Nerve flossing techniques / Neuromobilization drills
- Rehabilitation exercises
- Stress management
- Reduce systemic inflammation via food
Pain is in the brain
When you have pain where do you feel it? You are likely answering in the location that actually hurts you. Here is the kicker, in order for you to feel pain your brain must interpret it. The pain signal initially comes from the damage tissue. In order for you to actually feel the pain, an impulse is sent from the site of injury to your brain. From here, you then perceive the pain and react to it. That being said, all pain is 100% located in the brain, no matter how long you have had it (even if you are having shoulder pain, neck pain, lower back pain, hip pain, or knee pain). This is true for both nociceptive and neuropathic pain.
There are regions in the brain that correlate to different areas of the body. In the brain they call this the homunculus.
Chronic pain tends to be defined as pain that presents itself for more than 3 months and is very common. Although most of the tissues are healed, then why do we still have that pain? This is because the brain learns pathways though the nerves, and the nervous system, and pain can be exacerbated by many other factors including high stress, emotions, poor nutrition, negative thoughts, and other factors. Basically, chronic pain is a long-duration issue that has a learned response incorporated and is much more complex and it carries multiple factors.
Chronic nerve pain can be a real issue but within chronic pain, there are almost always multiple factors! To help reduce chronic pain therapist use rehabilitation to help stimulate the body and mind to retrace and rewire the neurology of the injury. Mental health therapy in conjunction within exercise programs have shown to have better outcomes than either therapy and/or rehab itself. For this reason it is important that patients incorporate proper stimulation of exercises, brain retraining, meditation, and other aspects of healing into their program.
Hоw tо diagnose nerve раin ?
Testing for nerve pain first begins within a history and physical exam. As mentioned before, it is important to take a look at many factors, especially if this is a chronic injury.
To diagnose nerve pain a Chiropractor may want to check and likely should check several things with your body.
- Sensation & Touch – often times when there is nerve pain a patient may have altered sensation and touch. To test this we can use a test called 2 point discrimination, vibration, and a pinwheel to help asses if you can feel the object.
- Muscle testing – When there is nerve pain we can test the muscle that is associated with this nerve. This can tell us information if there has been long term compression on the nerve.
- Measuring – Measuring the muscle bulk can be crucial to asses atrophy from a nerve compression.
- Reflexes – in nerve pain you may have altered reflexes that are not symmetrical, absent, or hyper-reflexive.
- Orthopedic testing – certain orthopedic tests can help a Chiropractor determine where and which structures are involved.
- Neurodyanmic testing – testing the ability for a nerve to glide, slide, and stretch can help us determine how severe the damage may be and/or where the location of the pain may be coming from.
- Electrodiagnostic testing – in some cases patients may need to seek more specific testing such as an Nerve Conduction Velocity (NCV) and/or an Electromyography (EMG) testing. These tests help to compare and contrast the affected nerve to see if it is firing properly and they also test the muscle firing pattern as well.
What are some treatments for nerve pain?
Have you ever thought about the nerves in the body and if they actually move? Nerves in the body do move just like muscles, joints, and ligaments do. The concept of nerves moving is known as neurodyanmics.
In the body nerves are designed to stretch, move, glide, and slide. In many nerve based injuries it is as a result of tension or compression to the nerve that does not allow the nerve to glide or slide properly. For example, if someone falls onto their arm and/or neck (like a bicycle fall) they may overstretch the neck and shoulder creating a “stinger” or “burner.” In contrast, you can have a muscle that is too tight or a disc herniation (like sciatica) that can compress the nerve. In either case, there can be excess nerve tension causing the nerve to suffer some damage or ischemia (lack of blood flow). Using nerve related drills or mobilizations can aid in the nerve sliding or gliding better and in some cases we call this nerve flossing.
Active Release Technique, Graston Technique, & Myofascial Release for nerve pain?
Specialized soft tissue work is geared towards releasing the muscle and nerve can help not only the muscle pain but release the nerve as well. Nerves run between and sometimes through muscles, tendons, and ligaments. On occasion they can get “caught up” within the tissues. This can happen via overuse syndromes, poor mechanics and posture, scar tissue, swelling, and trauma to the area. Releasing the nerve along its course via specialized soft tissue work can greatly improve the nerve pain, mobility of the tissues, and help free up the nerve.
Chiropractic Care – Mobilizations, Adjustments, and Decompression
Chiropractic care and adjustments aka mobilizations are what most Chiropractors are known for. A Chiropractic adjustment helps to promote mobility in the spine and relieve pressure and tension on the nerve and nervous system. Movement inhibits or slows down nerve impulses into the body. Following a Chiropractic adjustment, evidence shows that there is an increase in space within the joint. This excess space can allow the joint to decompress. In addition, there is a large growing evidence that demonstrates that an adjustment helps to stimulate the brain. This is important because pain is in the brain and it therefore can aid in the perception of pain as well as help improve movement. A Chiropractor can deliver an adjustment to specific areas of the spine that actually correlate with your pain.
What should I do next?
Good question! If you have been suffering nerve pain you really should see someone. I know you will likely put this off another day but longer pain goes, typically the harder it is to get rid of. Having managed thousands of nerve related patient visits I can tell you most people do very well but most of their suffering is self inflicted in not having the proper guidance, skills or tools, and are typically performing the very stretches (exercises) that are increasing the dysfunction. My advice, do something, see someone. There is a reason you stumbled onto this page!
Get out of pain today and schedule your appointment!