Nerve pain is often caused by entrapment
Nerve compression, or entrapment, disrupts nerve conduction and is a major cause of nerve pain. This nerve pain can be experienced along a wide continuum of severity, such as acute pain, numbness, tingling, heat or cold sensation, cramping, or electric shock sensation, among others. Nerves trapped for an extended amount of time may eventually result in muscle weakness and muscle atrophy (loss of muscle mass).
A nerve may be pinched acutely or chronically by muscle tension, poor posture, sudden movement, or misalignment of joints. The pinched nerve becomes entrapped in the connective tissue (fascia, ligaments, tendons, meninges) which has become distorted by the above. Hence, releasing the distortions or restrictions in the connective tissue will often resolve such nerve pain.
Other sources of compression are tumors, lipomas, and edema, or leaning on any body part for an extended time period, thus irritating the nerve.
Nerves may also become injured with trauma to the nerve, resulting in temporary or permanent damage.
Common parts of the body that people experience nerve pain in are the head, spine, shoulder, elbow, the forearms, wrist, the groin, the side of the knee, and the ankle. Perhaps the most widely-known example is carpal tunnel syndrome.
Common examples of nerve pain.
Head — Face (Skin, muscles of mastication, teeth, upper and lower jaw)
- Trigeminal neuralgia results from irritation to the trigeminal nerve (5th cranial nerve) due to compression, stretching, or other distortion. Causes may be trauma to the face or head, tension in the muscles of the face, TMJ dysfunction, bruxism (clenching the teeth during sleep), dental work, braces, or ill fitting dentures.
- This type of nerve pain may manifest itself in the skin, the muscles of the face, or even tooth and jaw pain, as this nerve innervates the muscles for chewing, the skin of the face, and all the teeth.
Head — Cranial nerves I – XII (1-12)
- The cranial nerves which exit the skull to travel to the eyes, ears, mouth, and throat govern vision, eye movement, hearing & balance, taste, speech, swallowing, heart rate, breathing rate, and digestion, as well as the raising of the shoulders, and tilting of the head to one side while turning it to the other side.
- Therefore, compression or injury to any of these nerves may cause symptoms that relate to the function of these nerves.
- Common causes are direct trauma to the head, face, or neck, as well as whiplash injuries.
Spine — Spinal nerves
- The spinal nerves separate from the spinal cord and exit the spine (vertebral column) through spaces between any two adjacent vertebrae, called intervertebral foramina. These nerves often become pinched or compressed by misaligned vertebrae right where these nerves exit the foramina.
- Acute or chronically tense muscles may compress these nerves near the spine or anywhere along their paths through the muscles or between layers of muscle.
- This type of nerve pain may be felt anywhere along the spine, or in the legs or arms, depending on the location of nerve compression.
- Compression of spinal nerves may also affect organ function and cause a variety of symptoms depending on which nerve is affected.
Brachial plexus — Median nerve, Axillary nerve, Ulnar nerve, Radial nerve, etc
- The brachial plexus is formed by the cervical nerves C5-C8 and the first thoracic nerve T1. These nerves bring motor function to the muscles of the shoulders, chest, arms, hands, and fingers. They also relay sensory impressions, such as heat, cold, pressure, or vibrations back to the brain.
- Compression of the brachial plexus most commonly occurs between the middle and anterior scalenes. Poor posture while working on the computer or reading a book is a major cause of chronically tense scalene muscles.
- Compression may cause nerve pain, tingling, numbness, or weakness to the muscles that they innervate.
Shoulder — Suprascapular nerve
- The suprascapular nerve exits the spine between the fifth and sixth neck vertebrae. It moves posteriorly through a space formed by the superior transverse ligament and the suprascapular notch, as well as a space formed by the inferior transverse (spinoglenoid) ligament and the spinoglenoid notch. Thus, this nerve may be compressed at these two sites.
- Compression at the suprascapular notch mostly affects the supraspinatus muscle, which helps to lift the arm.
- Compression at the spinoglenoid notch affects the infraspinatus muscle, which helps to externally rotate the shoulder joint.
Shoulder — Axillary nerve
- The axillary nerve combines fibers from the fifth and sixth cervical (neck) nerves, separates from the brachial plexus, and moves through the quadrangular space before winding around the neck of the humerus (upper arm bone) and innervating the anterior, middle, and posterior deltoid muscles, as well as the skin above.
- The quadrangular space is formed by the teres minor above, the teres major below, the triceps muscle medially, and the humurus laterally. Moreover, it is heavily invested with fascia (connective tissue).
- Overuse of the arm, injury, and inflammation may lead to restrictions in this space and compress the axillary nerve, resulting in restriction of movement, weakness of the deltoid muscles, and nerve pain.
Elbow — Ulnar nerve and Radial nerve
- Cubital tunnel syndrome refers to the entrapment of the ulnar nerve. This nerve passes through the cubital tunnel underneath the “funny bone” at the inner aspect of the elbow.
- Resting the arm on an arm rest for extended time periods, holding the arm in a bent positions for a long time, or sleeping with the arm bent may compress the nerve and cause numbness, tingling, or muscle weakness in the ring finger and little finger.
- Radial tunnel syndrome refers to the entrapment of the radial nerve, specifically the posterior interosseous nerve, which is a branch of the radial nerve. This nerve passes through the “radial tunnel” on the outer aspect (extensor surface) of the forearm near the elbow.
- Compression of the posterior interosseous nerve causes pain in the forearm near the elbow and sometimes muscle cramping like a charley horse. Overuse, bone fractures or lipomas may cause nerve pain.
Wrist — Median nerve
- Carpal tunnel syndrome arises when the median nerve becomes compressed as it passes through the carpal tunnel. Repetitive movements, injury to the wrist, inflammation, arthritic changes of the wrist bones, or retention of fluid in the wrist during pregnancy may cause this type of nerve pain, with common symptoms being swelling of the soft tissue or distortion of the connective tissue forming the flexor retinaculum (transverse carpal ligament) that holds the flexor tendons in place.
- Intermittent pain, numbness, or tingling in the area innervated by the median nerve are common symptoms.
Side of the knee joint — Common Peroneal nerve
- Peroneal nerve entrapment near the tibiofibular joint on the lateral aspect of the knee may cause drop foot — difficulty or inability to lift the front end of the foot (dorsiflexion) when walking. Hence, a person with peroneal nerve entrapment or injury will lift the lower leg off the ground in order to clear the ground beneath the foot. Setting the foot back on the ground is often accompanied by a “foot slap”.
Ankle — Posterior Tibial nerve
- Tarsal tunnel entrapment of the posterior tibial nerve (tarsal tunnel syndrome) has similar causes as the carpal tunnel syndrome such as trauma, inflammation with swelling (fluid accumulation) from sprains and strains of the ankle, bony changes from arthritis (bone spurs) or injuries, or edema in the ankle from prolonged standing, pregnancy, or chronic heart failure.
- Nerve pain symptoms are many, such as burning, tingling, or numbness radiating up into the calf.
How can nerve entrapment be counteracted?
Nerves often pass through very narrow places, such as tunnels or canals, formed by tough connective tissue, bones, or both. With trauma, improper use of the body, overwork of any body part, or inherent structural challenges, the connective tissue becomes even tougher, drier, and distorted, putting a strangle hold on the nerves and blood vessels, which often accompany them through these tight spaces.
Craniosacral therapy is ideally suited to releasing any tension or distortion of the connective tissue anywhere in the body. This frees the nerve and allowing it to recover its normal function. Release of connective tissue distortion opens up the tight spaces for improved nerve function, blood flow, lymph flow, and energy flow (meridians), reducing edema (swelling) and nerve pain, as well as improving muscle strength and function.
Energetic unwinding of the spine, joints, & muscles is particularly effective in releasing nerve compression in specific areas of the body, such as around the joints and along the spine. Energetic unwinding is an intuitive blend of craniosacral therapy, acupressure, and soft tissue work.