Nerve Tension – Ulnar Nerve and Median Nerve
Nerves that travel through our body needs to be able to slide between the tissues with movement because nerves do not structurally stretch very easily. At 8-15% stretch, the nerve loses blood circulation and this may cause cell death and inflammation (Shacklock, 2005). From the brain at the base of the skull, the nerve needs to be able to travel through the spinal canal, through the intervertebral foramen and then between the tissues of the body without adhering or getting stuck between any structures. However, there are some conditions that may compress the nerve or cause the nerve to adhere to the structures next to the nerve and this may cause damage, irritation, or sensitization around the structure.
Conditions related to Nerve Tension?
Radiculopathy – Nerve root may be impinged due to a disc, osteoarthritis, or other debris in the spinal canal or as it exits the intervertebral foramen.
Nerve Entrapment Neuropathy – Possible that a nerve gets stuck in scar tissue. The area affected by granulation tissue will become inflamed after a wound has healed. Inflammatory cells combine with protein matrixes such as collagen to form granulation tissue, which eventually becomes scar tissue. Granulated tissue has an adhesive nature, so it can work as a sealant for wounds. A side effect is that structures that want to be able to slide tends to get stuck as the scar tissue matures and this may cause the nerve to be unable to slide with movement so this may create some nerve tension with certain positions.
Common symptoms / signs
- Nature of Pain – Lancinating/Burning/Electric/Stabbing
- Highly Irritated
- Muscle guarding of aggravating movements
What causes Nerve Tension?
When a nerve gets trapped, compressed, inflamed or irritated, the nerve releases inflammatory cytokines around the area that sensitizes the nerve and makes it aggravated by previously benign actions. This can explain how sometimes nerves may become highly irritated even when no active disc bulges are compressing a nerve.
How is Nerve Tension treated?
An application of nerve sliders is necessary to treat a nerve caught in scar tissue.
The viability of this method of treatment depends on the capacity of the nerve to slide. This is tested by putting the provocative upper limb nerve on tension (abduction of the shoulder, flexion of the elbow, lateral rotation, and extension of wrist), observe the symptom, then observe whether turning away from the affected limb doesn’t affect it, and turning towards it relieves it. If symptoms can be modified, this indicates that the nerve has the capacity to slide between the tissues.
Although it is unclear how nerve sliders improve pain symptoms, some hypotheses have been outlined by Shacklock (2005):
- Sliders may milk the nerves of inflammatory exudate and produce increased blood flow thereby increasing oxygenation of the neural tissues.
- Movement may contribute to control pain at a central nervous system level.
Risk factors of Nerve Tension?
- Previous Surgeries/Scar Tissue
- Myofascial Tension
- Bone Spurs/Arthritis
- Swelling or Edema
- Repetitive or prolonged activities with repetitive movements.
- Systemic conditions like diabetes
- Neck pain
- Low Back Pain
- Prior fracture or dislocations to local area
Shacklock, M. (2005). Clinical neurodynamics: a new system of neuromusculoskeletal treatment. Elsevier Health Sciences.