Nerve Mobilization Massage
Therapists use a variety of movements to assess for sites of irritation. Sometimes patients may test negative, but this does still not rule out nerve irritation, in these cases a more refined assessment along the entire path of the involved nerve may be needed.
Neurovascular bundles may be exposed to mechanical irritation at many different points. Prolonged irritation may result in the release of inflammatory mediators, known as “inflammatory soup”.
In some cases of peripheral nerve inflammation may contribute to ongoing symptoms without overt nerve damage. In these cases five minutes of passive mobilization may help to diminish intraneural edema and/or pressure (Boudier-Revéret et al. 2017). This will have a modulatory affect on peripheral and central processes.
In longer standing cases the development of fibrosis, may contribute to peripheral nerve dysfunction. If implemented early the application manual therapy that may attenuate tissue fibrosis and restore motility of peripheral nerves (Bove et al. 2016).
There is a fair bit of research to support the use of nerve mobilizations for musculoskeletal pain. Furthermore, a biopsychosocial framework of manual therapy helps put into context the interconnected and multidirectional interaction between physiology, thoughts, emotions, behaviours, culture, and beliefs.
Precision Neural Mobilization is an approach to identifying and treating various mechanical disorders of the nervous system.
When a compression or entrapment occurs, whether acute or chronic, edema and fibrosis are two of the most common consequences.
When nerves are exposed to fibrosis they lose their necessary capacity and capabilities to slide, bend and move around and through the various bodily tissues in which they traverse.
When a nerve loses this ability to move, it becomes subjected to further insult of compression and traction during normal everyday movement.
When this happens, these are precisely the people that come to our office requesting our help.
Precision Neural Mobilization is about identifying what movements and postures are putting these irritable nerves on stress and showing your clients how to reduce these loads at home through either positioning or self “flossing” procedures.
The technique is also about teaching the therapist the most effective and safe methods of restoring the lost relative movement between the nerves and their bodily interface, thus restoring their function and physiology.
The symptoms that these clients will come in with will, on the surface, present in the exact same way as other common muscular issues.
One way to determine the difference is to properly identify a neural compression or entrapment issue through assessments taught in the Precision Neural Mobilization intensive.
What makes this essential in the clinic is that the procedures for treating a muscular disorder will make a neural disorder, almost always, worse.
And what’s even more frustrating about this, is that by the nature of many neural issues, the response will be delayed, so the client may describe feeling looser or possibly more relaxed following a session only to have the complaint come on worse that night or just return unchanged the next day.
From investigators R.F. Ellis and W.A. Hing: “It is vital that the nervous system is able to adapt to mechanical loads, and it must undergo distinct mechanical events such as elongation, sliding, cross-sectional change, angulation, and compression.
“If these dynamic protective mechanisms fail, the nervous system is vulnerable to neural edema, ischaemia, fibrosis, and hypoxia, which may cause altered neurodynamics.
“When neural mobilization is used for treatment of adverse neurodynamics, the primary theoretical objective is to attempt to restore the dynamic balance between the relative movement of neural tissues and surrounding mechanical interfaces, thereby allowing reduced intrinsic pressures on the neural tissue and thus promoting optimum physiologic function. “The hypothesized benefits from such techniques include facilitation of nerve gliding, reduction of nerve adherence, dispersion of noxious fluids, increased neural vascularity, and improvement of axoplasmic flow.”
Neural Mobilization is Different From Other Types of Bodywork
Precision Neural Mobilization is highly focused on the mechanisms of injury and the precise methods of treating them in a graded manner with the patient’s disorder irritability in mind, as well as all other factors associated with the specific and individual behavior of their complaint.
Neural Mobilization has shown a definite and specific effect to identify neural issues such as carpal tunnel syndrome, sciatica and tarsal tunnel syndrome.
In one study, after subcategorizing patients with low back pain and sciatica they were all treated with procedures of neural mobilization.
As is common and expected with all sorts of interventions, all of the subcategories had some patients receiving positive results from the intervention.
What was unique and noteworthy was that the group that was determined to have symptoms predominately from peripheral nerve sensitivity responded with approximately a five-fold better success rate than the other back pain and sciatica groups.
*Disclaimer: This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider.
Please consult your healthcare provider with any questions or concerns you may have regarding your condition.
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