What you need to know:
What is Neural Tension?
- Many healthcare providers and trainers poorly understand how movement of the nervous system relates to several common pain syndromes and musculoskeletal conditions.
- Dealing with neural tension is not as simple as just stretching. While stretching may feel good, it very easily may aggravate symptoms.
- Once appropriate treatment of neural tension begins, patients often normalize their movement very quickly and experience pain relief. Often this pain relief is instantaneous.
Neural tension is rather unheard of yet it often plays a significant role in many pain syndromes and musculoskeletal conditions. We all understand for movement to occur in the body, joints must move and your muscles must contract. But did you know that your nervous system tissue must also move freely and unimpeded during movement? Neural tension is commonly mistaken for muscle tension. Your nerves were not designed to stretch, but rather to glide and give during movement.
If some form of obstruction (soft tissue or bony) impedes your neural tissue then pain or restriction of normal nerve movement is a common result. This normal nerve movement may only be a matter of millimeters, but nerve tissue is highly sensitive and does not like to stretch. Thus if too much stretch is placed on a nerve, the result is adverse neural tension and that can create pain, limited range of motion, as well as other classical symptoms associated with nerve tissue (numbness, burning, shooting pain, etc.) Neural Tension Treatment
The movement of your nerves, or neurodynamics, can be assessed by a licensed chiropractor or therapist trained in the process of detecting and treating neural tension. Screens or tests commonly used to identify neural tension help identify not only which nerve(s) have adverse neural tension but also where the nerve is being obstructed during its movement. Identify where the nerve is being obstructed is critically important because treatment is tailored to the site of obstruction.
Again, this highlights the importance of an accurate assessment as treatment can be more accurately applied to the structure(s) creating adverse neural tension. Once treatment begins, patients often normalize their movement very quickly and experience pain relief. Often this nerve pain relief is instantaneous. What Conditions Commonly Involve Adverse Neural Tension?
Some common conditions that adverse neural tension often plays a role in or is a complicating factor that must be treated include:
Stretching vs Nerve Mobilizations
- Neck Pain
- Shoulder Pain
- Tennis Elbow
- Carpal Tunnel Syndrome
- Low Back Pain
- Hip Pain
- Plantar Fasciitis
A common misconception in the treatment of back pain and associated muscle tightness is the idea that one must stretch to get relief. Stretching may bring temporary relief, only for one to experience the tightness come back once again or, worse yet, an increase in their pain.
Interestingly, when neural tension is identified as the underlying reason for muscle tightness, the treatment of neural tension doesn't actually involve stretching. Excessive stretching can actually irritate your nerves and increase pain. Excessive stretching may potentially damage your nerves as well.
This should make the message pretty clear - stretching may not be the best thing for your back when it's giving you all the signs that it isn't responding favorably.
Rather than stretching, restricted nerves and the surrounding muscles require a different approach known as nerve mobilizations or nerve sliders. Qualified chiropractors and physical therapists will utilize nerve mobilizations to help entraped nerves slide better during movement. They will also treat the surrounding muscles or tissues that is obstructing your normal nerve movement. After treatment, they will retest your neurodynamics and repeat the process until your full neural movement is restored. This process may take a few treatments to clear up, or take several, depending on severity. Research Supports Neurodynamics
The concept of neurodynamics or neuromobilization is originally based on the research of Michael Shacklock and David Butler. Over the past several years, further research has added to the scientific support of the concept that your nerve tissue requires full freedom of movement to remain pain-free.
The following excerpts are from Michael Shacklock’s book Clinical Neurodynamics: a new system of musculoskeletal treatment
"Neurodynamics is an innovative management tool involving conservative decompression of nerves, various neural mobilising techniques and patient education techniques. Neurodynamics offers a fresh understanding and management strategies for common syndromes such as plantar fasciitis, tennis elbow, nerve root disorders, carpal tunnel syndromes and spinal pain."Final Words
"Essentially the entire nervous system is a continuous structure and it moves and slides in the body as we move and the movement is related to critical physiological processes such as blood flow to neurones. This movement is quite dramatic and it is not hard to imagine that fluid such as blood in the nerve bed, a constricting scar, inflammation around the nerve or a nerve having to contend with arthritic changes or proximity to an unstable joint could have damaging effects, some of which could lead to pain."
Neural tension can be present with many common musculoskeletal conditions, such as back pain. Very often neural tension is easily mistaken for muscle tension, leading many to want to stretch in order to find relief. Stretching can be counterproductive and may aggravate pain symptoms. In order to treat neural tension, it must be examined accordingly. At GP, we are trained in detecting and treating adverse neural tension and why it is present.
If your pain is not resolving with other interventions, consider your pain may be associated with neural tension and you may benefit from the most appropriate course of treatment and client education.
More related reading: