Nerves: What are they and how do they work?

Nerves: What are they and how do they work?

For many people, nerves are often under estimated when they talk about pain. Typically, muscles, joints, bones and other soft tissues get blamed for being sources of pain (ie, “tight hamstrings and tight hip flexors”, “bulging disc in the spine”, or “bad knees”). Not that muscles and other tissues aren’t part of the equation, but let’s talk about nerves.

Some nerves supply the abilities for muscles to move (motor) and other nerves only supply the abilities to feel (sensory). Some nerves do both. But ALL nerves are the messengers that transmit pain signals. Nerves that travel away from the brain and spinal cord are called peripheral nerves. These nerves travel all the way to the tips of the fingers and toes (oh, and also into the pelvis!). Peripheral nerves can be irritated for a number of different reasons. They can be compressed by bones/organs, scar tissue, altered postures, various activities (i.e., sitting on a bike seat for prolonged periods of time), or placement of a foreign object (think: mesh with hernia surgeries). When nerves are compressed, their own blood flow is reduced and in time this can cause pain and/or muscle weakness. A well-functioning muscle is at the mercy of a well-innervated and happy nerve.

Let’s peek at an example. One well known peripheral nerve is the sciatic nerve. The sciatic nerve is the largest and longest nerve in the body. It runs from the lower spine/sacrum, through the deep buttocks, into the back of the thigh, and finally into the foot all the way to the tips of the toes. By the time it ventures into the thigh and leg, it branches out into smaller nerves. Not only does it supply motor functioning to the lower extremities, but it also supplies sensation to the leg and foot. It can be compressed by: 1. vertebrae (and, yes, perhaps even a disc), 2. scar tissue from a surgery, 3. muscle spasms, 4. swelling, or 5. prolonged sedentary postures (especially sitting). In states of compression or injury, people start to get pain that radiates into their buttock, back of thigh, and maybe even into their foot. In more serious situations, they may also lose motor abilities in the leg and foot (muscle weakness = automatic visit to the doctor). When pain and/or muscle weakness presents itself, it takes a thorough examination by a physician and/or physical therapist to determine specifically where the issue is arising from. Is it occurring where the nerve exits the spine, or maybe deep in the buttocks muscles, or is the issue occurring somewhere in the lower extremity? The moral of the story is that the nervous system acts like a warning system and is an important starting point for medical providers to get down the root of the problem. After all, our goal is to treat the source of pain and weakness (free the nerve!) as opposed to just the symptoms (such as tight, painful muscles).

When nerves aren’t happy, they’ll let you know. Sometimes that symptom you feel may be as simple as a muscle that doesn’t feel quite right. Other times nerves signal loud and clear: pain, pain, and more pain! If you are experiencing something that feels off or you’re having to stop doing certain activities because of pain/weakness, then talk with a medical provider (physical therapists or physicians specialized in physiatry/physical medicine and rehab are great places to start). The good news is the nervous system adapts quite well and can be influenced by the right treatments. Pain as a result of nerve signaling is a normal human experience. It’s also a powerful motivator, telling us to stop, pay attention, move, or take care of the problem.

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Covid-19 Notice

3/27/2020 Covid-19 Notice:

On March 19th, we made the difficult, yet important decision to close both clinics, in order to do our part to flatten the curve. We will reopen the clinics part time on Monday, April 6th, with an emphasis on telemedicine. This will allow us to comply as much as possible with the governor's Stay Home Stay Healthy order if it is extended, while also meeting our obligation as essential infrastructure workers. According to Dr. Matos, an expert in biological surety and the management of select agent programs at federal facilities: "Physical therapists are essential in flattening the curve of the Covid-19 pandemic. They play a key role in keeping people they can help out of doctors' offices and ER's. This will not only free up the medical teams to treat those impacted by Covid-19, but also limit the exposure of those seeking the care of the physical therapist." To that end, we will focus on telemedicine, but also allow for select, necessary in-office treatments for low risk, healthy individuals. This will be a joint determination between you and your PT. Many, if not all of our patients, have come to appreciate the effectiveness and efficiency of the hands-on manual therapy techniques our physical therapists use to help relieve pain and improve function. So, we recognize that a telemedicine visit may not seem as appealing. At this time, telemedicine is the appropriate and safe way to continue your care without further interruption and your physical therapists are prepared to alter their approach in order to still provide effective care.

During our temporary closure, your physical therapists have been on unemployment and not able to contribute to our communities financially as they normally would like to. Getting back to work, providing your care will allow us to resume caring for you and our community. For every telemedicine visit we provide in April, the clinic will donate $5 to the following organizations:

Kelsea Cannon, PT- Westside Baby
Lauren Esmailka, PT- Treehouse
Elizabeth Rogers, PT- Rainier Valley Food Bank

We remain passionate about helping you improve and maintain the function of your movement system so that you can do the activities you love. I remain available for urgent (i.e. post-op care, acute injury, treatment needed to decrease/avoid use of NSAIDs and Opiods) in-clinic treatment and telemedicine treatment from now until April 6th. We invite you to follow/Like our  Facebook page, where I am offering complimentary weekly Pilates mat class on Wednesdays at 7am and foam roller class on Fridays at 7am. All are welcome to participate in these classes or view them anytime on our Facebook page.

Please contact me directly with any questions or concerns. If you are a current patient, you should have received an email from me with scheduling/rescheduling info. Be in touch with your PT to schedule your telemedicine visit. I am available via clinic phone (206-535-7356) and email ( We will update you here and our Facebook page as things change.

We are counting the days until we get to resume our work together both virtually and in the clinic! Thank you for your support of this small, locally-owned physical therapy private practice!

Elizabeth Rogers, PT

Owner, Elizabeth Rogers Pilates & Physical Therapy, PLLC

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