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

06/09/2020 Covid-19 Notice:

Our clinics are open for in-clinic physical therapy visits, telemedicine physical therapy visits and virtual Pilates sessions. This allows us to comply as much as possible with the phased reopening of WA State, while also meeting our obligation as essential infrastructure workers. For in clinic treatment, the PT will wear a mask and patient needs to wear a mask of their own, social distancing is observed throughout the clinic and rigorous cleaning guidelines will be followed. At times during your treatment, it may not be possible for your PT to observe social distancing, such as during certain manual therapy techniques. The need for in-clinic treatment vs. telehealth treatment will be a joint determination between you and your PT. You may review our Covid-19 Exposure Control, Mitigation and Recovery Plan for the details of how we provide safe in-person care.

We are grateful for and support all of our clients who have been able to march and protest in support of Black Lives Matter. In order to continue to provide the safest clinic experience possible for our clients and providers, we are asking that any client who has participated in a march or protest do one of the following: 1.) Switch to telehealth visits for 14 days. 2.) Get tested for Covid-19 and provide us with negative results. Note that Seattle's mayor has cleared the way for those who march to get tested without symptoms and encourages participants to get tested. 3.) Wait 14 days after marching/protesting to return to the clinic. Thank you for understanding that this policy is in place to allow us to meet our responsibility to all clients, which is to do no harm.

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Thank you for your support of this small, locally-owned physical therapy private practice!

Elizabeth Rogers, PT

Owner, Elizabeth Rogers Pilates & Physical Therapy, PLLC