October Update

Nerve Pain

Article by Graceville Physio Joni Levine

Nerve pain is a common condition we treat at Graceville Physio Pain Slayers. Nerve pain is typically described as a sharp, shooting pain rather than a dull, achy pain that is typically associated with joint or muscle pain. Patients may also describe a burning sensation, numbness or pins and needles in the area of concern, as well as muscle weakness and lack of co-ordination of the affected muscles. If the patient describes symptoms such as unsteadiness with walking, bladder or bowel incontinence, numbness in their pelvic region or inability to discriminate hot and cold sensations, these can be signs of more severe nerve-related pain that requires immediate medical attention.

Our nervous system runs from our brain down the spine via the spinal cord and has nerve roots that exit at various segments from the spinal cord. Typical nerve pain presentations we see in the clinic will be caused by an irritation to the exiting nerve roots from our neck or lower back. The irritation to the nerve can also be located away from the spine, such as the wrist in the case of Carpal Tunnel Syndrome. The cause of this irritation is often inflammation but can also be due to muscles and joints.

Whilst it may seem scary to hear that your nerve pain is caused by an irritation to the nervous system, this is often not cause for concern. If the physiotherapist is suspecting nerve pain as a cause of your symptoms, they will undertake a series of assessments to ensure your pain can be treated with physiotherapy. This includes assessing your muscle strength, skin sensation, tendon reflexes and nerve flexibility in the area of symptoms. In very rare cases, we will refer patients to their GPs or hospitals if their symptoms are severe and require medical attention, but this is very rare and most patients respond well to physiotherapy treatment within a few sessions.

Physiotherapy treatment for nerve pain can be quite similar to other causes of musculoskeletal pain. Treatment may still involve hands-on techniques such as joint mobilisations and massage, as well as exercises to improve flexibility and strength. When nerve flexibility is impacted, there are specific exercises your physiotherapist can prescribe that can help with this (which is different to muscle stretching). As is the case with any other cause of musculoskeletal pain, our physiotherapists can identify contributing factors to the onset of your nerve pain and strategies to help reduce the likelihood of it recurring.

What is Ankylosing Spondylitis?

Ankylosing Spondylitis (AS) is a chronic inflammatory disease that mainly affects joints within the spine resulting in pain and stiffness. It can also affect other joints such as the hip, ankle and shoulder. Typical symptoms include pain starting in the lower back which progressively moves up the spine, pain with increased activity and stiffness in the mornings. AS generally affects males more than females and onset typically occurs between 20-45 years of age.

Physiotherapists see many clients with back pain, and although AS is rare, it is something we keep in the back of our minds when assessing our patients. Our thorough analysis of back movement and symptoms together with blood tests and Xrays can provide information for a diagnosis of AS.

Physiotherapists are commonly involved with the management of AS. This can include high intensity aerobic exercise, resistance training, stretching, hydrotherapy, breathing exercises and managing flareups.

With the arrival of spring and the warmer weather many people kick off their shoes and spend more time in barefeet or thongs. If you haven’t been shoe free for awhile it’s a good idea to gradually transition to barefoot walking. Here are a few quick tips …

• Limit the time you spend barefoot … then each day gradually increase your walking time shoe free.
• If you are at the beach and want to do some long walks on the sand consider wearing your joggers for the first half of the walk, and go barefoot on the way home.
• If you need to purchase a new pair of thongs/flip flops … make sure they are supportive . There are some great options now that have good arch support.