Shoulder Pain Osteopathy

(Part 2: Nerves matter too)

I cannot remember ever working a day in a clinic where I did not treat a client who was suffering from some form of nerve dysfunction.

Nerve pain, often called neuralgia will affect most of us at least once. Neuralgia

Is a painful condition, that feels stabbing and shooting, and sometimes burning or electric. 

 Nerve dysfunction can affect multiple nerves, including:

– Trigeminal Neuralgia (affecting the face)

– Occipital Neuralgais (effecting the back of the head)

– Intercostal Neuralgia (effecting between the ribs on the side)

– Femoral Neuralgia (effecting the front of a thigh)

– Sciatic Neuralgia (effecting the glutes and hamstring and sometimes calf and foot)

– Ulnar, radial, and median Neuralgia (affecting an arm or a hand)

Neuralgia has many different causes. Usually nerve dysfunction arises when a nerve is mechanically pinched or strained, outright damage (palsy) of a nerve is relatively rare. It is worth remembering that it is not always bio-mechanical injury or our posture which causes nerve problems. Diabetes, hypothyroidism and low B12 levels can all irritate peripheral nerves (any nerve outside of the brain or spinal cord). 

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How Osteopaths Assess Nerves….

Part 1: state of damage/irritation

Case history, this is where an Osteopath asks lots of questions. Such as…

Do you feel any tingling/pins, needles or numbness? If so where?

When did it first start?

Is this the first time you have ever felt this?

Testing is next where an Osteopath tries to figure out where the nerve is strained/pulled and where it is pinched. These tests are important as they tell the Osteopath if the nerve is damaged and whether a referral to get a scan is warranted or not.

These tests include….

-> Neural tension tests, seeing what stretches reproduce the pain

-> Joint compression tests, finding out if pinching a nerve as it comes out of the spine causes the pain and/or pins and needles to get worse.

-> Reflex testing

-> Muscle function/strength which can be impaired with a pinched nerve.

-> Ability to feel (sensation) in the limbs.

* Unfortunately, some of these tests can irritate the nerve, so it is common to feel worse after the consultation. Rest assured treatment afterwards should ease some of the irritation. It is vital that anything untoward is ruled out, if we are not assessing we are guessing!

Part 2:

Reporting their Findings back to you

Throughout the tests the Osteopath will be recording the results. They will then tell you their diagnosis based upon all of the positive results that they have found.  A diagnosis will tell you where a nerve is pinched and/or strained before any treatment or advice. 

Telling clients what is going on, helps the healing process as knowledge is power. When clients understand what is going on they are far more likely to be able to allow it to heal.

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When Osteopaths do NOT manipulate nerves….

Osteopaths try to avoid tugging on parts of nerves that have traumatically or repetitively tugged. We want to help the healing process, not make it worse. Which is why Osteopaths go out of their way not to use any techniques which might strain a nerve.

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How Osteopaths release pinched nerves….

Joint manipulation (cracking joints) is the primary tool in our toolbox when it comes to freeing up trapped nerves. Sometimes the gap between the bones, where the nerves come out of the spine is pinching of the nerve because the joint is tight and compressing on the nerve. This is where Osteopathic and Chiropractic manipulation can really help. Bone-settling can temporarily loosen up joints and free up a trapped nerve. As I said in another https://www.eastcornwallosteopathy.co.uk/osteopaths-dont-just-treat-joints/

Our muscles, joints and nerves are all interrelated and connected. Meaning that sometimes the best way to treat a nerve is to treat the corresponding joint.

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How I release trapped nerves……..

-> If the nerve root out of the spine is compressed I nearly always manipulate the joint to free the nerve up (if my client is on-board with that approach). 

-> If the nerve root is acutely or chronically strained then I use techniques to get the bloodflow to the nerve root to encourage the healing process.  

-> When it is a muscle pinching on a clients nerve, I do not press hard on the nerve like a lot of massage therapists, as it is not the best long-term strategy. Instead I relax off unnecessary muscle tension of a muscle, especially if it is in spasm. Stopping a muscle from compressing a nerve, usually takes a lot of pressure off the nerve. Sometimes the best way to treat a nerve is to treat the corresponding muscle.

On the occasions where I feel that fixing a nerve problem is outside of my scope of practice, I refer clients out to places where they can get an

– MRI

– Nerve Conduction test

– Blood tests (to rule out peripheral neuropathy)