Unlocking Relief: How Physiotherapy Can Alleviate Neuropathic Pain and Restore Your Quality of Life
Neuropathic pain is a type of pain that happens when there is dysfunction to the nerves themselves. Unlike the usual pain that occurs when tissues like muscles or joints are injured, neuropathic pain is caused by problems with the nervous system. Nerves send signals to the brain to tell us when something is wrong, but when the body undergoes some form of trauma, the nervous system begins to send excessive signals throughout the body which then leads to increased body sensitivity and discomfort. This type of pain often feels different from regular pain and can be described as sharp, burning, tingling, or even like an electric shock, and it might be constant or come in waves. People with neuropathic pain may also experience hypersensitivity to touch or a feeling of numbness in the affected area. Common causes include conditions like diabetes (which can cause diabetic neuropathy), herniated discs, shingles, osteoarthritis, and nerve compression from being in prolonged positions (such as being hunched over or sitting for too long).
As an example, when someone is feeling a burning or tingling sensation going down to their toes while bending over, it could suggest that they are experiencing neuropathic pain that is originating from their lumbar spine (lower back). More specifically, the nerves that provide muscular function and sensation to the feet and toes are located in the lumbar spine may become irritated and possibly compressed in some way or another. Of course, this is not normal and should be assessed by a physiotherapist to determine an appropriate treatment plan to help treat this neuropathic pain.
How Physiotherapists Can Help
When you see a physiotherapist for neuropathic pain, we begin by determining how the pain is affecting your daily life, your movement, and your posture. We’ll ask you about the type, intensity, and location of the pain, and the use specific assessment tools and tests to better understand how your nervous system is behaving. This then helps us determine which treatment strategies may work best for you. Here are some common treatment options that a physiotherapist may provide for neuropathic pain:
- Intramuscular Stimulation (IMS) and Dry Needling: This technique involves inserting a very fine needle to stimulate specific muscles (next to the spine or into the shoulder, hip and leg areas) or sometimes directly into a sensitive muscle area called a trigger point. This process has been shown to help relieve muscle tightness surrounding specific nerves and to improve blood flow in the area. IMS has also been found to be helpful as it can create a reset (or desensitization) to the nervous system, thus leading to reduced pain in our body.
- Manual Therapy: involves hands-on techniques such as soft tissue and joint mobilization, which can help relieve muscle tension, improve movement in the area, and reduce pain. This can also improve blood flow to the affected areas, which may help reduce inflammation and promote healing. In some cases, gentle spinal mobilizations or stretching techniques can also help relieve nerve compression that contribute to neuropathic pain.
- Exercise Therapy: when appropriate, guided movements can help reduce nervous system hypersensitivity. Once the nerve tissue irritability is under control, adding gentle and controlled movements can reduce muscle tightness, improve posture, and decrease nerve irritation. Some examples include:
- Nerve gliding exercises: specific movements that gently slides a nerve within the surrounding muscles, promoting better movement and less pain.
- Core exercises: help improve strength, flexibility, and postural stability which is optimal for nerve tissue function. This can also promote better circulation to the nerves which is essential for healing.
Written by: Chelsea Chua