Beyond Muscle Aches: The Truth About Nerve Pain and How It Behaves

Do you ever wonder why pain seems to pop out of nowhere in places like your neck and back? You've done the same workout routine or work activities for the past 20 years without an issue, and now it hurts. You might experience tightness, tingling, or sharp, electrical pain. Some people jump to conclusions, thinking it could be a tear or tendinitis, but what if it was nerve pain?

I want to preface that nerve pain and nerve pain science are very complicated. In the next few minutes, I plan to simplify these tough concepts in my own words, the way I make sense of it.

Why Does Nerve Pain Behave This Way?

There are a few key reasons why nerve pain can manifest and linger:

1. Pressure from Physical Structures and Inflammation: Something in your body, like a muscle, bone, or even internal scar tissue (adhesions), might be putting direct pressure on a nerve. Inflammation in the area can also irritate it.

2. Irritation from Spinal Disc Material: If you have a spinal disc issue, the material that leaks out from a disc can be toxic and highly irritating to nearby nerves.

3. Lack of Slide and Glide (My Prevailing Theory): Imagine a nerve as a long, flexible cord that needs to slide and glide smoothly through your body as you move. If it becomes "short" or gets stuck due to adhesions or physical structures gripping it, every movement will tug on it, causing pain.

The Nerve Behavior Scale: Understanding Your Symptoms

Back in 2014, I created this nerve behavior scale based on my own journey with nerve pain. It helps explain the progression of nerve symptoms, both when they worsen and, importantly, when they improve.

Here's how it generally behaves, from healthy to severe dysfunction:

• Healthy: No symptoms, smooth movement.

• Pressure: You might feel a gripping, tickling, or strange pressure sensation.

• Hot/Cold Issues: Some people experience a constant hot or cold sensation, often mistaken for circulation problems.

• Pain: This is where the sharp, electrical, or burning pain typically kicks in.

• Tingling/Pins & Needles: You might feel "pins and needles," or a sensation like something isn't quite flowing right.

• Numbness: This is a loss of sensation, where touching the skin feels anasthetic or strange.

• Motor Paralysis: The most severe stage, where you lose fine motor control (e.g., dropping keys, difficulty turning a doorknob) or experience issues like foot drop.

  
  

Here's the crucial part for recovery: If you started at a more severe stage (like numbness or paralysis) and you begin to feel tingling, and then pain, it's actually a sign of improvement!

Many of my patients call me around their fifth or sixth visit, thinking their pain is worse after a treatment because they've moved from numbness/tingling to feeling more pain. I always tell them, "Remember our first talk? Going from numb to tingling to pain is a good thing!" It means the nerve is waking up and re-establishing communication.

However, if you went from pain to tingling and then numbness because of a session, something went wrong, and the degenerative process is worsening. We want to see the reverse: pain decreasing to hot/cold sensations, then pressure, and finally back to healthy.

The Nerve Migration Man: Centralizing Your Symptoms

Another fascinating aspect of nerve pain is what I call nerve migration. We generally want your symptoms to centralize, meaning they move closer to your spine.

Imagine a nerve like a branch off a tree trunk. If you have tingling in your leg or hand (like with carpal tunnel syndrome), the issue is often stemming from where the nerve originates in the spine or closer to it. You want to "squeeze" the symptoms back up the nerve, like toothpaste being squeezed back into the tube.

• Good Migration: If your pain started in your leg and moves up to your hip or lower back, or if hand tingling moves to your neck, that's a good sign! It might feel more intense at the "stem" (closer to the spine) because all the symptoms are consolidating there, but it means your limbs are clearing up.

• Bad Migration: If your symptoms start centrally (e.g., in your neck) and then spread down into your arms or legs, that's a bad sign. You want your pain to move towards the "mothership" (your brain/spine), as ultimately, pain is interpreted in your brain.

Sometimes, when doing nerve work, people might even develop headaches as the symptoms centralize all the way up. This is part of the healing journey – moving all the way up and eventually eradicating the pain.

What to Do If You Suspect Nerve Pain

If your pain isn't making sense and you suspect nerve involvement, the best thing to do is get thoroughly evaluated by a professional.

If nerve pain is truly what you have, there are highly effective techniques:

• Manual Physical Therapy: Hands-on techniques to free up structures.

• Neuromechanical Physical Therapy: Addressing the mechanics of how your nerves move.

• Nerve Threading or Glides: Specific exercises to help nerves slide and glide more efficiently.

  
  

These approaches can help free up adhesions, restore proper nerve mechanics, and allow you to become biomechanically efficient again.

If your nerve pain had a personality, which of these would it be?

• 0%A mischievous pixie that randomly zaps you
• 0%A clingy ex who just won't leave
• 0%A grumpy old landlord who is always making demands
• 0%A faulty car alarm that goes off for no reason

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