Nerve pain and nerve damage – How Mayotherapy can help

Nerves are the body tissue that control motion, sensory feeling, and can create a pain response. When nerves get damaged or compressed, due to tight structures, like muscle or ligaments of the spine, because of lack of strength, injury, external forces, the pain reproduced or the weakness caused to certain muscles can be quite annoying and make daily activities challenging. In this blog, I will break down the basics of nerve structure, the types of nerve injuries, how nerves recover, when surgery is appropriate, and how Myotherapy can play a supportive role in your rehabilitation journey.

What’s the Nerve Structure

In order to better understand nerve damage, let’s compare the nerve to an electric cable:

• Axon: This is the core wire that transmits electrical signals. It’s the long extension of a nerve cell (neuron) that communicates with muscles, skin, and other tissues. This structure is indeed the equivalent of the copper wire in the electric cable.

• Myelin Sheath: A protective, fatty coating that wraps around the axon and helps speed up the transmission of nerve signals. To ensure the signal can travel smoothly along the axon, the myelin sheath works as a coating layer that doesn’t allow dispersion.

• Endoneurium, Perineurium, Epineurium: These are connective tissue layers that bundle individual axons into fascicles (groups), and fascicles into full nerves, like insulation and support around an electric cable.

Thanks to this multilayer organisation, the nerve’s structure is both efficient and delicate. Therefore, damage can occur to any part of this system, and based on the layers that are damaged, it will determine how the nerve recovers, including the need for external interventions (surgery) and the time of recovery.

Symptoms of Nerve Damage

Based on the type of nerve damage, you may experience different types of symptoms.

Sensory Nerve Damage (affects feeling/sensation):

• Numbness or reduced sensation (especially in hands, feet, or limbs)

• Tingling or “pins and needles”

• Burning or shooting pain

• Heightened sensitivity to touch (even light touch feels painful)

• Poor coordination or balance (especially in the dark or with eyes closed)

Motor Nerve Damage (affects movement/muscles):

• Muscle weakness or heaviness

• Muscle twitching or cramping

• Difficulty with fine motor tasks (e.g., buttoning a shirt)

• Muscle atrophy (wasting) over time

• Dropping objects or foot drop (inability to lift the front of the foot)

Autonomic Nerve Damage (affects internal organs/functions):

• Dizziness or fainting when standing (due to blood pressure regulation issues)

• Abnormal sweating (too much or too little)

• Digestive problems (bloating, constipation, or diarrhea)

• Bladder dysfunction (urgency, incontinence, or retention)

• Heat intolerance or inability to regulate body temperature

Other General Signs:

• Pain that follows a specific nerve path (e.g., sciatica)

• Delayed healing or tissue changes (e.g., in diabetic neuropathy)

• Sensory loss that makes walking or using limbs unsafe

When reading those symptoms, we have to be aware that multiple symptoms can be present, and that some symptoms may be related to other pathologies, so that’s why consulting with a physical therapist or the GP is the best step to better understand what is happening.

Types of Nerve Damage

Nerve injuries are classified based on the severity of the injury.

1. Neuropraxia (mild):
   A temporary block in signal transmission, often due to compression or stretching. The structure remains intact, and recovery is typically quick. Think of when sleeping with the arm in a funny position, or sitting for too long with one foot under the tight, and either the arm or the leg goes numb.

2. Axonotmesis (moderate):
   The axon is damaged, but the surrounding connective tissues are preserved. The nerve can regrow, but it takes time. It is estimated that the axon can regrow 1 mm per day up to 18 months. This gives you the opportunity to regrow a nerve from head to toes.

3. Neurotmesis (severe):
   The nerve is completely severed — both axon and connective tissue. Without surgical repair, recovery is unlikely. This is obviously the worst-case scenario, and it is more common in severe incidents, when an external factor may lacerate body tissues.

Each type of injury presents differently, from numbness and tingling to complete loss of movement or function in the affected area. In fact, nerves not only transmit sensation, but also allow muscles to contract and move. So, a lack of strength, sometimes, can be due to a nerve compression and not from a lack of actual muscle load capacity.

When Is Surgery Needed?

As we just saw, surgical intervention is usually recommended when the damage is extended to the full nerve structure and:

• There is a complete nerve severance (neurotmesis).

• There is no sign of functional recovery after several months.

• Scar tissue or compression is impeding nerve signal transmission.

• There is associated structural damage (e.g., after fractures or deep lacerations).

In order to restore nerve functionality, the surgeons may attempt nerve repair, grafting, or decompression, depending on the case.

How Fast Can Nerves Regrow?

Peripheral nerves (outside the brain and spinal cord) do have the ability to regenerate, but slowly. On average:

• Nerve regrowth occurs at approximately 1 mm per day, or roughly 1 inch per month.

• Recovery can take months or even years, depending on the distance the nerve needs to travel and the extent of the damage.

• During this time, muscles and tissues that rely on the nerve may weaken, which makes active rehabilitation crucial.

Indeed, to ensure a complete recovery, we want to stimulate via hands-on treatment and exercises the needs of the nerve to regrow. So, by stimulating the structure like the muscles controlled by the damaged nerve, we can stimulate the nerve itself to regenerate.

On the other hand, be aware that nothing can make your nerve grows faster, but we can ensure that the regrowth is stimulated.

The role of Myotherapy for Nerve Recovery

As a myotherapist, I focus on assessment, treatment, and rehabilitation of musculoskeletal pain and dysfunctions. Thanks to this approach, via the hands-on treatment and exercises skills learn during my Clinical Myotherapy training, I can help immensely someone who is suffering from nerve damage.

Hands-On Therapy

Assessment first

A fundamental tool to ensure we are looking at nerve damage is the myotome, dermatome and reflex test, where we can see which nerve is eventually entrapped and also evaluate at what level of its pathway the entrapment is.

• Myotome is a specific movement applied to resistance that shows pain in the back (while you apply movement) or extreme weakness (within the movement I ask you to go for), which can direct us to conclude that your nerve entrapment is at the spine level.
• Dermatome, as you can guess from the term, refers to skin sensation. So by the aid of a really light skin stimulation and a more intense skin stimulation (we usually use a cotton ball and a plastic stick), we can see if there are abnormalities in your skin sensation. Based on the area of the skin that feels numb, or where you may not perceive sensation, we can interpret what nerve is entrapped along its pathway.
• Reflex is a technique used to see the body’s autonomic response to a stimulus. That’s when we use a rubber hammer and bounce it off a specific nerve pathway (elbow, knee…) to see a joint reaction. Based on the anatomy, we have a better understanding of nerve entrapment or damage.

Manual Therapy:

Once we have a better understanding on where and maybe why a nerve is entrapted or is not functioning at its best, that’s where we can use different type of therapies:

• Soft tissue release, nerve gliding, and scar tissue management can reduce mechanical pressure on nerves and support blood flow to the area that needs recovery.
• Trigger point therapy may help alleviate muscular compensation patterns that develop as the body attempts to adapt to nerve injury.
• Dry Needling is ideal to stimulate certain muscle fibres, reduce the pain response in the target area and increase the neurological awareness of these tissues. Also used to the dermatome level (skin level) to create sensations that stimulate the nerve to grow.
• Joint mobilisation is often used to stimulate the spine and to reduce compression of the nerve at the spine level.

All these techniques can be used individually, but they are most often combined with a detailed clinical history and other assessment tools to create a differential diagnosis that can then be interpreted in a clinical impression.

Targeted Rehabilitation Exercises

Exercises are the takeaway homework that, as a Myotherapist, I always recommend to my patients.

The hands-on treatment is an ideal kick starter for the healing journey, but the exercises are what can maintain and keep the change evolving for the best.

When looking at exercises, we think of:

• Specificity: be specific to the case we see and work with, by starting from the mobility, working up to the strengthened or weakened muscles.

• Sensory retraining: there are exercises may also be used to help restore accurate sensation in areas affected by nerve injury.

• Nerve gliding: Those a form of specific exercises use to make sure your nerve is moving along its pathway to reduce stiffness and discomfort during daily movement.

Education and Self-Management

As you probably read in my Google Review, I am a therapist who emphasises the educational aspect of the recovery journey. Leave you with the understanding of what is happening to your body and how you can be in control of your healing journey, I believe it is fundamental for the best outcome.

And here are some of the things I believe can help the most:

• Share what the healing timeline is;

• Adjust activities to prevent aggravation;

• How to monitor your progress;

• Home care tools like exercises and ergonomics advice are often included in treatment plans.

In conclusion, if you are suspicious of nerve damage, and you are in need of help with your recovery, book now an initial consultation for Myotherapy and feel confident that, via a few sessions, we can create a healing journey that best works for your presentation.

And if you have any questions, please reach out to me via the form below:

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Frequent Ask Question about Nerve Damage

Frequently Asked Questions about Nerve Damage