Its every medical professional’s job to steer away from overly medicalised language when explaining a diagnosis to a patient. Ideally, your diagnosis should be explained to you in simple everyday language so that you’re able to fully comprehend your diagnosis. Whether you’ve been told that you have “’adverse neurodynamics” or an “’altered straight leg raise” by your physio or another medical professional, these terms should be fully explained to you as they may mean different things to different people.
Neurodynamics is actually a general term for the health and movement of the nerves in the body. If we think of the nerves in the body as motorways with lots of side roads, which steer off into other roads, you’d have a good comparison to describe all of the main nerves and the tiny branches, which come off them. Most people have heard of the sciatic nerve, one of the bigger nerves in the body. The sciatic nerve has lots of small branches coming off it along its length, including the tibial nerve, which travels down towards the leg and foot.
Nerves, like some roads, take a winding path through the body. They can travel round sharp corners of bones, such as the ulnar nerve at the elbow, or they can pass through tight spaces such as the median nerve at the wrist. They pass through muscles and they pass round blood vessels on their route down the arms and legs and through the trunk.
The routes of nerves are brilliantly displayed in the bodies of Gunther von Hagens’ Body Worlds Exhibition, which has been exhibited around the world. The bodies of the exhibition have been stripped back and their nerves, blood vessels and muscles immortalised by injecting plastic into them. Go to see this show if you ever see it near you, it’s a wonderful display of the human body!
Motorways and Messages
As these nerves travel along their path through the body and pass by bones, discs, muscles, blood vessels and other tissue layers on their route, they can be trapped, irritated or possibly even compressed by the tissues they pass. This is not dissimilar to a 4-lane highway moving into 2 slow moving lanes of traffic due to heavy road works. Like the slow moving traffic on a motorway, the messages being passed along nerves can be increased or decreased, stopped or changed by the surrounding tissues acting on them. Symptoms such as pins and needles, numbness, shooting pain, burning pain and pain at a site further away from the actual cause of the problem, can all be due to problems with the nerves. Medical professionals call these points where problems occur ‘interfaces’ – an area where the nerve and the tissue around it interacts.
One Big Linked System
Nerves, like a road network, are in fact one big linked system, which covers the whole of the body. At the centre of this system is the spine, where nerves travel down from the brain to the limbs. A neurodynamic test is a method of moving the nerve tissue along its entire length by moving the tissues of the body. When we do these particular movements we are trying to elicit the symptoms of nerve injury or pain. A medical professional is best qualifies to carry this out, as even in individuals with no symptoms at all, these movements can be uncomfortable and can bring on nerve symptoms. It takes careful clinical reasoning and thorough assessment to work out where the nerve is irritated along its full path, and what tissue is at fault. Once the problem has been identified then treatment can be aimed at the appropriate interface to the nerve and the best outcomes can be achieved. For instance, those with carpal tunnel syndrome may require surgical release of the wrist tissues, or those with ulnar nerve pain at the elbow may need nerve-gliding exercises.
If you think your symptoms might be due to nerve irritation or injury, contact us today to get appropriately assessed.
Post by Leanne Plenge, Physiotherapist and Bristol Manager.