It May Be Necessary To Encounter The Defeats, So You Can Know Who You Are, What You Can Rise From, How You Can Still Come Out Of It !!!
Proper management of peripheral nerve injuries requires an understanding of the distribution and function of nerves, the mechanisms of nerve injury, and an appreciation of the regeneration process. It is imperative to astutely examine the patient to obtain the clinical clues necessary for accurate diagnosis. Detection and localization of nerve injury can be complicated in the presence of multiple additional trauma, such as fractures or vascular compromise. Carefully planned and performed electrodiagnostic studies based on the history and examination offer additional diagnostic and prognostic information.
Injuries to peripheral nerves are common in the general population. This includes prevalent conditions such as “pinched nerves” in the neck or back, caused by disc herniations, bone spurs or thickened ligaments, and carpal tunnel syndrome. When a nerve has been compressed of sufficient magnitude and duration, the usual transport up and down the nerve of various proteins and other substances may be blocked or slowed down, increasing the irritability of the nerve. Even slight nerve compression also reduces the blood flow to the nerve, which makes it more sensitive. Greater nerve compression can lead to cell death in the nerve, and subsequent re-growth, or regeneration of the nerve, after the nerve compression has been sufficiently relieved.
In cases of mild nerve injuries, function of the nerve may return within a few months, at which point the nerve irritability typically resolves, whereas in more severe cases, the regeneration process can take over a year.
Significant stress put on a paralyzed muscle through e.g. stretching or strengthening delays, and may even prevent full nerve recovery, and such treatment should not be started until the late stage of nerve regeneration, when progressive strength return can be seen. As a general rule, a muscle which has been weakened due to nerve compression should not be exercised until there is measurable return of muscle strength due to nerve regeneration, and there is minimal pain associated with the nerve injury.
A severely injured nerve may require many months before initiating any resistive exercise to the involved muscle, in order to allow for sufficient nerve healing. A less traumatized nerve may be able to tolerate light exercise within the first month.
If a nerve cannot handle the task of exercise, there may be increased pain, tingling or numbness, or even increased muscle weakness during or after the exercise. Therefore, such signs must be watched for when starting and progressing an exercise program.
When rehabilitating the neck and back, and there is remaining arm or leg tingling/numbness or residual arm or leg weakness, the muscles in the arm or leg that have been affected by the nerve injury should typically not be exercised with resistance or stretching early on. Focus should instead be put on exercising stabilizing muscles in the neck and back, in positions which provide plenty of room for the affected nerve, and to gently promote nerve mobility. With back injuries, even exercise in standing may be too much for the nerve to handle at first, whereas lying exercises can be tolerated well.
This topic of how to proceed with appropriate exercise after spinal nerve roots or other peripheral nerves have been compressed or traumatized is keenly understood by our physical therapists at Accessible Physical Therapy Rehabilitation Services Center, and we are well experienced to recognize that such nerves often need considerable time to regenerate.
At Accessible Physical Therapy Rehabilitation Services Center, we aim to identify and then rectify the cause of your pain, rather than just treating the symptoms. Our treatment and rehab programs are designed to get you moving normally and back to full fitness.
Contact Accessible Physical Therapy in Waldorf | Silver Spring | Greenbelt, MD to get back to your activities.
Accessible Physical Therapy Services provide fast recovery from accident, sports, work related injuries, lower back, neck, leg pain (sciatica), strains, sprains, fractures, arthritis, burns, amputations, stroke, multiple sclerosis, and conditions such as cerebral palsy, spina bifida (split spine) and musculoskeletal problems through physical therapists that are highly trained and experienced in physical therapy, aquatic therapy, hand therapy and industrial rehabilitation.