Anatomy 101: What is a Nerve Entrapment?

A nerve entrapment occurs when a nerve is "stuck"to adjacent structures or not sliding properly along its course due to acquired scar tissue adhesions. Symptoms of a nerve entrapment include numbness, tingling, pain, weakness and tightness. You are probably familiar with Sciatica and Carpal Tunnel Syndrome; they are the most common nerve entrapments. These are familiar terms to the general public but most don't know what causes a nerve entrapment and that there are new treatment methods that are effective in managing them.

Nerves arise from your spinal cord and travel out of the spinal column like long telephone wires. They are sandwiched between your muscle groups as they course their way to send information to and from your muscles and joints. The Sciatic Nerve, the most well-known nerve, originates from the spinal cord at your lumbar spine and forms a thick nerve tract roughly 2cm wide and takes a course from your back and down the back of each leg. Chiropractors and physicians are taught in school that sciatica is caused by inflammation resulting from a nerve being compressed at the spinal disc level. Research is now showing however, that this traditional emphasis on the inflamed nerve root as always being the primary cause of leg pain is not only inaccurate but ignores the fact that the sciatic nerve can be entrapped anywhere along its length.

Conventional Therapy
Conventional treatments focus on relieving inflammation or blocking pain associated with a nerve root impingement through drug therapy, joint manipulation or physiotherapy. Surgery is another route of treatment which has been discredited as being an effective management strategy for most patients.

How do Nerve Entrapments Develop?
Unfortunately, in the case of sciatica, these therapies are often not enough to manage pain or improve activity intolerances. Nerve entrapments develop as a result of chronic compression the nerves by tight muscles through which the nerve travels or repetitive rubbing or sliding of the nerve against adjacent structures. Friction between the nerve and adjacent structures results in tissue damage which triggers the onset of inflammation to repair the damage; scar tissue is the result of the inflammatory response.

How does Scar Tissue Contribute to Onset of Symptoms?
Over time, scar tissue will build up and accumulate into what we call adhesions. Adhesions affect the normal health and function of the muscles resulting in pain, tightness, stiffness, restricted joint motion and diminished blood flow. Poor posture, prolonged sitting, previous injury and physical deconditioning set the stage for muscles to become chronically tight and can lead to continuous compression on nerve tissue, essentially damaging the nerve itself.

What is Active Release and How Does it Work?
The good news is that a new procedure in Active Release Techniques (ART) called Peripheral Long Tract Nerve Release is one of the most significant advances in treating sciatica and other nerve entrapments conservatively. The primary focus of this new technique is to move the nerve through the tissue. In these procedures, the doctor uses their hands to tension the soft tissues involved and then performs procedures that enable the nerve to be pulled through the soft tissue structure, thereby releasing the nerve from surrounding adhesions. The true power of this procedure is that the doctor can actually feel the scar tissue causing the restriction and actually feel the nerve pull through any site of entrapment, alleviating symptoms of nerve compression. Both Drs. Jason and Stephanie Gray are certified to treat these conditions and have integrated these procedures into clinical practice.