Anatomy 101: What is a Nerve Entrapment?

A nerve entrapment occurs when a nerve is “stuck” to its adjacent structures or is not sliding properly along its course due to scar tissue adhesions. Symptoms of a nerve entrapment include numbness, tingling, pain, weakness and tightness. Sciatica and Carpal Tunnel Syndrome are the most common nerve entrapments. These are familiar terms to people 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 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 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 Entrapment’s 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 its adjacent structures result 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 can 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 approach 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 myself and Dr. Jason Gray are licensed to treat these conditions, are certified to use ART and have integrated these procedures into clinical practice.