With patients who suffer from neuropathic pain or from pain in a structure that that nerve innervates, we need to treat the mechanical interface, or the structures the nerve runs through, the nerves themselves and also the innervated tissues that are breaking down from the negative effects of compressed or strained nerves.
The mechanical interface is the muscle, bone and fascia structures that the nerves run through. There are different treatment options for the mechanical interface of the nerve. First, physical therapy is implemented to correct muscle imbalances focusing on posture, strength and flexibility. Manipulation and alignment can also be performed to decrease abnormal forces coming from the mechanical interfaces. Sometimes we use taping as well as unloading braces release or unload the areas. Weight loss and fitness are always part of the goals to decrease the stress and strain of the mechanical interface on the nerves.
The neural structures are the nerves as they course deeply through muscles and fascial planes, and also the superficial branches that course on top of the fascia under the skin. We can perform hydro-dissections to the deeper compressed fascial tunnel areas as well as superficial nerve blocks to the peripheral branches. Epidurals can be performed for spinal nerve impingement using the “sweet caudal” dextrose based epidural, avoiding the degenerating side effects of steroids. Topical compounded creams containing elements like vitamin D, dextrose and/or mannitol can be used to treat the superficial nerve branches as well. There are also some supplements that are helpful to decrease inflammation around the nerves and improve nerve function, including omega-3 fats and B vitamins.
As we’ve seen, the innervated tissues can break down because of the effects nerves have on either healing or degenerating them. When these tissues are breaking down, we can use treatments like Prolotherapy, PRP and Stem Cell treatments to initiate a healing response and regenerate those areas. Physical therapy is also important to strengthen the structures themselves and the supporting structures around them. Ultrasound, cold laser and infrared heat can be used to augment the healing response and increase blood flow to the area. Supplements are often given to maximize healing responses, including amino acids like glutamine and arginine, vitamin D, optimizing anabolic hormones, and antioxidants like resveratrol and vitamin C. Optimizing nutrition with whole, healthy foods is also important for the cell health of the innervated tissues. To summarize optimal healing, the umbrella that covers all other aspects of health is CELL HEALTH. This includes optimizing fitness, nutrition, avoiding food sensitivities, hormone optimization, avoiding medications with degenerative side effects, controlling stress in the body, maintaining adequate hydration, and avoiding environmental and food toxins. While you are optimizing your cell health, that is a good time to work on FUNCTIONAL MOVEMENT. This is the time to work on strength, balance, posture, fascial health and joint and spine stability. After functional movements and cell health has been restored, a good examination of any pathologic function of spinal and peripheral NERVES needs to be done to make sure those don’t have to be treated before focusing on the articulation regeneration. Finally, the ARTICULATION, or joint, can be addressed with the goal of avoiding surgery or joint replacement and focusing on treatments that can restore function and regenerate the degenerating area. Treatments include Prolotherapy, PRP and Stem Cell procedures. Through the implementation of the above C.F.A.N. plan, we truly can regenerate our bodies, optimize our health and ourselves to a level of activity and function we once enjoyed. Cheers to your health! Take charge and regenerate.
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