Pain is the response of some form of adverse stimulus that our bodies perceive when there is a potential threat of injury, or when an actual injury has occurred.
Pain can be caused when tissue is damaged or irritated. With injury to different tissue types, there are different symptoms that patients perceive. A sharp pain with movement, for example, is most likely a muscle pain, caused by either one large insult to the tissue (macrotrauma), or repeated smaller trauma to the tissue (microtrauma). A deep, burning pain can be indicative of Nerve pain.
Nerve tissue supplies the awareness of sensation to all areas of the body. Different nerves supply different areas of the body with sensation, and can be organized via a “Dermatomal” distribution. This essentially means that one nerve conveys information about one area of the body. Patients will present complaining of pain in a certain location and through questioning the therapist can determine if a muscle, nerve, joint, or other tissue is the cause of this pain. The body is like the USA. Each nerve governs a certain region (State). There is minimal overlap between States, so pain in one region can be traced to one particular nerve.
Nerve pain is not like muscle pain. If you cause an injury to a muscle, the muscle will respond immediately, giving the patient symptoms, and then when the muscle is unloaded, the pain reduces. Nerve pain generally does not go away as fast as muscle pain. When you aggravate a nerve, the pain will not go away immediately, as nerve tissue has something called latency. Latency is a delayed response to being aggravated. Nerve injury may cause you pain 12, 24 or even up to 72 hours after the injury has occurred. If nerves give you pain for thirty seconds after they are aggravated, then they have a low latency. If a nerve causes you pain for 72 hours after aggravation, this is termed a high latency. This is why nerve treatment is slightly more complex than treating other body issues, as the nerve may not give you immediate symptoms, and therefore may not give you immediate relief when you are being treated.
The questions that a Physical Therapist may ask a patient who has nerve pain are vital to forming a picture of how the pain reacts, how it behaves, and the duration of the pain after some form of aggravation. If we do not ask you how severe your pain is, and the “latency” of this pain, we can cause more damage to the nerve, or make you more aggravated for a longer period of time.
Nerves also control what is called motor output. They are the “electric supply”. They provide the power to muscles to contract/relax. Pain in your nerve can ultimately disrupt the power supply to muscles.
Pain from nerves can be extremely frustrating to patients. Pain that does not always respond to therapy, or even drugs, immediately can be confusing, but with this brief intro into what nerve pain is, hopefully you can understand what nerves do, how they respond to aggravation and why they are quite complex at times to treat.
If you have any other questions about nerve pain, please contact me at Luke@JointVenturesPT.Com.