A different paradigm for managing nerve related pain

The nerve protection paradigm for the management of movement provoked nerve pain is a very simple idea.

Exercise is seen as the antidote to injury and pain that appears to be of a musculoskeletal origin. For injuries to muscles, ligaments and fascia a programme of graded movement is usually therapeutic. The appropriate exercise programme may improve muscle strength and co-ordination, protecting the injured or painful joint from excessive loads; and it may improve soft tissue flexibility, reducing the mechanical load within tissues and therefore altering the point at which nociceptors and load receptors within the tissues fire of a message. 

Exercise may also improve the microcirculation and lymphatic drainage of an injured region. 

Exercise is very good for our health; for almost all aspects of our health. 

But there are some nerve related pains for which some particular movements are just provocative. Movements that would normally be innocuous and movements that are therapeutic for muscles and joints are provocative. 

Pain perceived to be in joints or muscles; pain that is increased with movement of the joint or muscle, may arise in part or entirely from the nerves that pass near the joint or muscle; some of these nerve pains also respond to gentle graded movement, however some do not. Movement may easily provoke the pain, and exercising as though it were a muscle injury just keeps the problem going. 

Protecting the nerve from painful provocative movements allows the underlying neuro-pathophysiology to subside. 

I use the analogy of repeatedly fuelling; kindling, a campfire to describe the process by which normal daily activities provoke the nerve pain.