What Is Neurodynamics and How Does It Work?

Neurodynamics considers the nervous system’s relationship to the musculoskeletal system, focusing on how nerves move and function within the body. The primary goal of applying neurodynamic principles is to restore the normal movement and physiological function of nerves. This approach aims to alleviate symptoms such as pain, tingling, or numbness that can arise from impaired nerve mechanics.

Neurodynamics is based on the understanding that the nervous system is a continuous organ that must adapt to the body’s movements. This continuity means that movement in one part of the body can affect the entire nervous system. The health of a nerve depends on its ability to move relative to the tissues that surround it.

The Science of Nerve Movement

The nervous system is designed for movement, with nerves possessing the ability to glide, stretch, and compress within their surrounding tissues as we move. Nerves slide longitudinally within their soft tissue “tunnels” and can elongate slightly when joints are moved. This natural “excursion” allows the nervous system to adapt to constant changes in body posture and position without sustaining damage.

A healthy nerve maintains a delicate balance of internal pressure, known as intraneural pressure, which is necessary for its blood supply and the transport of substances along the nerve axon. When a nerve’s movement is restricted by inflammation, scar tissue, or sustained postures, this pressure can increase. Elevated intraneural pressure can compromise blood flow to the nerve, impede substance transport, and lead to irritation.

This mechanical and physiological disruption can manifest as pain, a pins-and-needles sensation, numbness, or muscle weakness in the area the nerve supplies. The body may also instinctively guard the area to prevent movements that provoke these symptoms, contributing to a cycle of restricted mobility and nerve irritation.

Fundamental Neurodynamic Techniques

Neurodynamic techniques are specific, controlled movements intended to restore the healthy mechanics of the nervous system. These methods are broadly categorized into two main types: “sliders” and “tensioners.” Each approach is applied based on a careful assessment of the individual’s condition and the specific nerve involved.

Slider techniques aim to produce a gliding motion of the nerve relative to its adjacent tissues with minimal tension. This is often achieved by moving one joint to elongate the nerve bed while simultaneously moving another joint to shorten it. The goal is to gently mobilize the nerve, improve its excursion, enhance its circulation, and reduce its sensitivity to movement without provoking symptoms.

Tensioner techniques involve gently and progressively applying a controlled stretch to the nerve at the end of its available range of motion. This method is used to challenge the nerve’s ability to elongate and can help to reduce adhesions that may be restricting its movement. These techniques are applied to ensure that the nerve is mobilized safely and effectively.

Applications in Health and Rehabilitation

Neurodynamic principles are frequently applied in the assessment and treatment of musculoskeletal conditions involving the peripheral nervous system. One of the most common applications is for nerve entrapment syndromes, where a nerve is compressed or irritated at a specific location. Conditions that may benefit from this approach include:

• Carpal tunnel syndrome, where the median nerve is compressed at the wrist. Neurodynamic techniques can improve the gliding of this nerve to reduce hand pain and numbness.
• Sciatica, which involves irritation of the sciatic nerve. Mobilization can help reduce nerve sensitivity and improve its mobility as it passes from the lower back down the leg.
• Cubital tunnel syndrome, which involves the ulnar nerve at the elbow.
• Thoracic outlet syndrome, which affects nerves and blood vessels between the neck and shoulder.
• Cervical or lumbar radiculopathies, where a nerve root is compressed as it exits the spine.

Beyond entrapment syndromes, neurodynamics plays a role in post-surgical rehabilitation. After a surgical procedure, scar tissue can form around nerves, restricting their normal movement and causing pain or dysfunction. Neurodynamic interventions can be used to carefully mobilize these nerves, helping to prevent or reduce the formation of restrictive adhesions and promote a more complete recovery.

Accessing Neurodynamic Interventions

Individuals seeking treatment based on neurodynamic principles typically consult with physical therapists, occupational therapists, or chiropractors who have received specialized training in this area. These healthcare professionals are skilled in the assessment and management of conditions affecting the nervous system’s mechanical function.

An initial assessment usually involves a detailed patient history and a physical examination. The clinician will perform a series of specific movements and positions, known as neurodynamic tests, to assess the mobility and sensitivity of the nerves. These tests help determine if a nerve is the source of the patient’s symptoms and guide the selection of appropriate treatment techniques.

Treatment is highly individualized and based on the findings of the assessment. The interventions are often gentle and graded, starting with movements that do not provoke symptoms and progressing as the patient’s condition improves. Patient feedback throughout the treatment process is important for ensuring the techniques are applied safely and effectively.