Median Nerve Flossing for Neck- Arm Pains

Several years ago I listened to a talk on using nerve “flossing” mobilizations to help victim with hypermobility issues. This would stretch the nerve in their “tracts” and help reduce pain.

They were taught to do a routine -repeated like a dance –  with their arm that varied from
– arm up in “stick’um up position” with wrist fully extended like you were holding a tray
– arm straight out 90 degrees at side with wrist still bend up
– then move arm straight down behind you with wrist bend other way = fully flexed

then proceed to first position.

It was never clear how much difference this would make until present article did therapist led median nerve flossing 5 days a week for 6 weeks. The wait listed group did not change in pain level while the active group cut their pain by half.  Unfortunately, we don’t know about the placebo effect of active touching so it is not clear how much it actually helped.

Effects of Median Nerve Neural Mobilization in Treating Cervicobrachial Pain: A Randomized Waiting List–Controlled Clinical Trial
David Rodrıguez-Sanz et al
Pain Practice 2018 in press
http://onlinelibrary.wiley.com/doi/10.1111/papr.12614/full

  • Cervicobrachial pain (CP) is neck pain that radiates or refers to the arm.
  •   affects 83 in 100,000 people during their lifetime.
  • Hypothesiszed that any distortions in nerve tracts could worsen pain and that stretching nerve through their tracts (flossing) could help this
  • 18 to 45 years with a clinical diagnosis of CP confirmed by
    -magnetic resonance imaging
    -the presence of unilateral symptoms of arm pain, paresthesia, or numbness in the upper limb
    positive results in all the following tests:
         -Spurling

    –    -distraction  – lessening of symptoms with pulling/distracting head (I like to use an inflatable cervical collar):

    , and upper limb tension tests:

    Intervention:

  •  supine
  • shoulder in 90 degrees of abduction with external rotation during the whole process of neural tissue mobilization
  • start with : elbow flexion with extension of the wrist and fingers, – head in a neutral position. (stick-um up  and hold tray position)
  • Then elbow extension with flexion of wrist and fingers
  • straighten arm then go back to first position
  • approximate speed of 1 complete repetition of upper limb flexion and extension movement every 2 seconds without re-emergence of symptoms
  •  continuously five times for 2 minutes, with 1 minute of rest between
    applications
  • 5 days a week for 6 weeks

Results:

Comment – combined with cervical traction this add a dimension of treatment not available up to now. Sometimes injecting knotted muscles and sensitized nerve tracts on skin helps as well but results vary. We don’t know how much relief was the laying of hands because there was no good control group cheap air max 97 cheap air max 97

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