Ultimate Guide to Nerve Flossing - The Apeiron Life Perspective
- Elizabeth Bradley, MS
- Apr 1, 2024
- 5 min read
What is it:
Many people have experienced nerve pain at some point in their lives. Nerves that travel deep in our muscles can get compressed and irritated, causing pain, tingling, and numbness that travels along the nerve path. Compression or irritation to the nerves can result from an injury, disease, and/or changes to the surrounding nerve structures, such as muscles and fascia.
Nerve flossing, also known as nerve gliding or neural mobilization, is a gentle exercise where you stretch the nerve to reduce pain and improve the range of motion and flexibility. It involves tensioning one end of the nerve while releasing tension on the other end. Gliding the nerve back and forth, similar to flossing your teeth, aims to mobilize the nerve and release it from the surrounding muscles and fascia. Nerve flossing exercises can be used to target nerves at different parts of the body.
Purported claims:
There is a lack of comprehensive scientific data to verify the benefits of nerve flossing. Studies have usually looked at nerve flossing alongside other treatment methods such as physiotherapy, wrist splints, and medication. However, nerve flossing is a natural, non-surgical way to help alleviate pain, and the exercises are simple enough to do at home without any equipment. Nerve flossing may help to:
Increase range of motion
Reduce nerve pain
Reduce damage to nerves
What the science says:
The sciatic nerve runs from the lower back down to the toes. Sciatica, also called lumbar radiculopathy, refers to the pain along the sciatic nerve often caused by a herniated disc or degeneration of the lumbar spine that places pressure on the sciatic nerve roots and can be felt in the lower back, legs, calves, and feet. This condition is quite common, affecting about 40% of low back pain cases in adults. A study in a Nigerian hospital investigated the impact of the Nerve Flossing Technique (NFT) on acute sciatica symptoms and hip range of motion. The study used Numeric Pain Rating Scale (NPRS) scores and Passive Straight Leg Raise (PSLR) values before and after the treatment. The group that received NFT along with conventional physiotherapy improved significantly more both in acute sciatica symptoms and hip range of motion compared to the group that received physiotherapy alone. The researchers suggested that improvement in symptoms may be attributed to the restoration of neural physiology by restoring the normal neural pressure and flow of impulses. This might lead to the clearing of intraneural edema, which is often present in acute sciatica. A systemic review and meta-analysis of neural mobilization (NM) for reducing pain and disability in patients with lumbar radiculopathy found that NM effectively reduced pain, whether alone or in conjunction with other treatments. Furthermore, NM significantly alleviated disability, particularly in chronic cases.
Piriformis syndrome can cause pain in similar areas of the body, so it's often confused with sciatica. However, piriformis syndrome is caused by a piriformis muscle compressing or impinging the sciatic nerve that travels below, above, or in between the muscle. A recent study from India found that the nerve gliding method can be effectively used for those with piriformis syndrome.
Carpal tunnel syndrome (CTS) is one of the most common conditions that affect the median nerve as it passes through a narrow tunnel in the wrist. Symptoms include numbness and tingling in the hand's palm, thumb, index, or middle finger. CTS is a typical condition among people working with their hands, and some studies have shown an increased risk between CTS and the use of the mouse. A study among women with CTS found that those who added nerve gliding exercises in addition to day and night splints and conservative therapy demonstrated more rapid pain reduction. The patients also showed more significant functional improvement, especially in grip strength, than those who didn't add nerve gliding. In a review of 13 studies about the effectiveness of neural gliding in treating carpal tunnel syndrome, about half showed similar or better results than conservative techniques, such as ultrasound and wrist splint. However, researchers pointed out that due to limited evidence, standard conservative care seems to be the most appropriate option for pain relief and recovery of function for mild to moderate cases.
Home exercises:
Seated Sciatic Nerve Floss:
1. Sit upright in a chair, with knees hip-width apart, feet flat on the floor, and facing forwards.
2. Extend the right leg, with the foot flexed toward the body.
3. Extend the neck up and back to look up at the ceiling.
4. Lower both the neck and leg down gently so the chin tucks into the chest and the leg goes slightly back past 90 degrees.
5. Extend and lower the neck at the same time as extending and lowering the leg.
6. Switch legs and repeat the exercise 10 times for the left leg.
Do this exercise 2–3 times a day.
Prone Piriformis Syndrome Nerve Floss:
1. Lie flat on the back with both legs extended.
2. Bend the left leg and hold the left knee and foot.
3. Bring the left leg across the right side of the body toward the right shoulder and hold for 5 seconds.
4. Gently lower to the floor and repeat the exercise with the right leg.
5. Repeat 5 times on each side.
Do this exercise 2–3 times a day.
Carpal Tunnel Syndrome Nerve Floss:
1. Sitting upright with arm stretched out to the side, elbow extended with the palm facing up.
2. Bend the wrist as you tilt your head away from your body and hold for 5 seconds.
3. Bend your wrist downward as you tilt your head toward your body and hold for 5 seconds.
4. Repeat 5-10 times.
Do this exercise 2-3 times a day.
Remember to keep breathing throughout the exercises and go slow.
Our take:
Since nerve pain can be intense and traumatizing, it’s a good idea to talk to the Apeiron Life physiotherapist or your personal one about whether nerve flossing is a recommended practice for you. A physiotherapist can also make sure you’re doing the exercises correctly and prescribe other exercises that will support your recovery.
Will this help you:
If you’ve been cleared to practice nerve flossing, it is usually best done alongside other methods such as stretching, massage, and strengthening the muscles along the nerve path. As nerves are closely involved with muscles and fascia, a connective tissue surrounding our muscles and organs, it’s essential to keep them healthy as well.
If you’re still interested, here’s what to keep an eye on:
Nerve flossing is relatively safe and has few risks if done properly. None of the exercises should exacerbate nerve pain. To make sure you don’t further irritate the nerve, start with only a couple of exercises and listen to your body. The general rule of thumb is that symptoms should subside five to ten minutes after the exercises are completed. If you continue feeling pain, you may be doing too many repetitions or going too aggressively. Doing too much too soon can make the inflammation and pain worse.
Nerve flossing is not advised for acute cases as it may cause more unnecessary aggravation to the nerve. Consult with your physician if you continue feeling pain after a few weeks of doing the exercises, as it may suggest other underlying problems or point towards incorrect form or exercises being used.
References and additional reading:
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