What is nerve flossing and does it help with nerve pain?
As a fairly diligent stretcher who tries to get at least five minutes of stretching in a day, I’d like to say that I’m fairly in tune with my body, and all its aches and pains. But recently I’ve been experiencing a bit of numbness and stiffness in my glutes that none of my usual stretches could address. Could the numbness indicate a possible issue with my nerves?
It’s possible it could indicate a tight sciatic nerve, said Morgan Sileo, an orthopedic clinical specialist at the Hospital for Special Surgery, the treatment for which could include sciatic nerve flossing.
Nerve flossing – also called nerve gliding, nerve sliding or nerve mobilization – gained traction among doctors and physical therapists in the 1980s and 1990s. It is a common technique taught to physical therapy patients recovering from injury or nerve compression conditions like carpal tunnel syndrome. It can be a helpful tool to improve mobility and reduce painful movements, but experts caution that you shouldn’t jump in to it by yourself before knowing a few critical things.
What is nerve flossing?
Muscles can contract and stretch with movement, but nerves can only stretch a little – they’ll usually slacken or become taut to accommodate different bodily positions, says Andrew Dilley, a professor in neuroanatomy at the Brighton Sussex Medical School at the University of Sussex. Dilley and his team of collaborators did some of the earliest work on visualizing how nerves move in living bodies.
Each nerve attaches somewhere along the spine and extends out into a part of the body. Ideally, a nerve should be able to slide smoothly as it adjusts to our movements. But sometimes, through injury, inflammation or trauma, a nerve can get stuck or tighten. This can lead to pain like sciatica, more inflammation, and nerve compression conditions like carpal or cubital tunnel syndrome.
The goal of nerve flossing is to coax a nerve to slide more easily by gently and repeatedly pulling the nerve towards one of its ends and then to the other, typically by positioning the body in a particular way to isolate the problematic nerve, then moving usually two body parts slowly and smoothly to get the gliding motion. The nerves typically targeted are the median, ulnar and radial nerves in the arms; and the sciatic nerves in the legs.
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When deciding whether nerve flossing is something that might help, a therapist or clinician will first assess whether a nerve is the source of a patient’s pain, says Sileo. Typical symptoms include radiating pain, numbness, or a pins and needles feeling. The location of pain or irritation will indicate which nerve pathway is affected, she says, and the clinician will then prescribe specific exercises targeting that nerve.
How does nerve flossing help?
Nerve flossing is a relatively new type of therapy, and we don’t yet have a definitive explanation for why it can help, says Dilley. One hypothesis is that if a nerve gets physically stuck and causes hindered mobility, nerve flossing can unstick it and reverse those symptoms. However, Dilley and his team have found no evidence of this in the patients they looked at through ultrasound studies. A second theory is that nerve pain can come from disruptions in blood flow and circulation around neurons – so nerve flossing helps by improving that circulation. There’s some research supporting this theory, but it has not been proved, says Dilley. The last idea is that moving nerves might help to decrease inflammation, but this is simply a theory right now, and current evidence is scant.
Studies on nerve flossing tend to be small and limited. But research does suggest that it is effective at tackling nerve pain in places like the neck, arms and legs, and can help treat conditions like carpal tunnel syndrome.
Who should use nerve flossing?
Signs you could benefit from nerve flossing include shooting or radiating pain with certain movements, says Dilley. Stephanie Kannas, an occupational therapist at Mayo Clinic in Rochester, Minnesota, says that “if people are experiencing numbness or tingling, that’s also a good sign to talk to their health professionals and get guidance to know if nerve gliding would be beneficial”.
All experts consulted for this piece emphasized that if you have nerve pain, you should consult a doctor before trying out any nerve flossing exercises by yourself. “If you’re too aggressive, you can actually make the nerve worse,” says Kannas, exacerbating your existing symptoms. A clinician or physical therapist will be able to give you the right exercises for the right nerve, ensure you’re using the proper technique and identify if you’re overdoing it.
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It’s important to use proper flossing motions, with your nerve being pulled toward one end and then to the other. Pulling and stretching your nerve from both ends is called “tensioning”, and might cause harm, says Dilley. “Stretching nerves, particularly injured nerves, can cause even more pain and inflammation,” he says.
If you’re experiencing a lot of tension or pain with your nerves, see a professional before attempting nerve flossing. “Nerves are very sensitive,” says Sileo, and “they take a long time to heal too.” If you’re healthy, with no nerve pain, Sileo says gentle nerve flossing exercises are fine to do to maintain mobility. But she emphasizes that these exercises are not like other stretches. “It’s not like where you try to touch your toes and hold it for a long period of time,” she says. That is, you’re not supposed to push yourself. Our nerves glide as we move and exercise in daily life, says Dilley. “It’s important for people to keep moving.”
