The two types of nerve impingement syndromes are
- Compression: les tissus durs (par exemple, les os) exercent une pression inappropriée sur les nerfs.
- Nerve entrapment: soft tissues (e.g. muscles, ligaments) exert inappropriate pressure on the nerves
As a general rule, osteopathic treatment is more effective for a nerve that is trapped than one that is compressed.
Entrapment; compression occurs when, regardless of what is impinging (pressing) on the nerve, the symptoms are similar; however, the therapeutic intervention varies.
Cervical plexus
- If the cervical plexus is affected, the person will experience headaches, neck pain and breathing difficulties.
- The muscles most responsible for pressure on the cervical plexus are the
- suboccipital
- sternocleidomastoid muscles. The shortened connective tissue at the base of the skull will also exert pressure on these nerves. The cervical plexus is formed by the ventral branches of the four upper cervical nerves. The phrenic nerve is part of this plexus. It innervates the diaphragm and any disturbance of this nerve affects breathing. Many cutaneous (skin) branches of the cervical plexus transmit sensory impulses from the skin, neck, ear and shoulder. The motor branches innervate the muscles of the anterior neck
Brachial plexus
The brachial plexus, located partly in the neck and partly in the armpit, supplies almost all the nerves that innervate the upper limbs. Any imbalance that causes pressure on this nerve complex results in pain in the shoulder, chest, arm, wrist and hand. The muscles most often responsible for brachial plexus impingement are the scalene, pectoralis minor and subclavian. The muscles of the arm sometimes impinge on the branches of the brachial plexus. Brachial plexus nerve impingement is responsible for the symptoms of thoracic outlet, which are often misdiagnosed as carpal tunnel syndrome. Whiplash involves the brachial plexus.
Lumbar plexus
Impingement of the lumbar plexus nerve can lead to lumbar discomfort with a distribution of pain in the belt, as well as pain in the lower abdomen, genitals, thigh and lower medial leg. The main muscles that impinge on the lumbar plexus are the quadratus lumborum and the psoas. Shortening of the lumbar dorsal fascia exaggerates a lordosis and causes spinal impingement of the lumbar plexus.
Sacral plexus
Has about a dozen branches, half of which serve the buttocks and lower limbs; the others innervate the pelvic structures. The main branch is the sciatic nerve. The impact of this nerve by the piriformis muscle gives rise to sciatica. The ligaments that stabilise the sacroiliac joint can affect the sacral plexus. Pressure on the sacral plexus can cause buttock pain, leg pain, genital pain and foot pain. Massage methods can soften and stretch connective tissues that may impinge on the nerves, as well as normalise muscle tension patterns, restoring a more normal resting time for shortened muscles, thus reducing pressure on the nerves.
