SEGMENTAL NEUROPATHIC DYSFUNCTION
What does neuropathy mean?
A neuropathy refers to an issue with the nerve root. We have nerve roots that branch off our spinal cord at each level of vertebrae, one to each side. These nerve roots are responsible for our motor function (strength), sensory function (physical sensation) and autonomic nervous system function to our tissues (sweat glands, goosebumps, temperature, and nutrition to our tissues, hair, nails, and skin). Many peripheral issues in the body can be tracked back to a Segmental Neuropathic Dysfunction.
There can be a local “mechanical” insult to these nerve roots that might compress, traction or angulate the nerve at is origin or somewhere along it’s pathway down our limbs. This can be a spinal dysfunction – arthritis, spondylosis, degenerative disc disease or the beginning of changes in the disc or joint space that can instigate changes to our nerve roots. These early changes may not show up on diagnostics such as Xrays and MRIs. We often notice these changes initially in our periphery – the hip, shoulder, or elbow for example. A spinal dysfunction can alter the nerve root integrity and may cause motor (muscle) changes such as tight muscles that can alter joint mobility and alignment. It may cause sensory changes to the tissues that nerve innervates, such as pain, tenderness or altered proprioception (body awareness). It may also cause autonomic changes to our tissues, such as hair loss in a certain area, goosebumps, poor nail condition, changes in skin temperature or sweat gland responses.
These changes in the spine where the nerve root originates, often manifest as peripheral conditions such as tendinopathies, bursitis, sciatica and fascial pain (ie. plantar fasciitis). It is called a segmental pattern or dysfunction because it refers to the pathway that nerve takes along the body and the certain tissues that nerve innervates and supplies nutrition to. At each level – segment – of our spine, there is a nerve root that travels down our periphery to our fingers and toes, one on each side of the body. For example, a Rotator Cuff Syndrome at the shoulder, may be considered a ‘C5 segment’ problem. In our neck, there are 7 cervical vertebrae and 8 nerve roots that exist at each segment. The nerve root at the 5th cervical vertebrae supplies nutrition and sensation to many of the shoulder muscles. The motor changes cause tight muscles and poor movement patterns, the sensory changes cause local pain and poor joint awareness and the autonomic changes may affect skin, temperature, or hair loss.
Another example could be Plantar Fasciitis. This may be considered an ‘L5/S1 segment’ problem. This level of nerve root originates in our lower back between the 5th lumbar vertebrae and the sacrum (tailbone) S1. The motor changes may be tight calf and foot muscles, tight fascial tissue, poor joint alignment and heel spurs. The sensory issues are heel pain, tender foot muscles, poor balance (proprioception). The autonomic changes may be poor nail health and dry, cracked skin.
The source of nutrition to our tissues originate in the spine – our arteries and nerves that exit from each segment of our spinal column. There can certainly be local problems and injuries caused by trauma or repetitive stress movement patterns. However, many of the injuries and chronic pain we suffer from slowly generate over time. Unless we address both the local symptoms and the source of where our nutrition is coming from, we are missing half the picture! I like to use the analogy of a garden bed of flowers, watered by a hose attached to the house. If we see a flower has dried up, and we simply dig it out and replace that flower – it will likely dry up as well. We need to address the kink in the hose that is blocking the water supply to that flower.
If you have a nagging pain that needs attention and have had too much fun this summer to make an appointment, please call the clinic and see one of our therapists. We would love to help you get moving to the best of your potential. We hope everyone had a wonderful summer, stayed cool during the heat waves, and made some great memories.
Jennifer Gordon
(BScPT, GunnIMS, Medical Acupuncture)
Physiotherapist – Bragg Creek Physiotherapy
www.braggcreekphysio.com
