The nervous system is a complex arrangement of the nerve cells and tissues. It regulates the body responses to external and internal stimuli. The peripheral nervous system is responsible for the transfer of information between the motor and sensory neurons and their effectors in both directions. Injuries to the peripheral nervous system often result in significant deterioration of the regular activities. Many of the peripheral nerve injuries in the upper extremity are often a result of traction injury to the brachial plexus. Such injuries are commonly associated with altered shoulder postures and functional imbalance in the arm, forearm and hand due to pain in the related nerves and muscles. Brachial plexus neuropathy is one of the commonly noted upper extremity pain syndromes. The involvement of the peripheral neuropathies and cervical spine pathologies can complicate the diagnosis of brachial plexus neuropathy. Most of the nerve injuries are believed to arise due to influence of the physical factors that alter the mechanical abilities of the nerve fibers. Nerve mobilization has been projected as an efficient therapy to treat the pathologies of the nervous system. It is essential to know about the basics of the nervous system, the neuropathology, the transmission of pain and movement dysfunction before initiating nerve mobilization procedure. The movements of the nerves or nerve fibers can result in changes in the internal nerve physiology by altering the neural tension. Neural mobilization aims at relieving such changes in the nerve physiology to relieve the symptoms of pain and restriction of mobility. It is also vital to have a clear idea about the principles, guidelines, precautions and contraindications of nerve mobilization for better utilization of this procedure.
About the Author: Caroline Joy Co, PT, DPT, CHT, CSFA, is a licensed physical therapist and certified hand therapist whose clinical experience includes acute, subacute, home health and outpatient settings. Her background includes Community Based Rehabilitation designed to assist people with disabilities access rehabilitation in their communities using predominantly local resources. She is the President and CEO of PTSponsor.com, an online resource for U.S. hospitals and clinics that seek to sponsor and hire foreign-trained physical therapists. She specializes in hand therapy through an integrated approach that includes education, counsel and exercise. She is also certified in functional assessment for work hardening and work conditioning. Her background includes current employment with Better Healthcare Inc, Mercy Medical Center and Silvercrest Center for Nursing and Rehabilitation. Her past affiliations include Long Beach Medical Center, Horizon Health and Subacute Center, and Grandell Rehabilitation and Nursing Center. She is a professional speaker for Summit Professional Education, Cross Country Education and Dogwood Institute for hand rehabilitation; myofascial release and nerve mobilization; coding, billing, documentation and ethics. She received her transitional doctorate from A.T. Still University and her BS in physical therapy from University of the Philippines- College of Allied Medical Professions. She is licensed in California, Nevada and New York and is a member of the American Physical Therapy Association.