Nerve pain feels different from muscle or joint pain. It can burn, tingle, shoot, or travel along a specific pathway. Many people describe it as electric, sharp, or deeply irritating. Because nerve pain behaves differently, it often raises concern about whether it will settle and what type of treatment is appropriate.
Physiotherapy plays an important role in managing nerve pain when it is applied correctly and based on a thorough assessment. We explained what nerve pain is, how physiotherapy helps, what to avoid, and when further medical review may be required.
What Is Nerve Pain?
Nerve pain, also known as neuropathic pain, occurs when a nerve becomes irritated, compressed, sensitised, or damaged. Unlike muscle pain, nerve pain often follows a specific nerve pathway and may change with posture, movement, or sustained positions.
Common sensations include:
- Burning or hot pain
- Pins and needles
- Tingling
- Sharp or shooting pain
- Numbness
- Pain that travels into an arm, leg, hand, or foot
Nerve pain does not always mean permanent nerve damage. In many cases, it reflects increased nerve sensitivity or mechanical irritation rather than structural injury.
Signs Your Pain May Be Nerve-Related
Certain features suggest nerve involvement rather than muscle or joint pain.
These include:
- Pain that radiates down an arm or leg.
- Tingling or pins and needles.
- Numbness or altered sensation.
- Weakness in a specific muscle group.
- Symptoms that follow a clear line or pathway.
- Pain that changes with posture, sitting, or movement.
A detailed assessment is required to confirm whether nerve structures are the main driver of symptoms.
Common Causes of Nerve Pain Seen in Physiotherapy
Physiotherapists commonly assess and manage nerve pain related to musculoskeletal and movement-based conditions.
Sciatica and Radicular Pain
Sciatica occurs when nerves in the lower back become irritated, often causing pain that travels into the buttock, leg, or foot. Similar nerve root irritation can occur in the neck, leading to arm and hand symptoms.
Nerve Entrapment
Conditions such as carpal tunnel syndrome or cubital tunnel syndrome occur when nerves are compressed as they pass through tight anatomical spaces.
Peripheral Neuropathy
Peripheral neuropathy involves altered nerve function, commonly affecting the hands or feet. It may be associated with medical conditions such as diabetes or prolonged nerve irritation.
Post-Surgical or Post-Injury Nerve Sensitivity
After surgery or injury, nerves can remain sensitive even when surrounding tissues have healed.
Persistent or Complex Pain Presentations
Some people develop ongoing nerve sensitivity without clear structural damage. These cases require careful, graded rehabilitation rather than aggressive treatment.
How Physiotherapists Assess Nerve Pain
Physiotherapy assessment focuses on understanding how nerves are behaving rather than relying solely on imaging.
Assessment commonly includes:
- Detailed symptom history and pain behaviour
- Postural and movement assessment
- Strength testing
- Sensory testing
- Reflex screening when appropriate
- Nerve movement and sensitivity testing
This approach helps differentiate between nerve compression, nerve sensitivity, referred pain, or other contributors.
How Physiotherapy Helps Nerve Pain
Physiotherapy does not directly “repair” nerves. Instead, it reduces irritation, improves nerve movement, and restores normal function. Here is how Phyisotherpay helps for pain relief:
Movement and Strengthening
Gentle, graded movement is one of the most effective tools for managing nerve pain. Strengthening and movement control reduce mechanical stress on nerves and support recovery. Prolonged rest often worsens symptoms.
Nerve Gliding and Neurodynamic Treatment
Nerve gliding exercises help nerves move smoothly within surrounding tissues. These exercises are not stretches and should never provoke sharp or worsening pain.
When applied correctly:
- Movements stay within symptom limits
- Symptoms settle quickly after exercise
- The focus is mobility, not tension
Incorrect or aggressive nerve exercises can increase irritation.
Pain Education and Nervous System Regulation
Understanding how nerve pain works reduces fear and over-protection. Education helps explain why pain can persist even when scans appear normal and supports confidence with movement.
Desensitisation and Sensory Retraining
For people with heightened sensitivity, graded exposure to touch and movement helps calm the nervous system. This is commonly used after injury or surgery.
Advanced Strategies for Complex Cases
In selected cases, approaches such as graded motor imagery or mirror therapy may be used to address altered pain processing.
Do You Need an MRI for Nerve Pain?
In many cases, an MRI is not required as a first step.
Imaging findings often do not correlate directly with symptoms, and many people without pain show changes on scans. A physiotherapist can refer to MRI, and the assessment typically occurs before imaging.
MRI may be considered when:
- Symptoms worsen despite appropriate care
- Progressive weakness is present
- Red flags are identified
- Surgical decision-making is required
What to Avoid When Managing Nerve Pain
Certain approaches commonly make nerve pain worse.
Avoid:
- Aggressive stretching aimed at “pulling” the nerve
- Long-hold nerve tensioning
- Pushing through sharp or worsening symptoms
- Complete inactivity for long periods
- Random online nerve exercises without assessment
Nerve pain responds best to controlled, graded exposure.
When to See a Physiotherapist for Nerve Pain in Sydney’s Eastern Suburbs
People seeking physiotherapy in Eastern Suburbs Sydney, commonly present with nerve-related symptoms linked to modern lifestyles and activity patterns.
These include:
- Prolonged desk-based work and sitting.
- High training loads from running, gym, or sports.
- Repetitive upper limb use from laptops and mobile devices.
- Postural stress from commuting.
Physiotherapy assessment helps identify whether symptoms are nerve-related and whether conservative care is appropriate.
Red Flags: When Urgent Medical Review Is Needed
Some nerve symptoms require immediate medical attention.
Seek urgent care if you experience:
- Rapidly worsening weakness
- Loss of bladder or bowel control
- Numbness around the groin or saddle area
- Severe, unexplained pain at rest or night
- Symptoms combined with trauma, fever, or unexplained weight loss
These signs are uncommon but important.
Frequently Asked Questions
Can physiotherapy help nerve pain?
Yes. Physiotherapy helps many forms of nerve pain by improving movement, reducing irritation, and restoring function.
How long does nerve pain take to settle?
Nerves recover slowly. Improvement may take weeks or months, depending on the cause and consistency of care.
Are nerve glides safe?
Yes, when guided and progressed correctly. Poor technique can increase symptoms.
Should I rest or keep moving?
Relative movement is usually better than complete rest, which often increases sensitivity.
Do I need imaging before seeing a physiotherapist?
In most cases, no. Physiotherapy assessment is often the first step.
Summary
Physiotherapy for nerve pain focuses on restoring movement, reducing sensitivity, and improving function rather than relying on scans or aggressive treatments. With proper assessment and evidence-based care, many nerve pain conditions improve without invasive intervention.
