There are many side effects of treatment based on physical therapy, chiropractics, massage therapy, sports medicine, and etc. Some are good and some are very very very bad. Either way, this is information that you should know when you are participating in a home program or are actively being treating by a health care practitioner.

1. You may experience increased symptoms due to something called the release phenomenon. This is okay.

The release phenomenon was first described in the 1970’s by James Cyriax, MD, a physician who is considered to be the father of orthopaedic medicine. It is described as a reaction of the nervous system when improved circulation occurs following increased tension or nerve compression.

We all have experienced this. Think about a time when you sat in a chair or on the floor for a prolonged period of time. When you stood up, your foot was asleep. Sometimes you can feel that tingling sensation from the foot all the way up the leg or that your foot and leg can barely move. That is an example of the release phenomenon.

What happens is that there is increased pressure over the body part that you sit on.  This compresses the nerves, typically the sciatic nerve and its branches. Then when we stand up,  there is a release of pressure and a rush of blood flow to the nerves which can stimulate it, thus “waking it up”. So the term “my foot is asleep” should be changed to “my foot is waking up”.

This is a common phenomenon during treatment. For those who are not my patients, please inform your clinician if your symptoms increase while or after you receive any type of treatment. Your symptoms should slowly start to decrease as your clinician stops what they are doing to let your nerves calm down.

A common sign that your nerves  are under a degree of constant compression involves increased symptoms when you lie down. Many people with carpal tunnel syndrome experience increased symptoms when they lie down to go to bed. The median nerve can be compressed through the carpal tunnel or through the axillary region (underarm) throughout the day and this tension decreases as you lie down.

Carpal tunnel syndrome is quite common and most people have heard of it. But, most are not aware that our nerves tunnel through our entire body as it comes out from the spinal cord to the body all the way to the finger tips and toes.  So symptoms that we feel can be due to nerve compression anywhere along its path.

The section on the sensitive nervous system will review treatment options that you learned during your physical therapy.

2. You may experience increased pain because you or your health care provider over did it and triggered pain or increased protective mechanisms. This is good and bad.

When you perform an exercise or activity that increases pain, you have learned what is too much for your body. Next time do less and slowly increase tolerance. Please do not force into pain. Anytime we do more than what our body is used to, we can experience soreness and pain.

Take this as a learning experience and try promote positive movement and stimulation into your nervous system without increasing pain.

References:

Photo: http://www.freedigitalphotos.net/images/Human_body_g281-Neuron_p66077.html

Hooper TL, Denton J, McGalliard MK, Brismée JM, Sizer PS Jr. Thoracic outlet syndrome: a controversial clinical condition. Part 1: anatomy, and clinical examination/diagnosis. J Man Manip Ther. 2010 Jun;18(2):74-83. doi: 10.1179/106698110X12640740712734. PubMed PMID: 21655389; PubMed Central PMCID: PMC3101069. Free full text

Hooper TL, Denton J, McGalliard MK, Brismée JM, Sizer PS Jr. Thoracic outlet syndrome: a controversial clinical condition. Part 2: non-surgical and surgical management. J Man Manip Ther. 2010 Sep;18(3):132-8. doi: 10.1179/106698110X12640740712338. PubMed PMID: 21886423; PubMed Central PMCID: PMC3109687. Free full text

Ombregt L.  Nerve lesions and entrapment neuropathies of the upper limb in: A System of Orthopaedic Medicine (3rd Edition) Edinburgh:Churchill Livingston Press.  2013.