This is a summary of chapter XV of “The Sensitive Nervous System” by David Butler. Intro In this chapter we discuss many specific neurodynamic pathologies and implementing the nervous system into treatment approach. Conservative Nervous System Decompression Here is a general step-by-step approach to decreasing threat throughout the nervous system. 1) Decrease tissue sensitivity by removing relevant stimuli and decreasing CNS threshold. 2) Improve container tissue health. 3) Improve the nerve tract’s ability to absorb traction forces. 4) Assess and improve the nerve to container relationship. 5) Assess/modify any adverse ergonomic or environmental factors. Carpal Tunnel Syndrome Tests to perform. ULNT1 & reverse. ULNT2 (median) & reverse. Compression (can add ULNT). Phalens and reverse Phalens. Phalens + ULNT. Treatment There are several options to treat carpal tunnel syndrome. Mobilizing not only the median nerve, but radial and ulnar is beneficial because the nerves are closely connected. Movement is critical because nerve inflammation and swelling does not leave the carpal tunnel easily. This problem is because there are minimal lymphatic channels in the tunnel. Nerve Root Complex Nerve root issues often have corresponding postural adaptations. Cervical – forward head posture. Lumbar – Flat lumbar spine with knees flexed, positioned toward the injured sign. In acute instance, it may be okay to let the patient rest in these antalgic postures until AIGS settle. Other presentations indicative of nerve root complex pathology include numbness/tingling down the extremities. Other possibilities include coldness, shooting, tiredness. Pain rarely goes into the extremities. Double Crush Double crush
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