Physio Edge podcast with David Pope23 Loka 2020

107. Treatment of peripheral nerve sensitisation with Dr Toby Hall

When your patient has neck and arm pain, or low back and leg pain from neural tissue pain disorders (NTPD) such as peripheral nerve sensitisation (PNS), how will you treat them? Pain associated with PNS can occasionally be mild and non-irritable, but more often than not, it's severe, highly irritable, and easy to stir up.

How can you provide treatment that settles their pain, without stirring them up? What advice, education, manual therapy and exercise will you provide to help improve symptoms and speed up recovery? What are the keys to success with PNS patients?

In Physio Edge podcast 104, Dr Toby Hall and I discussed PNS, common symptoms, causes, questions to ask, and how to assess and diagnose PNS in your patients. In this followup podcast, the second in our two-part series, Dr Toby Hall and I take you through the next phase - how to treat PNS. You'll discover:

The 7 keys to success with PNS
How to successfully treat PNS in the neck and upper limb, AND the low back and lower limb.
What education and advice should you provide to your patient about activities to avoid or reduce, and which activities should they increase?
What are the most effective exercises for patients with PNS?
Should exercise be painful or painless?
When is neural mobilisation an effective treatment?
When should you avoid using neural mobilisation as a treatment?
Is manual therapy effective in PNS?
Which manual therapy techniques can you use to improve symptoms and range of movement (ROM) immediately?
How to perform effective manual therapy techniques that reduce pain without stirring up your patients.
How can you combine neural mobilisation with manual therapy?
If you use manual therapy to improve symptoms, what home exercises should patients perform after each treatment session?

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