When the Muscle Isn’t the Problem: Understanding Nerve-Driven Pain

Ever get that nagging pain, weakness, or tightness that just feels like a stubborn muscle issue?

You think the issue is in the muscle, when really, the muscle problem started elsewhere. 

The go-to rehab protocol usually looks like this:
 

1. Improve mobility/ Range of motion

2. Strengthen the area

3. Go back to lifting like normal...

That’s a place to start… but it doesn’t always solve the problem. Why? Because it often overlooks one of the most important players in pain:

THE NERVE!

Not necessarily a specific nerve, but the network of nerves that powers your muscles and processes sensation throughout the body.

You might think: “But I don’t have numbness or tingling, so it can’t be a nerve issue, right?”

You don’t need classic nerve symptoms to have a nerve-driven problem. Sometimes, the muscle is just “mad” because the NERVE is mad. 

What happens is that the nerve irritation and inflammatory response causes muscle guarding, tension, and more inflammation surrounding the muscle group. This will lead to pain when we move our joints a certain way (aka, using the muscles or even putting a stretch on them). Additionally, when we try to mobilize and strengthen, we may feel 50% better but the pain lingers.

Okay, but what’s even the ORIGIN of this irritation? How do we know the “nerve is mad?” Well, often the problem is not actually  where the pain shows up, but where the nerve originates… the spine!

Yes, nerves can get compressed anywhere along their path (entrapment syndromes), but for this article, we’re focusing on a central source, which relates to compression or irritation right at the nerve root in the spine.

So if you’re dealing with pain, weakness, tightness, or a muscle group that just won’t calm down…

It might be time to focus on the nerve.

What’s going on?

Mechanical compression of the nerve root at the spine can happen for a lot of reasons. Everyone immediately blames a disc. Yes, discs can be involved, but they’re not the only issue. In fact, plenty of people with disc bulges have zero symptoms.

What’s often overlooked is joint stiffness in the spine, especially at the facet joints. When these areas can’t move well, they can irritate nearby nerve roots, especially under load or repeated movement.

So what does this actually mean for your rehab?

First, understand this: Nerves love two things: SPACE & LOAD (movement/muscle activation), in that order!

When we restore mobility to the SPINE, and reduce compression, we give that nerve more room to breathe… and therefore, it’ll FUNCTION better. 

Here’s what that improves:

✔️ Reduced inflammation around the nerve root
✔️ Better nerve mobility (it can glide freely without getting stuck. It moves better when WE move our bodies!)
✔️ Improved muscle activation (better nerve-to-muscle communication)

And most importantly…

✔️ A calmer nervous system. The reduction in nerve compression actually creates a Parasympathetic response. This means the body actually switches to a calmer state (reduced heart rate, respiratory rate, blood pressure), and this also which means less guarding, less pain sensitivity, and less tension overall. 

How can we make it happen?

The best place to start is with exercises that improve spinal mobility, particularly in the regions where the nerve roots exit. For the neck, one of my go-to movements is a cervical retraction with gentle traction. This helps create space between the facet joints, allows the nerve to move more freely, and can provide many of the benefits discussed above.

For the lumbar spine, extension-based exercises like prone press-ups are often effective in creating that same decompressive effect. However, some individuals respond better to flexion-based movements. Because of this variability, it’s best to work with a rehab professional to determine which direction is right for your spine.

Once spinal mobility improves, activation and strengthening exercises become much more effective. Nerves love load!! This increases blood flow, reduces inflammation, and promotes healing in the affected area.

Overall, 

Remember that your tight, painful muscle might have nerve involvement to some degree, whether it’s obvious or not. In fact, addressing the nerve component of your mobility and pain management may be the game changer for your rehab! If you’re dealing with ongoing, nagging pain symptoms that haven’t resolved yet, reach out to me directly and let’s talk about how to get this moving in the right direction!

Ready to learn more? Have specific pain problems that are limiting your performance goals? Czarbell is here to help. Reach out at [email protected], or schedule an appointment with me through the main page of this website, to learn more!