What is Nerve Flossing? Plus 3 Techniques Every Chiropractor Should Know

Nerve flossing has revolutionized chiropractic care, offering effective, targeted relief for conditions like sciatica, cervical radiculopathy, shoulder pain, and carpal tunnel syndrome. Recent studies highlight the impressive impact of nerve mobilization on patient outcomes, making these techniques essential tools for chiropractors looking to improve treatment results.

If you’re not incorporating nerve flossing into your practice, you’re overlooking a powerful method that can set your treatments apart. Read on to learn about the top three nerve flossing techniques every chiropractor should master.

What is Nerve Flossing?

Nerve flossing, also known as neural mobilization, involves controlled movements designed to enhance the glide and movement of nerves through surrounding tissues. When nerves become irritated, swollen, or restricted by adhesions, they can lose functionality, leading to pain, tingling, and numbness. Studies show that nerve flossing can help reduce these symptoms by improving nerve mobility and minimizing adhesions and swelling.

Neurodynamics 101: The Importance of Healthy Nerve Movement

Chiropractors understand how essential healthy nerve function is for musculoskeletal health. Nerve flossing supports symptom reduction for a wide array of conditions, including lower back pain, neck pain, sciatica, carpal tunnel syndrome, and shoulder impingement. Let’s dive into the top three nerve flossing techniques to ensure your chiropractic care provides optimal results.

1. Sciatic Nerve Flossing: The Go-To for Low Back Pain and Sciatica

Sciatic nerve flossing is highly effective for addressing low back pain and sciatica, two of the most common complaints among chiropractic patients. This technique helps alleviate nerve irritation and restore normal function, allowing patients to experience increased range of motion and reduced discomfort.

How Sciatic Nerve Flossing Works

Sciatic nerve flossing involves tensioning the nerve at one end (hip flexion) while releasing tension at the other (neck extension), promoting a smooth glide of the sciatic nerve through surrounding tissues.

Technique:

• Position the patient in a supine position with their affected leg extended.
• Flex the patient’s hip while they hold their neck in extension until symptoms are felt in the leg.
• Instruct the patient to flex their neck while you lower the leg.
• Repeat this gentle “flossing” motion about ten times.

Note: The exercise should never increase or worsen radicular symptoms. Patients should feel relief, not additional discomfort, during the flossing motion.

2. Median Nerve Flossing: Essential for Cervical Radiculopathy and Carpal Tunnel

The median nerve is frequently implicated in cervical radiculopathy, rotator cuff syndrome, and carpal tunnel syndrome. Nerve flossing techniques for the median nerve can restore nerve function and reduce pain, tingling, or numbness in the upper extremities.

Why Median Nerve Flossing is Effective

Median nerve flossing has shown remarkable benefits for conditions like neck pain, shoulder impingement, and carpal tunnel syndrome. One study found that adding nerve mobilization to a cervical radiculopathy treatment plan led to significant improvements in patients’ quality of life, while another trial showed that nerve mobilization offered relief similar to surgical intervention for carpal tunnel syndrome.

Technique:

• Position the patient in a supine position with their shoulder elevated and elbow flexed.
• Instruct the patient to slowly depress the shoulder and externally rotate the arm with the fingers and wrist extended.
• The patient then abducts the arm to provide gentle tension.
• Repeat this pattern ten times, ensuring the patient feels relief and no increase in discomfort.

3. Radial Nerve Flossing: A Must for Lateral Elbow Pain and Radial Tunnel Syndrome

Radial nerve flossing is an invaluable technique for treating lateral elbow pain, radial tunnel syndrome, and some cases of cervical radiculopathy. Studies show a strong link between lateral epicondylitis (tennis elbow) and altered neurodynamics, with over 60% of cases showing associated sensory disturbance in the superficial radial nerve.

How Radial Nerve Flossing Helps

Radial nerve flossing is particularly beneficial for patients dealing with tennis elbow, as it helps address the underlying nerve dysfunction contributing to pain. By promoting better movement of the radial nerve, this technique can reduce pain and improve mobility in the arm and hand.

Technique:

• Position the patient supine with their shoulder elevated and elbow flexed to 90 degrees.
• Ask the patient to depress the shoulder and slowly extend the elbow.
• Passively rotate the arm internally with fingers and wrist in flexion, then add gentle abduction.
• Repeat ten times, ensuring that the patient experiences relief rather than exacerbated pain.

Why Chiropractors Should Recommend Home Nerve Flossing Exercises

While nerve flossing techniques are highly effective in-office, encouraging patients to perform these exercises at home can accelerate their recovery. Patients who actively participate in their care tend to experience faster improvements, but they require guidance to perform these techniques correctly.

Providing instructional materials or offering home exercise recommendations can empower your patients to take charge of their recovery and promote long-lasting results. Digital resources, instructional videos, or printed instructions can make it easy to provide personalized exercises, maximizing the effectiveness of nerve flossing.

Bottom Line: Incorporate Nerve Flossing to Improve Patient Outcomes

Nerve flossing techniques like sciatic nerve flossing for sciatica, median nerve flossing for carpal tunnel, and radial nerve flossing for elbow pain offer simple, effective ways to improve patient outcomes. By reducing nerve adhesions and promoting better mobility, nerve flossing can relieve pain and support optimal function, making it an essential tool in every chiropractor’s skillset.

Incorporating these techniques into your practice can make a profound difference in your patients’ comfort, mobility, and quality of life—while setting your practice apart as a provider of comprehensive, evidence-based care.