Nerve flossing: what nerve glides are and when they help
Nerve flossing, also called nerve gliding or neural mobilisation, has become popular online as a fix for sciatica and tingling arms. It can be useful, but only for the right problem and done gently.
What is nerve flossing?
Nerves need to slide and stretch a little as you move. When a nerve is irritated, for example by a disc in the back or neck, it can become sensitive to being stretched or compressed. Nerve gliding exercises move the nerve gently through its surrounding tissues, without holding it on stretch, with the aim of reducing that sensitivity.
How is it different from stretching?
A stretch holds tissue at its end range. A nerve glide (or 'slider') moves one end of the nerve while releasing the other, so the nerve slides without much tension building. For example, straightening your knee while looking up, then bending your knee while looking down. A 'tensioner' adds tension at both ends at once and is more provocative; it's used later and more cautiously.
Does nerve flossing work?
For some conditions. A systematic review and meta-analysis found neural mobilisation improved pain and disability in chronic low back pain and improved pain in chronic neck and arm pain. For carpal tunnel syndrome, it wasn't effective for most clinical outcomes. For several other conditions the effect was uncertain, and the authors noted the evidence was limited and of varying quality (Basson et al., JOSPT, 2017).
When might nerve gliding help?
It's most often used for nerve-related leg pain (sciatica) and nerve-related neck and arm pain, once the most irritable phase has started to settle, and as one part of a broader plan with movement, strengthening and activity changes. It can also be part of rehab for hamstring tightness that turns out to be nerve-related.
How do I do a sciatic nerve glide?
Sit on a chair with good posture. Straighten one knee and pull your toes up while looking up towards the ceiling, then bend the knee and point the toes while lowering your chin towards your chest. Move smoothly and slowly, without holding. Start with 10 repetitions once or twice a day. You should feel, at most, a mild pulling or tingling that goes away straight afterwards.
How do I do a nerve glide for the arm?
For the median nerve, hold your arm out to the side at about shoulder height with the elbow bent and palm up. Straighten the elbow and extend the wrist while tilting your head towards that arm, then bend the elbow and tilt your head away. Keep it gentle and smooth. Other nerves in the arm use different positions, which we tailor to your symptoms.
How do I know if I'm overdoing it?
Nerves don't like being pushed. If symptoms increase during the exercise and stay worse afterwards, or tingling, numbness or pain spread further down the limb, you've done too much. Reduce the range and the number of repetitions, or stop and have it assessed. More is not better with nerve exercises.
When should I not do nerve flossing?
Avoid it during a severe, highly irritable flare, where even small movements send strong pain down the limb. Don't do it if you have worsening weakness, significant numbness, or any of the urgent symptoms below. It's also not a treatment for tingling caused by a medical condition such as diabetes.
Does nerve flossing help tight hamstrings?
Sometimes. If your hamstring 'tightness' changes when you move your neck or ankle in the stretch position, the sciatic nerve is contributing, and gentle sliders may help more than long static stretches.
See our post on tight hamstrings and lower back pain.
How long before it helps?
If nerve glides are going to help, people often notice a little more ease of movement within a couple of weeks. They're a supporting exercise rather than a cure; recovery from a nerve irritation mostly depends on the nerve itself settling over time.
Can an osteopath show me the right exercises?
Yes. We test which nerve is involved and how sensitive it is, show you the right version at the right intensity, and combine it with hands-on treatment and strengthening. We'll also check that nerve exercises are appropriate for you in the first place.
How often should I do nerve glides?
Little and often works best. One or two sets of around 10 gentle repetitions, once or twice a day, is plenty. If symptoms are easily stirred up, start with fewer and a smaller range.
When should nerve symptoms be checked urgently?
Go to an emergency department for new difficulty controlling your bladder or bowels, numbness around the groin or inner thighs, or weakness in both legs. See a doctor promptly for weakness that's getting worse in an arm or leg, clumsiness in the hands, or unsteady walking.
See our posts on sciatica exercises and pinched nerves in the neck. Book an assessment at our Berwick clinic. A 60-minute initial consultation is $149, with no referral needed and HICAPS on-site.
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Book an initial consultation at RISE Sports & Spinal in Berwick. Clear diagnosis, hands-on treatment, and a plan that actually gets you better.
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