Sandy Efflandt avatar
Written by Sandy Efflandt
Updated over a week ago

The diagnosis of neuropathy assumes that there is a dysfunction of peripheral nerves or injury to them, and that is the cause of pain. These diagnoses are almost always made with no actual evidence, they are guesses. Most practitioners in the medical community have no knowledge of muscle trigger points nor that skeletal muscle referral is the most common source of pain in the body. The assumption that pain must be from nerve dysfunction or entrapment is almost always wrong, and hence the diagnosis of neuropathy is almost every time a misdiagnosis. Usually, the pain is muscle trigger point referral.

The quality of pain ascribed to neuropathy is typically described as: burning or shooting, numbness, tingling. It is also often described as "radiating", traveling up or down a limb. If the pain happens to travel along the path of a nerve, it will typically be attributed to a problem with that nerve. Muscle trigger point referral generates these sensations and is the most likely cause, not nerve entrapment or damage.

Nerve entrapment is sometimes possible as a contributing factor, depending on the exact pain complaint. But it is the trigger point muscle fibers that do the entrapping via the taut muscle bands or be excess tension on the tendons due to the trigger point muscle fibers. When the trigger points are resolved, the taut band of fibers does not irritate the nerve and the pain is resolved.

Foot Neuropathy Misdiagnosis

Diagnoses of foot neuropathy or neuromas are common misdiagnoses of muscle trigger point referral. For example, Morton's neuroma is described as pain at the ball of the foot on the plantar side. The assumption is that a nerve is being impinged and causing the pain. The much more likely source is from muscle trigger points in the interosseus muscles that control the toe spacing. These muscles often get stressed and develop trigger points because of foot hyperpronation and the extra stabilizing load these muscles take in that scenario. CTB therapists typically resolve this pain complaint handily, by correcting the hyperpronation and reducing trigger points in the associated muscles with manual therapy.

Sometimes pain along the lateral lower leg, front of lower leg or posterior lower leg and plantar foot are described as neuropathies. Again, the true source is almost always muscle trigger point referral. Lateral lower leg pain is typically from glute minimus referral. Anterior lower leg is typically from glute minimus and/or tibialis anterior. Posterior lower leg pain and plantar foot pain are typically from muscles: tibialis posterior, soleus, gastrocnemius also commonly with glute minimus contributions.

Hand Neuropathy Misdiagnosis

Hand pain is usually ascribed to nerve damage, impingement or dysfunction and this is usually not the case. These misdiagnoses occurr because medical people generally have no knowledge of muscle trigger point referral, which is usually the source of hand pain.

There are muscles in the neck and shoulder (scalenes, infraspinatus) that refer pain along the arm and to the thumb and index finger. There are also shoulder muscles (lat, serratus anterior) that refer pain along the arm and to the pinky finger side of the hand. There are also forearm muscles that refer pain into different places of the hand and intrinsic hand and finger muscles that refer pain in the hand and along the fingers.

Sometimes there is a component of nerve entrapment to the pain complaint in addition to trigger point referral. Scalene muscles in the neck can entrap brachial plexus nerves as well as pec minor. This is called thoracic outlet syndrome. There are also nerve entrapment possibilities in the forearm. Again, it is the taut bands of muscle (trigger points) that compress nerves, and this can be resolved by resolving the taut bands with CTB.

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