This is a common question that I get, related to the common and excessive “nerve fear” in our society. Here’s an example:
One thing that helps sometimes when my neck pain gets excruciating is to really dig my fingers hard into a couple of knots in the back of the neck (not right on the spine but off to each side, below the occipitals), or to use a Thera Cane to do the same thing. Is there any chance of causing nerve damage from so much pressure?
reader Peter Spaeth, Boston
Fortunately, if you are even a teensy bit cautious, it is nearly impossible to damage your nerves with self-massage, because of these reasons:
In my years of clinical experience, I have never known of anyone injuring a nerve by massaging except … er, well, I did it to a patient once. Only once. Yikes. See below for the story.
It’s particularly unlikely that you could harm yourself by massaging in the location Peter asked about, on the back of the neck. Nerves and nerve roots are well protected from your pressure there, as they are everywhere behind and beside the spine, by the rather thick and meaty paraspinal muscles. The only nerves on the back of the neck that you might conceivably injure are the nerve roots, the bundles of nerve tissue that emerge from between each pair of vertebrae. But these too are under at least a half inch of that sturdy musculature.
There are places in the body where nerves are more exposed and can be injured by particularly strong pressures. (All of these sites are well known to massage therapists: we call them “endangerment” sites, but in reality the danger is minimal. Perhaps a better thing to call them would be “quite unpleasant places to rub.”) If you massage these locations (or any nerve anywhere) with reasonable caution, you will feel electrical or zappy pains before there is any risk of actually damaging the nerve. Healthy nerves aren’t particularly sensitive, but they will speak up if they are on the verge of being crushed or torn, like any tissue.
Interestingly, the front of the neck is not one of these official “endangerment sites,” even though there is a huge web of nerve tissue emerging from the spine called the cervical plexus. Some of it is superficial and relatively exposed. And yet you can massage the scalene muscle group without ever bothering a nerve fibre.
Most nerves, most of the time, can be firmly compressed without producing any symptoms whatsoever. However, there undoubtedly are some circumstances where nerves can be more sensitive. As discussed in the sections above, only oxygen-starved nerves are particularly sensitive. But this may be exactly what’s going on with some of the nerve tissue in your neck — muscles rotten with trigger points are measurably hypoxic (low-oxygen).
And so, very occasionally, nerve roots in the posterior of the neck are sensitive enough that you may get a little nervy, electrical sensation when self-massaging in the neck. However, this sensation tells you little that you didn’t already know: your soft tissues are cranky. And so, as long as the quantity and intensity of the sensation stay modest, there is no cause for concern.
If you increase massage pressure in spite of warning symptoms — which is hard to do, kind of like sticking your hand into a jar of scorpions — any injury you would do would most likely be minor. Nerves can recover from an enormous amount of abuse, up to and including being mangled in nasty accidents, or being pinched hard for years. For instance, many people who have severe carpal tunnel syndrome — years of crippling median nerve impingement — recover just fine once pressure on the nerve is finally relieved by surgery.Deliberately increasing pressure on a sensitive nerve is hard to do, kind of like sticking your hand into a jar of scorpions.
In the unlikely event that you cause yourself a nerve injury, it would probably only result in annoying but trivial symptoms that would take a few days to resolve, or perhaps a few weeks at the worst. But I have literally never heard of this happening by self-massage — it takes a lot of pressure, and it hurts too much as you approach the point injury to actually get there.
I’m sure that there are people, somewhere out there, who have hurt their nerves with self-massage. And I bet most of them were using a massage tool. When you use massage tools, it may be easier to apply too much pressure too quickly… before you have that “I’ve made a huge mistake” moment. It’s harder to control tools, and hard to tell what’s going on when you’re sensitive fingers and thumbs aren’t involved. (Example: You can easily feel the pulse of an artery when you are massaging with your fingers, for instance, but you can’t feel it at all when you use a tool.)
So if you use a tool, use it with extra caution.
Once upon a time I pushed my luck, and injured a patient’s cervical plexus — this area where most people will probably never self-massage strongly. I injured him by applying strong pressures in a vulnerable area too quickly. It was one of my more reckless moments in a decade of mostly quite gentle massage.
He was alarmed and unhappy with me, of course, but his symptoms were minor: he had annoying flashes of moderate pain that slowly faded over about three weeks, and probably the worst thing about it was simply that he was less sure of his prognosis than I was. I knew he’d get better steadily, but he didn’t know if he could trust my opinion! Fair enough.
I am a science writer, former massage therapist, and I was the assistant editor at ScienceBasedMedicine.org for several years. I have had my share of injuries and pain challenges as a runner and ultimate player. My wife and I live in downtown Vancouver, Canada. See my full bio and qualifications, or my blog, Writerly. You might run into me on Facebook or Twitter.