What actually happens during my first visit?

Your initial consultation starts with detailed history-taking, followed by a thorough physical, neurological and orthopedic examination, your modesty is preserved throughout, and gowns are provided where necessary. If you have prior scans, X-rays, or specialist letters, bring them along; if further imaging is ever warranted, we can refer you locally. By the end of your visit, you'll leave with a clear explanation of what's going on and a considered plan forward. Treatment is usually provided on the initial consultation given the case is deemed within our scope of care.

How many sessions will I need before I notice a difference?

Every case is different, but as a general guide, most patients suffering from nerve pain notice a change in their symptoms within 6-10 visits. Once the nerve has been decompressed and the inflammation around the neural tissue is reduced, the body's own healing processes can start to work much more rapidly, which is often where patients notice the biggest shift. Longer-standing or chronic presentations understandably take more time, why nerve recovery takes time explains the biology behind this., as nerve damage typically can last for several months to, in some cases, years. We'll give you a specific timeframe once your assessment is complete.

How does chiropractic care help with nerve pain?

Nerve pain often stems from compression or irritation somewhere along the nerve's pathway, whether the irritation is to a joint, pressure, from a disc or tightened surrounding muscles. By identifying exactly where that irritation originates and combining manual therapy with functional rehabilitation and neural mobilisation, we aim to relieve pressure on the nerve and support its function returning to normal over time.

How is nerve pain actually diagnosed?

Diagnosis starts with a detailed history, followed by a hands-on neurological and orthopedic examination, testing reflexes, strength, sensation, and how your specific symptoms behave with movement and provocation. This is what actually localises where along the nerve's pathway the irritation is coming from. Imaging such as an MRI or ultrasound can be a useful part of the picture where it's clinically warranted, but it's used alongside the physical examination, not as a replacement for it, a scan on its own doesn't tell us how a nerve is actually functioning.

What kinds of nerve-related conditions do you see?

We see a wide range of nerve-related presentations, including sciatica, disc-related nerve pain, carpal tunnel syndrome, cubital and Guyon's canal syndrome, thoracic outlet syndrome, piriformis syndrome, meralgia paraesthetica, Morton's neuroma, and other peripheral nerve entrapments, alongside general spinal and postural presentations that irritate nerves indirectly. Every case starts with an assessment to confirm what's actually going on before any treatment plan is built.

Is chiropractic care safe for nerve pain?

For most nerve-related musculoskeletal presentations, chiropractic care is generally considered a safe, conservative option. Treatment is adapted to your specific presentation, including low-force techniques where a nerve is highly irritated or sensitised, and we screen for red flags that would need onward referral rather than conservative care. As with any treatment, individual suitability depends on your specific history and presentation, which is exactly what your initial assessment is for.

Are there symptoms that mean I should see a doctor urgently, not book a chiropractic appointment?

Yes. Most nerve pain responds well to conservative care, but a small number of symptoms and history factors warrant prompt medical attention rather than a routine booking, loss of bladder or bowel control, or numbness in the saddle area (the inner thighs, groin, or around the genitals), which can indicate cauda equina syndrome; progressive or rapidly worsening weakness; symptoms affecting both legs at once; fever alongside new or worsening pain; a current or previous history of cancer; a history of inflammatory arthritis alongside neck pain or new neurological symptoms; or unexplained, significant weight loss. If any of these apply to you, please see a GP or present to an emergency department rather than booking with us. We screen for these red flags as part of every initial assessment.

Do I need a referral from my GP to book an appointment?

No, our doors are open to everybody. Chiropractors are primary contact practitioners registered with AHPRA, so you can book directly.

Can you still help if I have osteoporosis, or I'm recovering from surgery?

Yes, in both cases. For osteoporosis or generally fragile bone density, we modify our approach with gentler soft tissue techniques, low-force mobilisation, and decompression therapy. For post-surgical cases, spinal fusion or micro discectomies, for example, we treat more delicately, with your surgeon's timeframe and any complications shaping the pace of your rehabilitation.

Can I claim private health insurance on the day, and what will it cover?

Yes, bring your physical or digital private health insurance card and we can process your rebate on the spot. Coverage varies significantly between insurers and the level of cover you've selected, so it's worth checking your Product Disclosure Statement or calling your fund directly if you want an exact figure before you visit.

Back to Clinical InsightsNerve Entrapment

Saturday Night Palsy and Radial Nerve Compression

Aret AboulianChiropractor

April 13, 2025•6 min read

Falling into a heavy sleep with your arm pinned under your head or draped over a chair can compress a nerve in a very specific spot, and wake you up with a wrist that won't lift.

Where the Name Comes From

'Saturday night palsy' is an old but still-used clinical term for a radial nerve palsy, a dramatic example of radial nerve compression. that develops after the nerve is compressed against the humerus, the upper arm bone, for a prolonged period, usually during unusually deep or heavy sleep. The name comes from its classic association with falling asleep in an awkward position after a big night out, where alcohol's sedating effect meant the person didn't wake or shift position despite sustained pressure on the arm.

The same injury happens well outside that specific scenario, anyone who falls into an unusually deep sleep, whether from exhaustion, medication, or simply an odd position on a couch or armrest, can develop the same nerve compression. It's really a mechanism, not a lifestyle diagnosis.

Where the Nerve Is Actually Compressed

The radial nerve winds around the back of the humerus in a groove partway down the upper arm, the spiral groove, where it sits directly against bone with very little soft tissue cushioning it. In this position, the nerve is particularly vulnerable to sustained external pressure, such as an arm draped over the hard edge of a chair, resting under a partner's head, or hanging off the side of a couch for an extended period.

This is a different compression site to radial tunnel syndrome,, which affects a branch of the radial nerve much further down, near the elbow. The two conditions share a nerve but not a location, and they produce quite different symptom patterns as a result.

How It Presents

The hallmark sign is wrist drop, an inability to extend the wrist and fingers, so the hand hangs limply when the arm is held out. This happens because the radial nerve, at this level, supplies the muscles responsible for extending the wrist and fingers, and compression disrupts that function fairly abruptly rather than building gradually.

Numbness or altered sensation over the back of the hand and forearm often accompanies the weakness, though grip strength itself can be relatively preserved initially, since the muscles that close the hand are supplied by different nerves. People typically notice it immediately on waking, rather than it developing gradually through the day.

What Determines Recovery

Most cases of Saturday night palsy are what's known as a neurapraxia, a temporary conduction block in the nerve caused by compression, without the nerve fibres themselves being cut or structurally damaged. This type of injury generally carries a good outlook for recovery, often over a period of weeks, though the exact timeframe depends on how long and how significant the compression was.

More prolonged or significant compression can cause a greater degree of nerve fibre damage, which may extend the recovery timeline considerably. This is part of why an early assessment matters, distinguishing a straightforward neurapraxia from a more significant injury changes both the expected timeline and the rehabilitation approach.

What Helps While the Nerve Recovers

A wrist splint is often used in the interim to hold the hand in a functional position and help prevent overstretching of the weakened muscles and tendons while nerve function returns. Alongside that, gentle nerve mobilisation and monitoring of muscle and nerve function over time help track whether recovery is progressing as expected.

If wrist drop and numbness haven't shown any improvement after a few weeks, or if the weakness is severe from the outset, further assessment, including nerve conduction studies in some cases, is worth pursuing to rule out a more significant nerve injury and to help guide the right rehabilitation plan going forward.

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