Neuroinflammation and its role in precision physiotherapy for patients with entrapment neuropathies

Entrapment neuropathies are the most common conditions causing nerve-related pain. Even though Physiotherapy is the recommended treatment, research suggests only modest benefits. A major road-block is the lack of adequate patient stratification. My fellowship will address this by investigating the role of neuroinflammation in precision physiotherapy.

The key goals are to 1) characterise human neuroinflammation, 2) validate magnetic resonance neurography (MRN) as a non-invasive marker and 3) determine whether physiotherapeutic exercises (neurodynamics) can reduce neuroinflammation.

I will use longitudinal cohorts of patients with carpal tunnel syndrome (CTS) and Morton’s neuroma undergoing surgery as model systems with unparalleled access to injured tissues (e.g., nerve, skin, tenosynovium, blood).

I will characterise neuroinflammation and its relationship to symptoms in these samples using gene/protein expression and histological analyses.

By directly comparing MRN with histological findings, I will determine its validity as a non-invasive marker for neuroinflammation.

I will then perform a mechanistic trial to investigate whether neurodynamic exercises reduce neuroinflammation by measuring MRN before and after exercises or control interventions in CTS patients. My project will provide novel biological insights into neuroinflammation, and may revolutionise its clinical detection.

The development of precision physiotherapy has high potential to reduce patients’ suffering and decrease healthcare costs.