First aid for nerve damage (brief overview)

This is a quick summary. A detailed discussion of this topic can be found here.


Do NOT stretch out the affected area. Remember that stretch is often a contributing factor in getting the injury in the first place.

Do NOT compress the affected area. Again, compression is a causative factor and more compression will not be helpful.

We no longer recommend applying ice as part of routine care after a bondage-related nerve injury. If you do choose to ice, do so only for the first day. Apply ice to the site of damage for 10 minutes every hour while awake, being sure to use a padded ice bag that does not cool too aggressively.

It’s important to remember is that the site of the damage may not be immediately clear or intuitive. For example, if the bottom has radial nerve damage (and subsequent wrist drop) from a box tie , the temptation is to think that their WRIST is injured, when the injury probably originates in the upper arm.

Generally, nerve injuries resulting in mild symptoms in isolation likely do not require a trip to the emergency room RIGHT THIS SECOND, but if there are any concerns that there may be further or more severe injury (ongoing circulation compromise, severe deficits, ongoing pain, deformity of the limb, hematoma (large bruise) which could compress the nerve, etc) then a trip to the ER would certainly be appropriate. As a guideline: the “deader” the bottom’s limb and the slower it resolves, the more urgently they should visit the local ER. So, if they have a bit of tingling in their pinky from hitting their funny bone, they can easily wait. If their whole arm is numb, pale and doesn’t get ANY better in 10-20 minutes – RUSH to the ER IMMEDIATELY. And remember: Tell the ER docs the truth. They won’t judge you, and they need to know exactly what happened. The more authentic the story you’re telling is, the less likely they will suspect any abuse.

See an MD (a neurologist if possible) within a few days if symptoms persist.

After the first few days, you can consider using gentle heat.

Gentle mobilization as soon as possible is recommended, with minimal use of braces only as needed to prevent further injury. Consult a physical therapist if possible.

Nerve damage can be exacerbated by vitamin B-12 deficiency. Taking B-12 supplements, if it’s OK’d by your doctor, could help with healing.

Next: More detail about first aid for nerve damage, perhaps? Or read about some bondage myths and misconceptions?