At the first sign of a potential nerve compression issue, work to relieve any sources of compression as quickly as possible. This may include:

• Adjusting the position of the rope on the body. Sometimes moving a band of rope up or down even just a centimeter or two is all that is required to alleviate the issue.
• Shifting the physical position of the bottom to relieve the pressure on particular part of a tie. The bottom may be able to do this themselves or may need help to do so.
• Removing the rope from the affected location.

If none of these actions results in immediate and noticeable relief (within 15 seconds), end the rope session and remove all rope completely.

Time is a critical factor where nerve compression is concerned. The sooner the issue is addressed, the more likely that any injury will be minor and will heal relatively quickly. Every minute of delay can greatly increase the damage.

Speed is Crucial

If you do not immediately know where the source of a nerve impingement is, don’t waste time trying to figure it out. If moving any band of rope on the upper or lower parts of the arm doesn’t resolve the issue within 15 seconds, remove the tie. Nerve compression may have been caused by the position of the body or something else entirely. Any detective work regarding which specific nerve may have been impinged, and how, is best done when the potential cause has been removed. Use the new information you have learned to plan for future scenes and exploration.

Assess Severity of the Injury

• If the injury involves abnormal sensation but no loss of motor function, and if normal sensation returns within a few hours, then the damage is likely mild and will heal without medical intervention. Avoid additional compression of the entire affected area until the nerves are completely healed. Most people completely recover from mild nerve injuries within 6-8 weeks. Keep in mind that symptoms may dissipate before the nerve itself is completely healed.
• If the injury involves loss of mobility or strength, consider implementing the first-aid treatment described below and monitor the area closely for signs of change. If mobility does not improve within 24-48 hours, consult a medical professional.
• If the symptoms are severe, seek professional help immediately.

Response and Treatment

• Remove all sources of compression while maintaining as much control as possible to lower the risk of more injury. Avoid moving the bottom beyond what is necessary to remove the rope.
• Do not stretch or massage the injured area or the potential source location of the injury. Doing so may injure the nerve further. Remember, the site where sensation or mobility issues are being experienced may not be the same as the location of the injury.
• Rest the area for several days following the most recent injury. Depending on the location and severity, it may be necessary to immobilize the area using a splint.
• After a day or two of rest, conservatively explore the range of motion of the affected limbs or joints. If abnormal sensation or motor function are still present after two or more days of rest, seek advice and treatment from a licensed physical therapist.
• There is evidence supporting the role of B vitamins in nerve regeneration and remyelination of nerve cells after injury. Vitamin B12, in particular, appears to directly support nerve cell survival and repair with the combination of vitamins B1, B6, and B12 showing positive effects as well.

If sensory or motor symptoms do not improve within 24-48 hours — or if pain and/or other symptoms accompany the injury — see a medical doctor as soon as possible. Do not use this page as a substitute for medical attention. The advice of a licensed medical professional always outranks the information presented here.

When consulting with a medical professional about an injury sustained from rope bondage, be completely honest about the origin of the injury. Keeping relevant information from a healthcare provider may impact the quality of care that you receive.