Double Crush Syndrome & Neuropathy

According to the International Chiropractic Pediatric Association (ICPA), double crush syndrome (also known as carpal tunnel syndrome) is a compression neuropathy (disease or disorder affecting the nervous system) located in two areas, one usually distant from the other. Simply put: when a nerve is compressed a little, you probably won't notice it or feel any symptoms. But when you compress a nerve a little in several locations, the results---or symptoms---can multiply. For example, if the nerves in our arms are compressed, this means you'll have a neck problem and a shoulder problem, which can then also cause a previously small problem in the wrist to become exaggerated.

History

• Double crush syndrome was first publicly cited by Upton and McComas in the Lancet Medical Journal in 1973. They found that in 81 of 115 cases of carpal tunnel syndrome, there was an associated problem with one or more nerves being affected and not working properly. They proposed that if a nerve is impaired in one spot, it makes the patient more susceptible to similar nerve damage. This means that nerve compression alone or by itself is not enough to cause clinical dysfunction and that two or more sites of nerve compression will create abnormalities in function.

Types

• There aren't different types of carpal tunnel syndrome (CTS); however, the disorder is characterized as a repetitive strain injury of which there are many types. There are so many repetitive strain injuries, in fact, that they are often hard to diagnose because many of them deal with similar symptoms. Types include DeQuervain's syndrome, tendonitis and Tenosynovitis, among others.

Misconceptions

• CTS is very over-diagnosed and often misdiagnosed. Current research indicates that wrist supports or surgery for carpal tunnel syndrome is not very effective when additional compression of the nerves is occurring in either the shoulder or neck. You can't just treat carpel tunnel syndrome; you must find the root cause and for carpal tunnel-like symptoms, the root is often a nerve root.

Prevention/Solution

• Chiropractors are usually the types of doctors that will administer treatment for double crush syndrome. They treat the symptoms of the disorder by massaging the wrist, elbow and neck as well as utilizing ultrasound therapy and wrist supports.

Expert Insight

• According to the University of Maryland Medical Center, a study found that 25 individuals diagnosed with CTS reported significant improvements in strength, range of motion and pain after receiving chiropractic treatment.