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Double Crush Syndrome

The double crush syndrome which often is related to those with Carpal Tunnel Syndrome (CTS) involves two or more areas of nerve lesions along the peripheral nerve trunk 1. What this means is there is pressure or damage in more than one place between the brain and the body, most commonly the hand. The closer the nerve pressure or damage is to the the body the more likely there will be lesions that occur further down as well 1. For example if there is a lesion close to the spine (proximal), the rest of the affected nerve will be more prone to injury further down the arm to the elbow or down to the wrist.

It has been noted that Carpal Tunnel Syndrome is often related to a double crush syndrome and not just a nerve lesion or entrapment in the wrist but in the elbow or higher 1. What researchers have found is that oftentimes one will have surgery trying to correct the CTS, the surgery doesn’t work and the person still has pain. This has been attributed to many different things (as noted in our previous article) but one of the most common is the presence of double crush syndrome where the nerve entrapment was higher up and affecting the lower limb 1&3.

Involvement of the cervical spine is one of the main contributing factors to CTS and double crush syndrome 2. Cervical spondylosis also known as cervical degeneration or cervical arthritis was found to have a statistically significant contribution to patients with bilateral CTS and unilateral CTS as well as double crush syndrome 2.

Prevention is the key. Working to correct this problem, ideally before it causes Secondary Conditions (symptoms), is important. Prevention begins in the spine and specifically in the neck. If cervical spondylosis begins to occur it may never fully improve. Degenerative arthritis ONLY occurs when there is improper motion. This can be from a major trauma such as a motor vehicle collision, or many microtraumas built up over time such as a repetitive motion, working at a computer or texting. The body adapts to these stresses and will lay down excess bone around an unstable joint, attempting to add stability. This extra bone can be in the form of spurring or arthritis. With increased bone formation around the nerves in the spine can become blocked and will be unable to supply organs, muscles, tissues and cells of the body. Carpal Tunnel Syndrome and Double Crush Syndrome are great examples of nerves being impaired due to Cervical Spondylosis.

One of the best ways to help improve mobility, function and decrease the risk of cervical spondylosis is to have specific Foundational Chiropractic Care. Specific x-rays are taken help to determine if there is signs of cervical spondylosis. If it is present Foundational Adjustments can help to improve function, mobility and may help contribute to stopping the progression of further degeneration. Chiropractic Structural adjustments may help the nerves to fire correctly allowing those who suffer from double crush as well as CTS to have improved function and less pain.

References:
1. https://www.ncbi.nlm.nih.gov/pubmed/3275922
2. http://www.physio-pedia.com/Double_Crush_Syndrome
3. https://www.ncbi.nlm.nih.gov/pubmed/26306807

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