I recently underwent a surgery for carpal tunnel release, but my pain is still there. My doctor has now diagnosed with double crush syndrome, what does that mean?
Double Crush Syndrome is described as compression of a peripheral nerve at more than one site. Scientists have theorized that compression at one site can have no symptoms, but cause increase risk of symptoms at another anatomic site, thus the double crush of the nerve. When the nerve is disrupted at both sites it can result in a change in nerve function nutrient flow at the axonal level and increase the chance that distal nerve axons also become compressed and often symptomatic. The most common diagnosis of DCS is with patients who are unsatisfied with a carpal tunnel release procedure. Researchers have identified characteristics that differ between those with DCS compared to carpal tunnel syndrome (CTS) alone and have found that in comparison to patients with only CTS, patients with DCS have greater incidence of radiating pain closer to the neck and shoulder, more parathesias and less numbness, decreased grip strength. Some of the classic tests for CTS, including Phalens and Tinnels, were also less frequently positive in those with DCS. It is important in these patients, that the impairment at both the carpal tunnel and proximally, often in the neck and shoulder are both treated.