New Research on the "Double Crush" link to Carpal Tunnel Syndrome

Carpal tunnel syndrome patients often complain of neck pain. The same nerves that go through the wrist tunnel, emerge from the neck and can be compressed or irritated at the neck joints. If the nerve is pinched in these two areas, it has been referred to as a "double crush." Because of this irritation at the neck, focusing only on the wrist for treatment may not be a comprehensive solution to this often debilitating problem.

Recent research (Russel BS. Chiro & Osteo 2008,162doi:10.1186/1746-1340-16-2) has reviewed the evidence for and against this linkage of two problems. Dr. Russel concludes if the wrist symptoms only involve sensation, rather than weakness, then the double crush link may be more tenuous. However, if you have a "motor" problem with a nerve, and experience weakness or loss of grip strength, then the implication of a problem also at the neck appears to be more relevant.

However, since many patients with carpal tunnel will also have neck pain, a trial of chiropractic care at both the wrist and neck is a conservative strategy that seems prudent and should be considered.

If your carpal tunnel symptoms developed after a neck injury or you also have pain into the upper arm or shoulder, these may be clues that your nerve is irritated in more than one location.

Getting to the cause of a problem, rather than just treating the symptoms, is a hallmark of specific chiropractic care. We can assist you with doing corrective wrist strengthening exercises and stretches, which may relieve pressure at the wrist tunnel. Some patients can benefit from nutritional counseling and even weight-loss strategies, since excessive weight is a risk factor for developing carpal tunnel syndrome. Other patients may need simple ergonomic instruction such as modifying your posture at a workstation, to take pressure off of both the neck and wrist.

The important thing is get properly diagnosed, with x-rays if needed, to get a full and comprehensive picture of the actual problem. Simply limiting wrist motion with a splint may not be enough to make the wrist and hand both pain-free and functional. Many people only consider surgery or daily medications as their only alternatives and fail to consider natural and drug-free chiropractic care