Thank you for joining me again this evening for our nightly podcasts. I perform these podcasts in the hopes that you will be able to education yourself on the topics discussed so you can make better informed medical decisions regarding your health in the future. I am doctor Harrison Campbell of Restoration Health a premier sugar land chiropractors office. Previously we discussed vitals with a focus more on blood pressure. Tonight, we will be discussing the Double Crush syndrome.
Now at first glance double crush syndrome sounds like something is being crushed twice, after all it is in the name Double Crush Syndrome. However, nothing is being crushed in actuality. What Double Crush Syndrome is, is where a peripheral nerve coming off the spinal cord is being impinged in two separate locations. Now sugar land chiropractors know this is most common in the upper extremity peripheral nerves where there is a double crush happening to create neurological symptoms in the arm and hand.
Often times when this occurs in the hands people mis diagnose the condition as carpal tunnel syndrome. The differences lie in the symptom pattern of the neurological symptoms. To explain, we will first briefly go over the symptoms of carpal tunnel syndrome then explain how double crush syndrome differs. Carpal Tunnel is, as sugar land chiropractors know, a condition where the peripheral nerve for the hand is being impinged at the wrist in the carpal tunnel, hence the name carpal tunnel syndrome. The fingers go numb during the night and patients often wake in the middle of the night and have to shake their hands out to return feeling to them. The interesting symptom of this however, is the fingers go numb, not the palm of the hand. The reason for this is the cutaneous sensory nerve to the palm more often than not does not travel through the carpal tunnel, and is therefore unaffected by carpal tunnel syndrome.
In contrast, the double crush syndrome affects the entire pathway of the nerve which is affected. Typically, the nerve for double crush will affect the some of the fingers and part of the palm associated with that nerve. Rarely do all of the fingers become affected and rarely does the entire hand become affected with this condition. Again, the reasoning is due to the nerves influencing the sensation in the different parts of the hand.
Now the most common area for double crush syndrome to happen is the upper extremity as we said before. Typically, the area of the first crush is in the neck. Either muscle tension applies pressure to the brachial plexus, which we have discussed previously, or a nerve root is irritated near the spine. Now in some cases, as sugar land chiropractors know this can be symptomatic and cause issues, but what can also occur is a sub symptomatic response. What I mean by that is the nerve is irritated due to the impingement, but the level of irritation does not reach the level of conscious perception meaning we have no idea it is happening. There are no symptoms associated with this because the level of irritation does not warrant the symptoms being present.
Now if we take this nerve which is already irritated but not symptomatic and apply another area of irritation, we can produce a response. This as sugar land chiropractors can tell you means the nerve is primed for irritation due to the spot of the first crush lowering the threshold for irritation. Often times the area of the second crush is at the elbow. The mobility of the elbow occurs due to the joints and the muscles. These muscles are usually where the problem from the second crush in a double crush syndrome occurs, however. A muscle tightens and the nerve which is running near the muscle is caught up in this muscle contraction. This pressure applied to the nerve causes irritation, but usually not enough irritation to where this alone will become symptomatic. If you combine this irritation from muscle tightness with the irritation in the neck you produce nerve irritation or neuralgia.
If you do not believe me about the elbow irritation I want you to do something real quick. Look at your elbow and find the common extensor tendon, which as sugar land chiropractors can tell you is on the lateral aspect of the elbow. The easiest way for you to do this is go to the outside of your elbow or the lateral side and make a fist and extend or hand, similar to revving a motorcycle. Do you feel the muscles flexing near the lateral side of the elbow? This is the common extensor tendon. Palpate down this tendon and you will feel nodules, and more often than not this nodules are tender if pressure is applied. These are the tight muscles which irritate the nerves running down the arm.
Another possible location for the double crush to occur is at the wrist. This is usually in the carpal tunnel we discussed before. Now in this case carpal tunnel syndrome can occur due to a double crush syndrome. Now I know that confuses you on what we just discussed so let us simplify this really quick. Carpal Tunnel Syndrome and Double Crush Syndrome are two unique conditions. Depending on where the double crush occurs a double crush syndrome can be responsible for carpal tunnel syndrome, but they are not synonymous conditions. This means that when sugar land chiropractors talk about double crush syndrome, they are not necessary saying carpal tunnel. Remember carpal tunnel has very specific symptoms in a very specific pattern.
Thank you for joining me again this evening for another great podcast. I hope you enjoyed the discussion on double crush syndrome. As always should you or someone you know require a sugar land chiropractors services or simply have more questions on what was discussed please call Restoration Health today. We would love to schedule you an appointment and get you on the path to better health today. Thank you once again for joining us. Have a good night.