Index to Chiropractic Literature
Index to Chiropractic Literature
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Saturday, November 23, 2024
Index to Chiropractic LiteratureIndex to Chiropractic LiteratureIndex to Chiropractic Literature
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ID 20424
  Title Carpal tunnel syndrome and the "double crush" hypothesis: A review and implications for chiropractic
URL http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2365954/
Journal Chiropr & Osteopat. 2008 ;16(2):Online access only 9 p.
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Peer Review Yes
Publication Type Article
Abstract/Notes Upton and McComas claimed that most patients with carpal tunnel syndrome not only have compressive lesions at the wrist, but also show evidence of damage to cervical nerve roots. This "double crush" hypothesis has gained some popularity among chiropractors because it seems to provide a rationale for adjusting the cervical spine in treating carpal tunnel syndrome. Here I examine use of the concept by chiropractors, summarize findings from the literature, and critique several studies aimed at supporting or refuting the hypothesis. Although the hypothesis also has been applied to nerve compressions other than those leading to carpal tunnel syndrome, this discussion mainly examines the original application - "double crush" involving both cervical spinal nerve roots and the carpal tunnel. I consider several categories: experiments to create double crush syndrome in animals, case reports, literature reviews, and alternatives to the original hypothesis. A significant percentage of patients with carpal tunnel syndrome also have neck pain or cervical nerve root compression, but the relationship has not been definitively explained. The original hypothesis remains controversial and is probably not valid, at least for sensory disturbances, in carpal tunnel syndrome. However, even if the original hypothesis is importantly flawed, evaluation of multiple sites still may be valuable. The chiropractic profession should develop theoretical models to relate cervical dysfunction to carpal tunnel syndrome, and might incorporate some alternatives to the original hypothesis. I intend this review as a starting point for practitioners, educators, and students wishing to advance chiropractic concepts in this area.

Click on the above link for free full text. This abstract is reproduced with the permission of the publisher. PubMed Record
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