Double crush syndrome

Nerve symptoms whose origin is unclear caused by partial compression in two spots

The most common version of this entity we see would have to be carpal tunnel syndrome, where the median nerve is compressed by a tight carpal tunnel at the wrist, and the nerve roots are also being affected by degeneration in the lower cervical spine.  Nerve conduction studies can be ordered by the GP / neurologist to search for the source of the arm / hand ‘nervy’ symptoms, but if there is not major / obvious compression at one site, the patient is sometimes told that the test is inconclusive.  If there is also a MRI of the cervical spine, we often find there is a C5/6 or 6/7 disc or osteophyte problem slightly irritating the nerve root.  So while each area on its own might not be enough to really cause nerve symptoms, together, they induce enough tethering and compression to cause the arm symptoms.

As with the other nerve compression type problems, osteopaths want to free up the areas that are most likely to be the ‘choke points’.  As is carpal tunnel, the bones of the wrist can be manipulated and the ligaments stretched.  The nerve itself can be made to slide back and forth through the bony tunnels it negotiates using neural gliding manoeuvres.