This narrative review covers double crush syndrome (DCS) — compression at two or more sites along a single peripheral nerve — examining its contested pathophysiology, epidemiology, clinical presentation, and management. It asks: when is multi-site nerve compression a true synergistic pathology, and when is it coincidence or psychosocial overlay?
When a patient has persistent or atypical symptoms after carpal tunnel release — especially proximal radiation of pain and less distal median paresthesias than expected — evaluate for cervical radiculopathy and systemic neuropathy before attributing failure to surgical technique.
Counsel patients with dual pathology preoperatively that failure rates after isolated distal decompression are roughly five times higher than for isolated CTS.
This narrative review covers double crush syndrome (DCS) — compression at two or more sites along a single peripheral nerve — examining its contested pathophysiology, epidemiology, clinical presentation, and management. It asks: when is multi-site nerve compression a true synergistic pathology, and when is it coincidence or psychosocial overlay?
When a patient has persistent or atypical symptoms after carpal tunnel release — especially proximal radiation of pain and less distal median paresthesias than expected — evaluate for cervical radiculopathy and systemic neuropathy before attributing failure to surgical technique.
Counsel patients with dual pathology preoperatively that failure rates after isolated distal decompression are roughly five times higher than for isolated CTS.