Often times when a patient is suffering with hand or leg pain I not only examine the part that hurts I will also examine the entire nerve pathway up to the spine. Similar to telephone wires, nerves which are affect at one spot may not be felt at the injured location, instead it may hurt where the nerve ends.
Hand Pain/Carpal Tunnel Syndrome
All hand pain is not Carpal Tunnel Syndrome (CTS). When someone suffers with hand pain, the first thought is CTS; so what actually is carpal tunnel syndrome? There is a small tunnel located in your wrist, which is where the median nerve passes through. If any structures (bone, ligament, cartilage etc.) that make up that tunnel are injured, squeezed or inflamed the tunnel will tighten putting pressure on the median nerve. Theses symptoms may be any adverse sensations felt in the thumb, index and middle fingers. Hypotrophy may also exist in the thumb muscle if CTS has been around for a while. All other hand symptoms are from something other than CTS. This is why we need to look at all the tunnels and spaces the nerves transverse through and ultimately terminate in your hand. The nerves start in the neck, work though the shoulder, the elbow and into the wrist and ending in the hand. Proper evaluation will help any nerve that may be entrapped along the pathway.
Sciatic and Foot Pain
Similar to hand pain nerves that transverse from the lower spine may create foot pain if irritated along its pathway. Sciatica is a catchall diagnosis, which really is a symptom of nerves, impinged in the lower spine. Depending on which nerves are affected, pain may be experienced in the front, side or behind the leg. Discomfort may also be felt into the groin as well as the feet. It is very common to have a herniated lower back disc yet no back pain, only pain in the calf or foot. This can be confusing for the patient but well understood if examining the neurology.
So what is Double Crush Syndrome?
We have already talked about the numerous tunnels and pathways nerves may travel, and if one of those tunnels is affected, nerve pain (or neuralgia) may develop. So what happens if two tunnels are affected impinging the nerves? This is actually a very common event that requires both areas to be treated to effectively offer the patient relief. This also explains why someone may be receiving treatment for a specific aliment, thinking it would help his or her problem, yet the pain doesn’t resolve. It is important to not only treat the primary tunnel, but also the secondary tunnel. Double crush means two tunnels are closing in (or crushing) on a particular nerve. Can this happen in three or more tunnels too? Yes it can!
If you are suffering with hand pain, foot pain or sciatica call the office give the office a call at (201) 825-6601 for an evaluation.
Until Next Time,