Tunnel Syndrome (CTS) results from impingement
of the Median Nerve in the arm. This nerve runs
from the neck, down the arm, through bones in
the wrist (carpal tunnel), to supply the hand
and thumb. Irritation to this nerve often results
in numbness, tingling, and pain in the hand and
thumb, loss of grip strength in the hand and thumb,
and pain / numbness radiating from the neck and
IUCCA UPPER CERVICAL CARE RELATES TO CARPAL TUNNEL
a review of medically confirmed carpal tunnel
syndrome cases, it was discovered that the majority
of patients examined also had concurrent problems
with the cervical spine.1
Because nerve roots from the cervical spine form
the median nerve in the arm, it has been suggested
that cervical problems can contribute to the onset
of these patients do not respond to conservative
and/or surgical treatment directed solely at the
wrist. Because cervical nerve irritation and/or
compression renders the lower nerves in the wrist
more susceptible to injury, it is essential to
properly correct the cervical problem first if
the wrist condition is to fully resolve.
purpose of IUCCA upper cervical care is to correct
cervical spine mechanics that are irritating spinal
cord tracts and nerve roots that extend to the
wrist. A similar phenomenon can occur with Thoracic
Outlet Syndrome (TOS) and cervical radiculopathy
(tingling, pain down the arms). While many carpal
tunnel sufferers recall specific traumas
such as head injuries, auto accidents
or falls, which could have injured their cervical
spines, some do not. An upper cervical examination
Radiography and Digital
Infrared Imaging is
necessary in each individual's case to assess
whether an upper cervical injury is present and
whether benefit from upper cervical care can be
Tunnel Case Studies
Hurst LC, Weissberg D, Carroll RE. The relationship
of the double crush to carpal tunnel syndrome
(an analysis of 1000 cases of carpal tunnel syndrome).
J Hand Surg 1985 Jun; 10(2): 202-4.
2. Ide M, Ide J, Yamaga M. Symptoms and signs
of irritation of the brachial plexus in whiplash
injuries. J Bone Joint Surg Br 2001 Mar; 83(2):
3. Roquer J, Herraiz J, Maso E. Carpal tunnel
syndrome and cervical whiplash. Neurologia 1988
Sep-Oct; 3(5): 202-3.
4. Critelli N. Head injury-cervical strain-carpal
tunnel syndrome-a videotaped evidence deposition
of plaintiff's neurosurgeon-direct and cross-examination.
Med Trial Tech Q 1982 Summer; 29(1): 114-36.
5. Niwa H, Yanagi T, Hakusui S. Double crush syndrome
in patients with cervical spondylosis or ossification
of posterior longitudinal ligament-a clinicophysiological
study. Rinsho Shinkeigaku 1994 Sep; 34(9): 870-6.
6. Valente R, Gibson H. Chiropractic manipulation
in carpal tunnel syndrome. J Manipulative Physiol
Ther 1994 May; 17(4): 246-9.
7. Murray-Leslie CF, Wright V. Carpal tunnel syndrome,
humeral epicondylitis, and the cervical spine:
a study of clinical and dimensional relations.
Br Med J 1976 Jun 12; 1(6023): 1439-42.
8. Zahir KS, Zahir FS, Thomas JG. The double-crush
phenomenon-an unusual presentation and literature
review. Conn Med 1999 Sep; 63(9): 535-8.
9. Morgan G, Wilbourn AJ. Cervical radiculopathy
and coexisting distal entrapment neuropathies:
double-crush syndromes? Neurology 1998 Jun; 50(1):
10. Herczeg E, Otto A, Vass A. Significance of
double crush in carpal tunnel syndrome. Handchir
Mikrochir Plast Chir 1997 May; 29(3): 144-6.
11. Pierre-Jerome C, Bekkelund SI. Magnetic resonance
assessment of the double-crush phenomenon in patients
with carpal tunnel syndrome: a bilateral quantitative
study. Scand J Plast Reconstr Surg. 2003: 37(1):46-53.
12. Kuntzer T. Carpal tunnel syndrome in 100 patients:
sensitivity, specificity of multi-neurophysiological
procedures and estimation of axonal loss of motor,
sensory and sympathetic median nerve fibers. J
Neurol Sci 1994 Dec 20; 127(2): 221-9.
13. Mariano KA, McDougle MA, Tanksley GW. Double
crush syndrome: chiropractic care of an entrapment
neuropathy. J Manipulative Physiol Ther 1991 May;
14. Wood VE, Biondi J. Double-crush nerve compression
in thoracic-outlet syndrome. J Bone Joint Surg
Am 1990 Jan; 72(1): 85-7.
15. Narakas AO. The role of thoracic outlet syndrome
in the double crush syndrome. Ann Chir Main Memb
Super 1990; 9(5): 331-40.
16. Osterman AL. The double crush syndrome. Orthop
Clin North Am 1988 Jan; 19(1): 147-55.
17. Massey EW, Riley TL, Pleet AB. Coexistent
carpal tunnel syndrome and cervical radiculopathy
(double crush syndrome). South med J 1981 Aug;
18. Upton AR, McComas AJ. The double crush in
nerve entrapment syndromes. Lancet 1973 Aug 18;
web site is designed for educational purposes only and is not engaged in rendering
health care advice. The information provided through this website should not
be used for diagnosing or treating a health problem or disease. It is not a
substitute for professional care. If you have or suspect you may have a health
problem, you should consult a health care provider. The authors, editors, producers,
sponsors, and contributors shall have no liability, obligation or responsibility
to any person or entity for any loss, damage, or adverse consequence alleged
to have happened directly or indirectly as a consequence of this material.