What are my treatment options for double crush syndrome?
Treatment for double crush syndrome should be initiated with conservative measures that focus on distinct management of each individual lesion. This may include oral steroids, steroid injections, NSAIDs, relative rest to avoid irritating movements and positions, and physical therapy. It is important for the patient to understand that the treatment will involve both the area of pain and the secondary lesion contributing to symptoms, for example treating both the neck and the arm when dealing with carpal tunnel syndrome. If conservative measures fail, surgical consideration can be taken and may include cervical spine decompression and peripheral nerve decompression. This will include procedures such as cervical discectomy, fusion, total disc replacement, posterior laminoforaminotomy, 1st rib resection, or resection of a muscle. The decision as to where to focus surgical efforts first will depend on severity of symptoms and compression at each site. It is imperative that management, surgical or conservative, should focus first on accurate diagnosis and then treatment of all contributing elements.
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