Abstract
RATIONALE: Double crush syndrome (DCS) refers to multi-nerve entrapment based on the hypothesis that the distal nerve is likely to be more affected by pressure in the presence of a proximal lesion. DCS is difficult to diagnose, and thus far, few cases have been diagnosed from the perspective of DCS and reportedly treated with traditional Korean medicine. PATIENT CONCERNS: The patient was a 50-year-old Korean man with DCS, hand edema, cervical radiculopathy, and upper limb paraesthesia. DIAGNOSES: Based on the characteristic disc symptoms and symptoms extending beyond the dermatome and myotome of the C7/T1 nerve, the patient was diagnosed with DCS. INTERVENTIONS: The patient underwent 2 phases of Korean medicine treatment, including acupuncture, pharmacopuncture, Chuna manual therapy, and kinesiology taping, for 2 months. OUTCOMES: Significant improvement was noted in the patient's assessments (neck pain numeric rating scale scores of 7 and 3; handshake test 50% and 90%, Spurling test (++) and (-), range of neck motion (30/20/15/15; 45/45) and (45/45/45/45; 90/90) at initial treatment and end of treatment, respectively; during phase 1, pitting edema grade scale 2 and 1 at initial treatment and end of phase 1, respectively; during phase 2, the tenderness of the lateral epicondyle of the right elbow (++) and (+-), upper limb tension test for median and radial nerve (+) and (+-) at initial treatment of phase 2 and end of phase 2, respectively). At the 3-month follow-up, physical examination findings were either further improved or maintained, and cervical spine magnetic resonance imaging also demonstrated improvement. Since oral pharmacological treatment was not utilized, no blood parameters were assessed beyond the physical examination. LESSONS: Integrative Korean medicine can be considered as a treatment for DCS. More studies on the diagnosis of DCS using ultrasonography and the effectiveness of Korean medical treatment for DCS are needed in the future.