- The relative contribution at each site may be difficult to assess, and make surgical priorities unclear.
- The patient may have signs and symptoms out of proportion to findings documented by electrical nerve testing.
- Correction of the problem at one site alone is more likely to result in lingering or persistent symptoms.
- The patient may have an underlying constitutional tendency toward irritative nerve symptoms.
The existence of double crush syndrome is controversial, but I believe that it is a clinically significant consideration which makes the results of treatment less predictable.