To examine the use of Double Crush Syndrome (DCS) hypothesis in CTS patients in order to support or disguard the theory. This study was conducted on 80 adult patients, 40 presenting with brachialgia (Group I) and 40 patients claiming of failed CT release operation (Group II). Diagnostic work up included neurological examination, MRI of cervical spine, Phalens, Tinel’s sign, EMG examination and motor and sensory nerve conduction studies. EMG examination and nerve conduction studies results show 10 cases with CTS (25%), 20 cases (50%) with DCS and 10 cases (25%) with cervical radiculopathy in group I, while group II proved 10 cases (25%) with CTS and 30 cases (75%) with DCS. Accordingly, studied patients showed 20 cases with CTS (25%), 50 cases with DCS (62.5%) and only 10 cases with cervical radiculopathy alone (12.5%). When comparing the first nerve conduction studies of Group II before the operation and the follow up nerve conduction studies of the same group after the operation we found 32 cases (80%) with improvement of the NCS and 8 cases (20%) with deterioration of the nerve conduction studies results. The double crush syndrome element should be excluded whenever examining for CTS, to guide for treatment. DCS hypothesis was supported by this sudy. The double crush concept has gained some popularity among chiropractors because it seems to provide a rationale for evaluating the condition of the cervical roots when treating CTS, which was supported by this study.