Wrist and Hand Pain Trigger Points
Trigger Point Therapy for Wrist Pain and Hand Pain
Wrist pain is a very common pain disorder in modern daily life. Many job related activities such as using a computer, cutting hair, and carpentry, can overload the muscles of the forearm with daily repetitive tasks. Trigger points that refer pain to wrist are likely to develop in these situations. Unfortunately, many people are misdiagnosed with Carpal Tunnel Syndrome in these situations, and undergo needless surgeries.
Symptoms such as numbness and tingling sensations in the fingers may also result from trigger points in muscles of the neck and shoulder region. People with these symptoms are often diagnosed as having Thoracic Outlet Syndrome.
Both Thoracic Outlet Syndrome and Carpal Tunnel Syndrome are disorders that are more likely to be created by trigger points than by anatomical or structural malformations. Not only can trigger points refer pain that mimics these disorders, but the muscle tension created by these trigger points will frequently compress nerves as they travel in the neck, shoulder, and forearm regions.
There are over ten muscles that can contain trigger points that produce wrist pain and/or numbness in the hand or fingers. The following four muscles are the most commonly involved.
The Wrist Extensor Trigger Points that Cause Wrist Pain
The Wrist Extensors are the muscles that are located on the back of the forearm. They attach on the lower portion of the upper arm bone (the humerus) and run down the forearm to attach to the wrist bones. These muscles contract to flex the wrist backward (like the motion of working the throttle on a motorcycle).
The Wrist Extensor muscle group is comprised of the Extensor Carpi Radialis, the Extensor Carpi Ulnaris, and the Extensor Digitorum muscles.
Wrist Extensor Trigger Point Symptoms
Patients with active Wrist Extensor trigger points will complain on the back of the wrist and hand. They may also have pain on the outside of the elbow joint or lateral epicondyle. They will also have a hard time holding things with their weakened grip strength.
Activities such as carpentry, tennis, using a weed trimmer, and frisbee throwing will often overload these muscles and cause these trigger points to develop.
The Wrist Flexor Trigger Points that Cause Wrist Pain
The Wrist Flexors are the muscles that are located on the inside of the forearm. These muscles attach to the lower portion of the upper arm bone, and run down the inside of the forearm to attach to the wrist bones. Contracting these muscles causes the wrist to flex or curl.
The Wrist Flexor muscle group includes the Flexor Carpi Radialis and Flexor Carpi Ulnaris muscles.
Wrist Extensor Trigger Point Symptoms
Patients with active trigger points in the Wrist Flexors complain of pain that is felt on the inside of the wrist, thumb, and fingers. They will also have great difficulty in using scissors.
The Pectoralis Minor Trigger Points that Cause Wrist Pain
The Pectoralis Minor muscle is a small muscle that lies underneath the larger Pectoralis Major muscle group. This muscle attaches to the Shoulder Blade behind the collar bone, and runs downward to attach to the upper ribs in the front of the upper body.
Pectoralis Minor Trigger Point Symptoms
Patients with active Pectoralis minor trigger points complain of chest pain and shoulder pain on the front of the shoulder. The pain will often extend down the inside of the arm to the inside of the elbow, and to the wrist and hand. A hallmark of these trigger points is pain in the pinky, ring, and middle fingers.
A tight Pectoralis Minor muscle with active trigger points is likely to compress the nerve and blood vessels as they exit the armpit region to supply the arm. This can simulate or cause Thoracic Outlet Syndrome and Carpel Tunnel Syndrome with symptoms such as pain and numbness that travels down the arm into the wrist, hand, and fingers.
The Scalene Trigger Points that Cause Wrist and Hand Pain
The Scalene muscle group is found deep in the lower neck. It flexes the neck to the side and helps to lift the rib cage when you inhale sharply.
Trigger points in the Scalene muscles can produce a variety of upper body symptoms including chest pain, shoulder blade pain, and radiating pain down the arm, skipping the elbow joint, and into the hand.
Scalene Trigger Point Symptoms
Patients with active Scalene trigger points will complain of simultaneous chest pain and upper back pain. The upper back pain created by the Scalene trigger points is typically described as pain between the shoulder blades, while the chest pain is described as two-fingers of pain starting below the clavicle and traveling down the chest.
The arm pain can be caused by both trigger point activity directly and by entrapment of the nerves and blood vessels (indirectly) by a tense Scalene muscle in the neck. Like with Pectoralis Minor, this entrapment can cause Thoracic Outlet Syndrome symptoms such as pain and numbness down the arm, forearm, and hand. Unlike the Pectoralis Minor, the fingers affected are usually the thumb and index finger. These symptoms may also mimic Carpel Tunnel Syndrome.
Related Instructional Videos from Dr. Perry
While the videos below were created to teach therapists how to locate and release these trigger points, many non-professionals have used them to learn these techniques successfully.
If you have a partner, a little time, you can use these videos to learn how to treat your own trigger points.
Related Articles from Dr. Perry
More extensive articles on these muscles and trigger points are available from Dr. Perry on our sister website TriggerPointTherapist.com. Click on the titles below to read them: