During a fall individuals tend to automatically outstretch their hands to help break a fall, which can slam onto the ground causing a falling onto an outstretched hand or FOOSH injury. Should individuals get checked by a healthcare provider if they believe there is no injury?
FOOSH Injuries
Falling down usually results in minor injuries. A FOOSH injury occurs when falling down and trying to break the fall by reaching out with the hand/s. This can result in an upper extremity injury like a sprain or a fracture. But sometimes, falling on one’s hands can lead to serious injuries and/or create future musculoskeletal issues. Individuals who have fallen or suffered a FOOSH injury should consult their healthcare provider and then a physical therapist or chiropractor to safely develop a treatment plan to rehabilitate, strengthen, and expedite recovery.
After The Injury
For individuals who have fallen down and landed on their hand, wrist, or arm, here are a few things to ensure the proper care for the injury, including:
Follow the R.I.C.E. protocol for acute injuries
Visit a healthcare provider or local emergency clinic
Contact a physical therapist
A FOOSH injury could be or become serious, so to avoid letting small issues become big problems, get examined by a musculoskeletal specialist. The healthcare provider will obtain an imaging scan of the injured and surrounding areas. They will perform a physical examination to determine the type of injury, like a sprain or muscle strain. Not getting appropriate medical treatment after a fall can result in chronic pain and loss of function. (J. Chiu, S. N. Robinovitch. 1998)
Common Injuries
A FOOSH injury can injure different areas. These usually involve the wrist and hand, but the elbow or shoulder can also be injured. Common injuries include:
Colles’ fracture
A wrist fracture where the end of the arm bone is displaced backward.
Smith’s fracture
A wrist fracture, similar to a Colles’ fracture, is where the end of the arm bone is displaced towards the front of the wrist.
Boxer’s fracture
A fracture of the small bones in the hand.
Typically, it occurs after punching something, but it can happen from falling on an outstretched fist.
Elbow dislocation or fracture
The elbow can pop out of the joint or can break a bone in the elbow.
Collarbone fracture
The force from falling with the hands and arms outstretched can travel up to the collarbone, causing a fracture.
Proximal humeral fracture
Falling onto an outstretched hand injury can cause the arm bone to get jammed into the shoulder, causing a proximal humeral fracture.
Shoulder dislocation
The shoulder can pop out of the joint.
This can cause a rotator cuff tear or labrum injury.
Regardless of the injury, individuals should visit a healthcare provider to evaluate the damage. If the injury is serious, the practitioner can make an accurate or differential diagnosis and develop a treatment plan. (William R. VanWye et al., 2016)
Physical Therapy
Individuals can benefit from physical therapy to help recover and return to their previous level of function. Physical therapy varies depending on the specific injury, but generally, a physical therapist can help individuals return to function after a fall on an outstretched hand. (William R. VanWye et al., 2016) Common treatments can include:
Treatments and modalities to decrease pain, inflammation, and swelling.
Instruction on how to wear an arm sling properly.
Exercises and stretches to improve the range of motion, strength, and functional mobility.
Balance exercises.
Scar tissue management if surgery was necessary.
The therapy team will ensure the proper treatment is utilized to quickly and safely return to normal activities.
Chiropractic Care For Healing After Trauma
References
Chiu, J., & Robinovitch, S. N. (1998). Prediction of upper extremity impact forces during falls on the outstretched hand. Journal of biomechanics, 31(12), 1169–1176. doi.org/10.1016/s0021-9290(98)00137-7
VanWye, W. R., Hoover, D. L., & Willgruber, S. (2016). Physical therapist screening and differential diagnosis for traumatic-onset elbow pain: A case report. Physiotherapy theory and practice, 32(7), 556–565. doi.org/10.1080/09593985.2016.1219798
Finger sprains and dislocations are common hand injuries that can happen during work, physical/sports activities, or in automobile collisions and accidents. Can recognizing the symptoms help in developing an effective treatment strategy?
Finger Sprains and Dislocations
Finger sprains and dislocations are common injuries of the hand that cause pain and swelling.
A sprain happens when the finger tissue that supports a joint gets stretched beyond its limits in a way that stresses the ligaments and tendons.
The ligament tissue can be partially or completely torn. If the damage is bad enough, the joint comes apart.
This is a dislocation – A dislocation happens when the joint in the finger gets shifted out of its normal position.
Both injuries can cause pain and stiffness in the finger and hand.
Sprains
Finger sprains can happen any time the finger bends in an awkward or unusual way. This can happen from falling on the hand or getting hurt when engaged in physical activities like sports or household chores. Sprains can occur in any of the knuckle joints in the finger. However, most commonly, the joint in the middle of the finger gets sprained. It’s known as the proximal interphalangeal or PIP joint. (John Elfar, Tobias Mann. 2013) Symptoms of a finger sprain can include:
Other treatments to help a sprained finger include:
Elevate the hand if swelling and inflamed.
Gentle finger exercises/movements to prevent stiffness.
Icing the injured finger.
Take an anti-inflammatory medication.
Individuals who have not broken bones or dislocated the joint will probably be able to move their finger in about a week. A doctor will set a timeline for when to start using the finger normally.
Individuals who sprain their finger that feels swollen and stiff for longer than a few weeks are recommended to consult a doctor or specialist.
Thumb sprains and finger sprains in children may need to be splinted or taped for longer periods, as the ligament is not fully developed or as strong, which could lead to a tear.
Dislocations
A finger dislocation is a more severe injury involving the ligament, joint capsule, cartilage, and other tissues that causes misalignment of the finger. The ligaments and the joint capsule get torn when a joint is dislocated. The joint needs to be reset, which can be a simple process, or in severe cases, patients may need to be placed under anesthesia or undergo surgery to reset the joint properly.
In these cases, tendons or other tissues might be preventing the joint from getting into position.
Putting the finger back into the right position is known as”reduction.” Once reduced, the finger needs to be splinted.
Individuals also need an X-ray to ensure the joint is lined up correctly and that any bones were not broken or fractured when they sustained the injury. (James R. Borchers, Thomas M. Best. 2012)
Once reset, caring for a dislocated finger is basically the same as a sprained finger. Using ice on the finger, keeping the hand elevated to reduce swelling.
Elfar, J., & Mann, T. (2013). Fracture-dislocations of the proximal interphalangeal joint. The Journal of the American Academy of Orthopaedic Surgeons, 21(2), 88–98. doi.org/10.5435/JAAOS-21-02-88
OrthoInfo from the American Academy of Orthopaedic Surgeons. (2022) Hand fractures.
Hung, C. Y., Varacallo, M., & Chang, K. V. (2023). Gamekeeper’s Thumb. In StatPearls. StatPearls Publishing.
OrthoInfo from the American Academy of Orthopaedic Surgeons. (2022) Finger fractures.
Borchers, J. R., & Best, T. M. (2012). Common finger fractures and dislocations. American family physician, 85(8), 805–810.
Golfing wrist injuries are common with treatment requiring 1-3 months of rest and immobilization and if tears are present surgery. Can chiropractic treatment help avoid surgery, expedite recovery, and rehabilitation?
Golfing Wrist Injuries
Golfing Wrist Injuries: According to a study, there are over 30,000 golf-related injuries treated in American emergency rooms every year. (Walsh, B. A. et al, 2017) Nearly a third are related to a strain, sprain, or stress fracture.
This causes pain and inflammation and is usually accompanied by a grinding sensation when moving the thumb and wrist.
Chiropractic Treatment
Given the nature of these injuries, medical attention should be sought out for image scans to look at any damage and properly immobilize the wrist. Once a fracture has been ruled out or healed, golfing wrist injuries can benefit from chiropractic and physical therapy. (Hulbert, J. R. et al, 2005) A typical treatment may involve a multifaceted approach involving various therapies including:
Active release therapy, myofascial release, athletic taping, corrective exercise, and stretching.
A chiropractor will examine the wrist and its functioning to determine the nature of the injury.
A chiropractor may recommend using a splint to immobilize the wrist, particularly in cases of overuse.
They will relieve pain and swelling first, then focus on strengthening the joint.
They may recommend a regimen of icing the hand.
Adjustments and manipulations will relieve pressure on the nerves to reduce swelling and restore mobility.
Peripheral Neuropathy Successful Recovery
References
Walsh, B. A., Chounthirath, T., Friedenberg, L., & Smith, G. A. (2017). Golf-related injuries treated in United States emergency departments. The American journal of emergency medicine, 35(11), 1666–1671. doi.org/10.1016/j.ajem.2017.05.035
Moon, H. W., & Kim, J. S. (2023). Golf-related sports injuries of the musculoskeletal system. Journal of exercise rehabilitation, 19(2), 134–138. doi.org/10.12965/jer.2346128.064
Ray, G., Sandean, D. P., & Tall, M. A. (2023). Tenosynovitis. In StatPearls. StatPearls Publishing.
Zouzias, I. C., Hendra, J., Stodelle, J., & Limpisvasti, O. (2018). Golf Injuries: Epidemiology, Pathophysiology, and Treatment. The Journal of the American Academy of Orthopaedic Surgeons, 26(4), 116–123. doi.org/10.5435/JAAOS-D-15-00433
Tan, H. K., Chew, N., Chew, K. T., & Peh, W. C. (2014). Clinics in diagnostic imaging (156). Golf-induced hamate hook fracture. Singapore medical journal, 55(10), 517–521. doi.org/10.11622/smedj.2014133
Hulbert, J. R., Printon, R., Osterbauer, P., Davis, P. T., & Lamaack, R. (2005). Chiropractic treatment of hand and wrist pain in older people: systematic protocol development. Part 1: informant interviews. Journal of chiropractic medicine, 4(3), 144–151. doi.org/10.1016/S0899-3467(07)60123-2
The brachial plexus is a network of nerves that begin in the cervical/neck spinal cord and travel down the cervicoaxillary canal into the armpit. Forming in the area of the shoulder joint at the branch junction of the brachial plexus, the radial nerve extends down the arm, through the elbow joint, into the forearm, across the wrist, and tips of the fingers. The nerves are susceptible to injury that can cause abnormal function leading to unusual sensations and impaired muscle function.
Radial Nerve
One of the major nerves of the upper extremity.
There is one brachial plexus on each side of the body that carries the nerves to each arm.
The radial nerve has two major functions.
One is to provide sensations in the hands, forearms, arms, and fingers.
The other is to deliver messages to muscles about when to contract.
Motor Function
The radial nerve transmits signals to the muscles of the back of the arm and forearm on when to contract.
Individuals who have abnormal radial nerve function can experience weakness of the muscles and symptoms like wrist drop.
A wrist drop occurs when the back forearm muscles cannot support the wrist, causing the individual to hold the wrist in a flexed posture.
Abnormal radial nerve function can cause symptoms of numbness or tingling in the back of the hand.
Conditions
Associated conditions to the radial nerve include lacerations, contusions, fractures, and palsies.
Nerve Contusion
A contusion typically occurs through blunt force trauma that can crush and smash the nerve area.
This causes abnormal or no function.
A nerve contusion can occur from a personal, work, or sports injury or other conditions that generate intense pressure on the nerve/s.
Nerve Lacerations
A laceration occurs when there is a penetrating injury that cuts and/or severs the nerve.
This injury can occur from stab wounds or sliced by broken glass, metal, etc.
Fractures
Broken bones of the upper extremity can lead to extended damage to the nerves near the damaged bone.
The most common type of fracture associated with radial nerve malfunction is fractures to the humerus bone.
The nerve wraps tightly around the humerus and can be injured with a fracture.
Most fracture-related radial nerve injuries heal on their own and do not require surgery.
However, the way the injury heals can be the difference between normal function and chronic pain.
Crutch Palsy
Crutch palsy is pressure on the radial nerve in the armpit resulting from using crutches incorrectly.
To use crutches properly, the individual needs to support their body weight through the hands.
However, many tend to place pressure around the armpit at the top of the crutch, causing irritation to the nerve in that area.
Padding the top of crutches and using the proper form can prevent the condition.
Saturday Night Palsy
Saturday night palsy is the abnormal function of the radial nerve after sleeping in a position that causes direct pressure against the nerve.
This often occurs when an individual falls asleep with their arm draped over an armrest on a chair.
The name comes from when individuals are intoxicated and fall asleep in a location other than the bed and in awkward positions.
Treatment
Nerve injuries often cause symptoms at different locations other than where the nerve damage is, complicating diagnosis. Determining the specific location of nerve damage is the first step in developing an appropriate treatment plan. Once the location has been identified, steps can be taken to prevent worsening damage to the nerve.
The objective is to relieve the pressure from the irritation or compression.
Massage to relax the area and increase blood circulation.
Decompression to physically restore alignment.
Adjustments to restore body balance.
Exercises and stretches to maintain treatment, strengthen the muscles, and prevent injuries.
In cases where there is structural damage, surgery may be necessary to remove pressure or repair damage.
Avoid Surgery
References
Ansari FH, Juergens AL. Saturday Night Palsy. [Updated 2023 Apr 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK557520/
Barton, N J. “Radial nerve lesions.” The Hand vol. 5,3 (1973): 200-8. doi:10.1016/0072-968x(73)90029-6
Daly, Michael, and Chris Langhammer. “Radial Nerve Injury in Humeral Shaft Fracture.” The Orthopedic Clinics of North America vol. 53,2 (2022): 145-154. doi:10.1016/j.ocl.2022.01.001
DeCastro A, Keefe P. Wrist Drop. [Updated 2022 Jul 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK532993/
Eaton, C J, and G D Lister. “Radial nerve compression.” Hand Clinics vol. 8,2 (1992): 345-57.
Glover NM, Murphy PB. Anatomy, Shoulder and Upper Limb, Radial Nerve. [Updated 2022 Aug 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK534840/
Ljungquist, Karin L et al. “Radial nerve injuries.” The Journal of hand surgery vol. 40,1 (2015): 166-72. doi:10.1016/j.jhsa.2014.05.010
In cold weather, it’s normal to experience cold hands and fingers. But if there is a coldness in only one finger while the rest of the hand is normal, changes to skin color, numbness, tingling, or pain symptoms could be a sign of poor circulation or an underlying medical condition. Cold fingers could indicate various problems, including overuse injuries, vitamin deficiencies, Raynaud’s syndrome, hypothyroidism, anemia, arterial disease, or an autoimmune condition. Chiropractic care and massage therapy can increase circulation, release compressed nerves, relax the muscles, and restore mobility and function.
Cold Fingers
Blood circulates throughout, nourishing and maintaining body warmth. When compression, obstructions, or narrowing paths inhibit blood flow, the body cannot achieve proper circulation. Unhealthy circulation can cause several symptoms, including:
Pins and needles sensations along the shoulder, arm, hand, and fingers.
Weakened arm and hand muscles.
Numbness.
Cold finger/s.
Muscles aches, soreness, and tightness.
Swelling.
Pale or bluish skin color.
Overuse Injury
Repeating one movement or motion constantly over time can lead to overuse syndrome/repetitive motion disorder in the hands and arms. Certain jobs and activities can cause overuse syndrome, including:
Cashiers.
Food service work.
Graphic sign work.
Computer work.
Sewing work.
Landscaping.
All of these jobs and activities can put a lot of repeated stress on the hands and arms.
Vitamin B-12 Deficiency
Vitamin B-12 is required for proper red blood cell formation and neurological function. It is found in many foods, including eggs, fish, meat, poultry, and dairy products. A vitamin B-12 deficiency can cause neurological symptoms like numbness, tingling, and coldness in the hands and feet. Other symptoms include:
Anemia
Fatigue
Weakness
Difficulty maintaining balance
Depression
Soreness of the mouth
A doctor requires a blood sample to test for the deficiency. A common treatment is a high dose of an oral supplement or injections for individuals that have difficulties absorbing B-12 through the digestive tract.
Raynaud’s Syndrome
Raynaud’s syndrome is a condition that causes some areas of the body, usually the fingers, to feel cold and numb when exposed to cold temperatures or high-stress levels. This happens because the small arteries that supply blood to the skin are experiencing spasms. During an episode, the arteries narrow, which prevents blood from circulating correctly. The fingers can change color, going from white to blue to red. When the flare-up ends, and the blood flow returns to normal, there may be tingling, throbbing, or swelling. The condition isn’t usually debilitating, and treatment options often include medications that expand the blood vessels to improve circulation. These include calcium channel blockers,alpha-blockers, and vasodilators.
Hypothyroidism
Hypothyroidism is when the thyroid doesn’t produce enough hormones. Hypothyroidism comes on gradually and rarely generates symptoms in the early stages. Hypothyroidism doesn’t cause cold fingers but increases the body’s sensitivity to cold. Other symptoms include:
Fatigue
Muscle weakness, tenderness, and achiness.
Joint swelling, stiffness, and pain.
Puffiness.
Dry skin.
Hoarseness.
Weight gain.
High or elevated cholesterol levels.
Thinning hair and hair loss.
Depression.
Over time, the condition can cause complications such as obesity, joint pain, heart disease, and infertility. A doctor can detect hypothyroidism with a simple blood test. Treatment involves taking a daily dose of synthetic thyroid hormone.
Anemia
Anemia is when the blood has a lower-than-normal amount of red blood cells. It also occurs when the red blood cells lack a crucial iron-rich protein called hemoglobin. Hemoglobin assists red blood cells in delivering oxygen from the lungs to the rest of the body. A low supply of hemoglobin to carry oxygen to the hands can result in cold fingers. There may also be fatigue and weakness. Iron deficiency is what typically causes most cases. A doctor may suggest nutritional adjustments if blood work indicates low iron levels. An iron-rich nutritional plan and taking iron supplements can help relieve symptoms.
Arterial Diseases
Diseases that affect the arteries can reduce blood flow to the hands, causing cold fingers. This can be from plaque buildup or inflammation in the blood vessels. Any blockage in the blood vessels can prevent blood from circulating normally. Another arterial problem is primary pulmonary hypertension, which affects the lungs’ arteries and can lead to Raynaud’s syndrome.
Chiropractic Care
Chiropractic adjustments can remove misalignments, restore proper nerve communication, increase blood flow, and correct an overactive sympathetic nervous system. Massaging the shoulders, arms, and hands relaxes the nerves, and muscles, breaks up compressed tissues, and increase blood flow. The circulation of lymphatic fluid around the body is also promoted, which carries toxins away from the muscles and tissues. To improve circulation, the following may be utilized:
Deep tissue pressure is effective at relieving congestion and tension.
Percussive massage to break up scar tissue.
Non-surgical Decompression to stretch the spine and body out.
Lymphatic drainage is designed to improve the circulation of the fluid.
Bilić, R et al. “Sindromi prenaprezanja u saci, podlaktici i laktu” [Overuse injury syndromes of the hand, forearm and elbow]. Arhiv za higijenu rada i toksikologiju vol. 52,4 (2001): 403-14.
Ernst, E. “Manual therapies for pain control: chiropractic and massage.” The Clinical journal of pain vol. 20,1 (2004): 8-12. doi:10.1097/00002508-200401000-00003
InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. How does the blood circulatory system work? 2010 Mar 12 [Updated 2019 Jan 31]. Available from: www.ncbi.nlm.nih.gov/books/NBK279250/
Pal, B et al. “Raynaud’s phenomenon in idiopathic carpal tunnel syndrome.” Scandinavian journal of rheumatology vol. 25,3 (1996): 143-5. doi:10.3109/03009749609080004
Waller, D G, and J R Dathan. “Raynaud’s syndrome and carpal tunnel syndrome.” Postgraduate medical journal vol. 61,712 (1985): 161-2. doi:10.1136/pgmj.61.712.161
When it comes to the body, the hands and fingers correlate with each other by giving the host the grip strength to carry and hold items. The items can range from the smallest to the largest, depending on the item’s weight that a person can physically hold. When the weight becomes overbearingly heavy that a person can not lift or hold, it can lead to unwanted symptoms that overlap with other chronic conditions. To that point, when the hand muscles begin to lose their grip strength, it can lead to the development of trigger points in the affected muscles connected to the hand muscles and tendons. Today’s article looks at a chronic condition associated with trigger points known as trigger fingers, what the symptoms are, and how to treat trigger fingers in the hands. We refer patients to certified providers specializing in hand and wrist pain therapies to aid many people suffering from trigger fingers affecting their hands. We also guide and inform our patients by referring them to our associated medical providers based on their examination when appropriate. We established that education is a great solution to asking our providers profound questions the patient requests. Dr. Jimenez DC takes note of this information as an educational service only. Disclaimer
What Is Trigger Fingers?
Have you encountered stiffness in your fingers? Do you feel pain radiating from your forearms to the palm of your hands? Does it seem difficult to carry or hold items for an extended period? Many people who have dealt with these symptoms believe it is something arthritic or just normal signs of age; however, it could correlate with triggering fingers affecting the hands. Trigger fingers or stenosing tenosynovitis happens when the flexor sheaths in the wrist become overused due to repetitive motions that cause the flexor tendon muscles in the forearm to be inflamed and development issues in the finger joints. This can be very problematic for many individuals who work with their hands as it can cause significant functional impairment to the hands and the fingers. Trigger fingers also commonly affect the individual’s dominant hand and involve the most common digit, the thumb.
The Symptoms
When many individuals are dealing with trigger fingers in their hands, they often complain about their fingers locking up in flexion or extension. When this happens, it can become problematic, as trigger fingers can affect the mobility of the fingers. Some of the symptoms that trigger fingers cause in the digits include:
Stiffness in the fingers
Popping or clicking sensations
Bumps at the base of the finger joint
Finger catching in a bent position and pops straight
Finger locking
What is the correlation between diabetes and trigger fingers? Studies reveal that trigger fingers are a multifactorial chronic condition that can occur in anyone, especially those with diabetes. Trigger fingers are diagnosed by palpating a thickened tendon. Other issues cause trigger fingers to form due to active trigger points affecting the flexor muscles in the forearms. According to Dr. Travell, M.D.’s book, “Myofascial Pain and Dysfunction: The Trigger Point Manual,” individuals with active trigger points along their forearm muscles tend to experience difficulty in utilizing mobility strength with their hands. To that point, many individuals may not be able to cup and supinate their hands, extend or flex their fingers, or be able to grip items they are reaching.
An Overview Of Trigger Fingers- Video
Are you dealing with joint stiffness along your fingers? What about feeling pain from flexing or extending their fingers? Or do you feel pain and tenderness in your forearm muscles? Many individuals with these symptoms could be dealing with the pain associated with trigger fingers. Trigger fingers occur when the finger digits suffer from microtrauma by repetitive use or compression forces that invokes pain and inflammation along the tendons of the fingers. The video above overviews trigger fingers, their symptoms, and how to diagnose and treat trigger fingers in the hands. Many associated factors can lead to the development of trigger fingers, and one related factor is diabetes overlapping trigger points along the forearms. Studies reveal that trigger fingers are a complication affecting the upper extremities in diabetic individuals. Individuals with trigger fingers associated with diabetes can also cause overlapping risk profiles for cardiovascular diseases. This relationship is known as somato-visceral pain, where the damaged muscle affects the corresponding organ. In this case, the tendons for the fingers cause referred pain to the heart, thus potentially involving the cardiovascular system. Luckily there are various ways to treat trigger fingers and prevent pain from occurring in the hands in the future.
How To Treat Trigger Fingers
Since trigger fingers are a common source of pain and disability in the hands, many individuals seek pain specialists to manage and relieve pain associated with trigger fingers. Studies reveal that various methods are used to reduce the pain along the affected finger digits and bring back mobility to the finger joints. Doing gentle finger stretches, not gripping items so tightly, or applying heat to loosen up the locked joints, can help manage trigger fingers while preventing the pain-like symptoms from coming back. Incorporating these treatments can help bring mobility strength back to the hands and prevent the fingers from locking up. However, treatment alone can not be the only solution; after the individuals get treatment for trigger fingers, they have to do their part to prevent future issues from reoccurring again in their fingers.
Conclusion
The hands and fingers have a casual relationship, providing mobility and grip strength for the host to hold and carry items. However, when traumatic factors or normal activities begin to overuse the joints and muscles in their hands, it can lead to trigger fingers. Trigger fingers can cause the finger joints to lock up and invoke pain-like symptoms in the hands. This can make many individuals lose their mobility function in their hands and can make them miserable. Luckily, various treatments can help manage trigger fingers and help bring mobility back to the individual’s hands.
References
Akhtar, Sohail, et al. “Management and Referral for Trigger Finger/Thumb.” BMJ (Clinical Research Ed.), BMJ Publishing Group Ltd., 2 July 2005, www.ncbi.nlm.nih.gov/pmc/articles/PMC558536/.
Jeanmonod, Rebecca, et al. “Trigger Finger – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 20 July 2022, www.ncbi.nlm.nih.gov/books/NBK459310/.
Makkouk, Al Hasan, et al. “Trigger Finger: Etiology, Evaluation, and Treatment.” Current Reviews in Musculoskeletal Medicine, Humana Press Inc, June 2008, www.ncbi.nlm.nih.gov/pmc/articles/PMC2684207/.
Mineoka, Yusuke, et al. “Trigger Finger Is Associated with Risk of Incident Cardiovascular Disease in Individuals with Type 2 Diabetes: A Retrospective Cohort Study.” BMJ Open Diabetes Research & Care, BMJ Publishing Group, Apr. 2021, www.ncbi.nlm.nih.gov/pmc/articles/PMC8039242/.
Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 1:Upper Half of Body. Williams & Wilkins, 1999.
The hands are the main show when it comes to the body. They can be expressive when a person is talking, they can carry items from place to place, and when it comes to sports, they have excellent grip strength. The various muscles, tendons, nerve roots, and ligaments surround the joints to provide functionality and mobility to each finger digit. The hands also have a great relationship with the wrist and forearms because the muscles in the forearms travel down to the hands to provide mobility, flexion, and extension to the fingers. However, when the muscles become overused from repetitive motions, it can lead to the development of pain overlapping other conditions that can affect the wrist and hands. To that point, trigger points can develop over time to invoke pain in the affected muscles and cause referred pain to affect the hands. Today’s article looks at one of the muscles known as the palmaris longus, how trigger points affect the hand muscles, and various techniques to manage trigger points along the palmaris longus muscle. We refer patients to certified providers specializing in hand and wrist pain therapies to provide aid to individuals suffering from trigger point pain associated with the palmaris longus muscles located on the hand. We also guide and inform our patients by referring them to our associated medical providers based on their examination when appropriate. We established that education is a great solution to asking our providers profound questions the patient requests. Dr. Jimenez DC takes note of this information as an educational service only. Disclaimer
What Is The Palmaris Longus Muscle?
Have you been dealing with numbness in the palm of your hands? Have you been experiencing issues holding items for an extended period? Or do your wrist and forearm ache constantly? If you have been experiencing these overlapping issues, it could be the development of trigger points along the palmaris longus muscle. The palmaris longus is a small muscle located on the front of the forearms and extends down from the wrist to meet with the rest of the muscles and tendons of the hands. The palmaris longus also connects to the roof of the carpal tunnel bones, where the median nerves and digital flexors tendons reside and provide movement. According to Dr. Janet G. Travell, M.D.’s book, “Myofascial Pain and Dysfunction: The Trigger Point Manual,” the palmaris longus muscle function is to flex the hands at the wrist while being able to tense the palmar fascia. Studies reveal that the palmaris longus muscle flexes the wrist weakly as an accessory muscle and abducts the thumb for mobility. This muscle is also prone to injuries as it can develop pain-like symptoms along the wrist and the palm of the hands.
How Trigger Points Affect The Hand Muscles?
When the palmaris longus muscle succumbs to injuries, it can develop chronic issues that can cause pain in the wrist and hands. One of the chronic issues that can affect the hand muscles and the rest of the forearms is trigger points. Trigger points can lead to the development of referred pain along the forearms, wrists, and hands. To that point, trigger points can mimic overlapping chronic conditions along the affected muscle area. So when trigger points begin to affect the palmaris longus muscle, the pain-like symptoms can mimic carpal tunnel syndrome. Now studies reveal that the palmaris longus muscle is connected to the median nerve and the pathophysiology of carpal tunnel syndrome is more likely to interplay between anatomic and systemic factors. This causes the median nerve root to become compressed, thus causing pressure and pain to the hands. To that point, trigger points in the palmaris longus muscle may be activated by direct trauma. Some examples that can cause the development of trigger points are:
Gripping tools too tightly
Leaning on a cane
Holding a tennis racket at the end of the handle
Falling and landing on the hands
Many of these actions can result from overusing and causing issues in the palmaris longus muscle, leading to unwanted pain and muscle injury symptoms.
Trigger Points On The Palmaris Longus-Video
Are you experiencing any numbing sensations in the palm of your hands? What about feeling the symptoms of carpal tunnel syndrome along your wrist? Or have you experienced aches and pain along your forearms? Some of these symptoms correlate with the development of trigger points along the palmaris longus muscle. The palmaris is a small muscle in front of the forearms and travels down to the wrist to connect with the rest of the muscle tendons of the hands. When traumatic events begin to affect and injure the palmaris longus, it can develop trigger points and cause pain to radiate down to the wrists and hands. The video above explains where the palmaris longus muscle is located and how trigger points activate pain-like symptoms that mimic chronic conditions like carpal tunnel syndrome. Studies reveal that when the median nerve (which is connected with the palmaris longus muscle) is being entrapped, causing trigger points to mimic carpal tunnel syndrome symptoms. Alas, all is not lost, as there are various techniques that many people can utilize to relieve pain from the palmaris longus muscle and manage trigger points from developing further.
Various Techniques For Managing Trigger Points On The Hand Muscles
When it comes to managing trigger points on the hand muscles and palmaris longus muscle, many people will incorporate various remedies to reduce the pain-induced inflammation on the affected muscle and manage trigger points from causing more issues in the affected muscles. Treatments like massaging the forearm to the hands can help release trigger points from the palmaris longus muscle. Granted, there will be involuntary twitching, but the results prevent future trigger points from forming the muscle. Another technique is placing a heating pad on the forearm to relax the tense muscles and reduce pain. And finally, gentle stretches and reducing a tight grip can prevent hyperirritability on the palmaris longus muscle and strengthen the muscles that are connected with the palmaris longus muscle.
Conclusion
Regarding the body, the hands have a very important function as they provide grip strength and have a great relationship to the wrist and forearms. The palmaris longus muscle is a small band in front of the forearms and connects to the various muscles and tendons of the wrists and hands. When traumatic injuries affect the palmaris longus muscle, it can develop trigger points correlating with carpal tunnel symptoms. When trigger points affect the palmaris longus muscle, it can cause symptoms of pain and numbness in the wrist and hands, causing a person to lose their grip strength. Thankfully, various techniques to manage and treat trigger points can reduce the pain quality on the forearms and wrist while bringing the grip strength back to the hands.
References
Boltuch, Andrew D, et al. “The Palmaris Longus and Its Association with Carpal Tunnel Syndrome.” Journal of Wrist Surgery, Thieme Medical Publishers, Inc., Dec. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7708024/.
Cooper, David W, and Bracken Burns. “Anatomy, Shoulder and Upper Limb, Hand Palmaris Tendon.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 3 Sept. 2021, www.ncbi.nlm.nih.gov/books/NBK519516/.
Ioannis, Dimitriou, et al. “Palmaris Longus Muscle’s Prevalence in Different Nations and Interesting Anatomical Variations: Review of the Literature.” Journal of Clinical Medicine Research, Elmer Press, Nov. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4596262/.
Meder, Marek A, et al. “Reliability of the Infraspinatus Test in Carpal Tunnel Syndrome: A Clinical Study.” Journal of Clinical and Diagnostic Research : JCDR, JCDR Research and Publications (P) Limited, May 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5483796/.
Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 1:Upper Half of Body. Williams & Wilkins, 1999.
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