Do you experience hand, wrist, or arm pain? Tingling or numbness? Whether we spend our days typing at a computer, or (if we’re lucky) playing golf or tennis, this is a fairly common complaint on my massage table.
Many people think that pain in any of these areas is caused by Carpal Tunnel Syndrome (CTS). In my 12+ years as a medical massage therapist, I’ve only had one client with these symptoms who was truly suffering from CTS. I’ve successfully treated every other client exhibiting hand, wrist and/or forearm pain with trigger point therapy, neuromuscular therapy, and myofascial work.
what are trigger points?
Let’s talk about what trigger points are – they’re tiny, contracted “knots” in muscle tissue. They maintain constant tension in a small band of a muscle, restricting circulation in that area and putting strain on the muscle’s attachments. They’re often caused by muscle injury or repetitive strain. Common causes are car accidents, sports injuries, or repetitive motion inuries such as extensive typing. The tricky part of working with trigger points is that they typically refer pain to another area, while not exhibiting pain in the actual injury site.
a common example of trigger point referral is whiplash
When you develop trigger points in your scalene muscles (along the front and side of the neck), usually from a car accident, ski or bike crash, or any other injury which causes your head to “whip” back, it’s because a minuscule section of the muscle will sometimes fail to release after the injury. That section remains contracted, and over time will recruit other muscle fibers around it. As it grows, it can refer pain into the upper chest, the outer arm, forearm, hand, and/or mid-back.
When clients come in with forearm or hand pain, this is often the cause. There are other trigger points that can cause pain in this area as well, such as in the subscapularis muscle referring into the wrist, or trigger points in the forearm muscles themselves caused by overuse (think typing, golf, or tennis).
identify the root cause of your pain
When I’m working with a client with pain in the arm, wrist, or hand, I typically work the painful area first to rule out tendonitis and other issues. I then start working “upstream” above the sore area to identify which muscles are the culprits. I pinpoint the tight spots and work to lengthen them using a combination of trigger point therapy, neuromuscular therapy, and myofascial work.
Typically, they’ll feel tenderness in the spot that’s been bothering them, but when I get up to the neck and start working the scalene muscles, the client will mention that they can feel their pain pattern flaring up. These painful referrals into the arm & hand can also come from trigger points in the upper chest and even the rotator cuff muscles.
Bottom line – if you’re feeling pain, tingling, or numbness in your arm, wrist, or hand, go see a good massage therapist or physical therapist who is experienced in working with trigger points. It may take a few sessions to identify the root cause, but once it’s found it’s a matter of time before your pain is gone.