Wrist, Hand, and Finger Pain

Usual Suspects:

  1. The muscles of the forearm
  2. The muscles and other structures of the wrist, hand, and fingers
  3. The muscles of the upper arm
  4. The muscles of the upper back
  5. The muscles of the front of the neck
  6. The muscles of the chest and side
  7. The vertebrae (spinal bones) and discs of the neck

The Imbue Pain Relief Patch temporarily relieves minor aches and pains of muscles and joints. In the diagrams below, the X’s show the locations of common trigger points (localized muscle strain), and the colored shading shows the pain pattern each trigger point produces. This pain is often several inches (or more) away from the trigger point at which it originates. If application of the Imbue Patch directly to the knee does not significantly improve your pain, applying the Imbue Pain Relief Patch at the site of strain in nearby muscles sometimes yields better results.

Pain in the wrist, hand, and fingers occasionally stems from a local problem – arthritis of the wrist or finger joints, sprain of a ligament of the wrist or a finger, strain or other trauma to the muscles of the hand, etc., and it is worth applying the Imbue Pain Patch directly to the site of pain at first. However, as you can see from the list of usual suspects above, pain in this area can also come from a wide range of other places, which are worth investigating when local treatment doesn’t yield satisfactory results. The good news is that most of it starts with muscle strain in the forearm, an area that is easy to feel and relatively easy to treat. What doesn’t originate locally or in the forearm tends to come from somewhere else “upstream” – that is, the upper arm, the upper back, the chest, side, and neck.

 

Wrist/Hand/Finger Pain Due to the Muscles of the Forearm

There are many muscles in the forearm that are capable of producing pain in the wrist, hand, or fingers. (Some of this long list includes: supinator, extensor carpi radialis longus, extensor carpi radialis brevis, brachioradialis, flexor pollicis longus, palmaris longus, pronator teres, pronator quadratus, flexor digitorum, and flexor carpi ulnaris.) You don’t need to know the names of the muscles in order to figure out where the pain is coming from. You just need to be thorough about feeling your forearm.

When wrist, hand, or finger pain comes from the forearm muscles, it almost always originates in the upper third of these muscles, where they are the most meaty. The X’s in this diagram show some common trigger points, with each of the different colors representing a different muscle. Each of the different colors of shading shows the pain pattern produced by the X of the same color.

Thus, the trigger point at the yellow X, just down from the middle of the inside elbow crease, can produce pain at the inside of the wrist at the thumb side; the green and orange X’s produce pain near the web between the thumb and index finger, and so on.

There are many more possible trigger point locations in the forearm, capable of producing pain in any part of the wrist, any part of the hand, and in any of the fingers. Generally (though not always), trigger points on the inside (that is, the paler, hairless side) of the forearm tend to produce pain on the inside of the wrist and the palm side of the hand and fingers. Likewise, trigger points on the back (that is, the darker, hairier side) of the forearm usually (but not always) produce pain on the back of the wrist and the back surface of the hand and fingers. We recommend just examining your whole forearm, especially because trigger points don’t always occur exactly where they appear on a diagram.

Try following a series of parallel lines, as shown in this diagram. Press firmly with your thumb or curled fingers, starting at the elbow and working down to the wrist. Then, shift over slightly and work down the next line, eventually going the whole way around the arm. Pay close attention to points that are significantly tender. You may wish to mark them with a pen. Massage any tender spots you find, pressing them firmly and slowly sliding your fingers or thumb downward, toward your hand. You may also try pressing a tender spot firmly while rotating your hand back and forth repeatedly. Then apply the Imbue Pain Relief Patch.

 

Wrist/Hand/Finger Pain Due to the Structures of the Wrist, Hand, and Fingers

If you have a history of trauma to some part of your wrist or hand, or have a known diagnosis of arthritis, sprain, or other mechanical problem in this area, by all means, use the Imbue Pain Relief Patch right where it hurts (always cover an area larger than the painful area, and don’t apply over broken skin). However, it is still worthwhile to check the other areas covered in this article. Untreated trigger points might be contributing significantly to the problem. In particular, Carpal Tunnel Syndrome is quite likely to be an incorrect diagnosis, and further investigation must be done.

Occasionally, hand, wrist, and finger pain are due to trigger points in the muscles of the hand. We should always be glad to discover that this is the cause of our pain, since muscular strain is easier to treat and less serious than, say, arthritis. The muscles involved are those that occur between the hand bones (interosseous muscles or interossei) and those in the fleshy mound at the base of the thumb.

Interosseous Muscles:

These muscles are located between the long bones of the hand. There are 4 “dorsal” muscles – closer to the back of the hand – and 3 “palmar” muscles – closer to the palm side of the hand. This diagram of the back of the hand shows the dorsal interosseous muscles, which have a greater tendency to cause problems. The blue X’s show trigger points in the first muscle, which forms a mound when you close your thumb against your index finger. When these trigger points are active, they can produce pain over much of the back of the hand and also down the index finger and pinky. Press firmly throughout the web area between the thumb and index finger, including against the side of the hand bone (the bone between the blue X’s and the yellow X). The yellow, green, and white X’s show trigger points in the second, third, and fourth dorsal interossei. Press firmly between every two hand bones, feeling the whole space from the wrist to the web between the fingers. You will probably feel tendons move out of the way as you press. It is likely that you will feel some tender spots; they are usually only worth treating if they produce pain into the fingers or are quite tender. In this case, do some massage and apply the Imbue Pain Relief Patch here. The red X at the side of the hand is in a different muscle (abductor digiti minimi), which can produce pain into the pinky. If you are experiencing pinky pain and pressing on this point reproduces (or alleviates) the pain, apply the Imbue Patch here.

Muscles of the Palm:

The main trigger points that occur on the palm are all near the base of the thumb and index finger. The blue X in this diagram is in another of the interosseus muscles. When irritated, it’s capable of producing pain in the area of the blue shading. The red X (in adductor pollicis) shows a trigger point capable of producing the pain pattern indicated by red shading. This includes the base of the thumb and the thumb itself. As you can see on the back side diagram, this pain radiates through to the other side. A trigger point in the vicinity of the green X (opponens pollicis) can produce pain at the thumb side of the wrist and also along the edge of the thumb. Press firmly throughout this entire region, searching for tender points that produce (or alleviate) the same pain you have been experiencing. If you find any likely spots, massage them and apply the Imbue Pain Relief Patch here.

 

Wrist/Hand/Finger Pain Due to the Muscles of the Upper Arm

Strain of the muscles of the upper arm can sometimes refer pain down to the wrist, hand, and fingers. Three muscles are commonly involved – triceps, brachialis, and coracobrachialis. Let’s explore them.

Triceps Brachii:

The triceps is a three part muscle that covers the back of the upper arm. Trigger points in triceps can cause pain that radiates up the arm into the back of the shoulder, and also down to the elbow, forearm, and hand. The X’s in this diagram show a few of the common locations of triceps trigger points. The one we are concerned with is the orange X, just above the back of the elbow, which is capable of producing pain down the back of the forearm and into hand, the ring finger, and the pinky. Keep in mind that this point is on the inside of the triceps muscle, sometimes closer to the front than the back. Here it is pictured a bit more toward the back than it tends to be. If this seems to fit your pain pattern, look for points of significant tenderness is this area. If you find any, especially if they reproduce your pain pattern, do some massage here and apply the Imbue Pain Relief Patch.

 

Coracobrachialis:

Coracobrachialis is a small, thin muscle located on the inside of the upper arm between the biceps and the triceps. The X in the diagram shows its general location. To actually find this muscle, you need to reach into your armpit with your (opposite) thumb, and feel along the upper end of the arm bone. While doing this, if you pull the tip of your elbow to your side, you should feel the coracobrachialis tighten. The red shading in the diagram shows the pain pattern this muscle can produce. Besides the nearby pain at the front of the shoulder, it may extend down the back of the upper arm, forearm, hand, and sometimes into the middle finger. If you find tenderness here, and especially when your pressure reproduces the pain you have been experiencing, gently massage this muscle and apply the Imbue Pain Relief Patch. Check after an hour or two to be sure the sensitive skin in this area is not becoming irritated by the herbs in the patch.

Brachialis:

Brachialis covers the lower half of the front of the arm bone (humerus), and it’s responsible for most of the work of bending the elbow. It’s partly hidden under the biceps (the primary muscle of the front of the arm). When it is irritated, it frequently causes pain (sometimes a numb sort of pain) at the base of the thumb. (It also has the potential to cause some aching at the outside of the upper arm, near the elbow.) If you experience discomfort in this region, feel for the brachialis under the outside of the biceps, just above the elbow. Push the biceps aside to get underneath it, feeling against the bone and working your way from the elbow to about halfway up the arm. The X’s in the diagram show the likely location of trigger points in this muscle, and the red shading shows the pain it produces in the thumb region. If you find a tender spot that reproduces your pain (or alleviates it), massage this area and apply the Imbue Pain Relief Patch here.

 

Wrist/Hand/Finger Pain Due to the Muscles of the Front of the Neck

The scalenes muscles, a group of three (sometimes four) bands on the front/side of the neck, can cause very unusual patterns of pain (sometimes a burning pain, tingling pain, or numb pain) in the arms, hands, chest, and back (see red shaded regions on diagram). People almost never suspect them because there is rarely discomfort at the muscle itself (except when pressed). The scalenes are fairly unpleasant to have massaged, but when they are implicated in pain, getting them to relax can yield profound results.

The scalenes are partly buried underneath the sternocleidomastoid (SCM). This diagram shows the SCM in red, which is easily visible through the skin. (If you press your hand on one cheek and try to turn your head against it, the SCM will pop out on the side you’re turning away from.) The scalenes are shown in yellow and are only partly visible. The blue area is muscles of the back and shoulder.

Start by pressing just above the middle of your collar bone on the side that you have pain on. Then gradually work your way toward the front of the neck where you will feel a superficial band of muscle (SCM), which lies on top of the scalenes. Then begin working your way up the neck, pushing the SCM aside, pressing instead on the harder deeper muscle beneath. Next work back, going as far back as the very side of the neck. Try to cover the entire area in the red triangle in the lower diagram. Pay special attention to points that produce an unpleasant painful sensation that may travel to other areas – particularly to the hand and fingers. These are key spots for gentle self massage and placement of the Imbue Pain Relief Patch.

 

Wrist/Hand/Finger Pain Due to the Muscles of the Upper Back/Shoulder

The muscles of the upper back are sometimes implicated in wrist, hand, and finger pain. Usually you’ll be aware of some soreness in the upper back or shoulder area if this is the origin of your pain, but not always. The six back muscles involved include all four rotator cuff muscles of the shoulder – infraspinatus, which lies over lower portion of the shoulder blade, supraspinatus, which lies over the top of the shoulder blade, teres minor, which runs from the outside edge of the shoulder blade to the upper arm, and subscapularis, which connects the front surface of the shoulder blade to the upper arm – plus serratus posterior superior, under the inside edge of the shoulder blade, and finally latissimus dorsi, which covers most of the side aspect of the back. You don’t need to know the names of these muscles in order to find the origin of your pain; you just need to be thorough about feeling all of them. It doesn’t take long, and chances are, they could use the attention!

To find trigger points in these muscles, you will need either the help of a friend who can press on your back, or the use of a tool, such as a Thera Cane or a small, firm ball (a lacrosse ball is ideal, but a tennis ball is okay). If using a ball, lie on your back on the floor with your knees bent and feet flat. Place the ball under your back and roll slowly on it to apply pressure along the whole inside border of the shoulder blade. Alternatively, you can also place the ball between your back and a wall, and then slowly bend your knees to roll the ball up and down your back (see diagram). You may find the wall method allows for better control of the ball, though for using the ball as a massage tool, lying on it provides stronger pressure. Now, let’s look at these muscles in more detail.

Supraspinatus:

Supraspinatus runs from the upper surface of the shoulder blade through the shoulder joint and attaches to the top of the arm bone (humerus). It is somewhat hidden under other layers of muscle, so press deeply to feel all along the region just above a horizontal ridge of bone on the shoulder blade (the spine of the scapula). The X’s in the diagram show these trigger points and the red shading displays the supraspinatus pain pattern – which can extend down the back of the arm to the wrist. Raising the arm may be difficult and painful, and there may be popping or snapping sounds in the shoulder joint. If you discover significantly tender spots, especially if pressing on them either produces the pain you have been experiencing or makes it feel better, do some massage and place the Imbue Pain Relief Patch here.

Infraspinatus:

Infraspinatus, despite being a very easy muscle to access, is often overlooked, maybe because the bulk of it is on top of the shoulder blade, and people either don’t think to press on bone or believe it’s sore just because there’s bone beneath it. The X’s in this diagram show where the main infraspinatus trigger points occur (in the rather shallow, tight muscle that lies over the lower 2/3rds of the back of the shoulder blade). The red shading indicates the pain pattern this muscle can cause (not necessarily all at once).

Infraspinatus is one of the most epidemically cranky muscles in the human body. The infraspinatus joins the back of the shoulder blade to the top of the arm bone (humerus) and when it’s strained, it usually sends pain deep into the joint and into the front of the shoulder, sometimes also inhibiting shoulder movement (“frozen shoulder”). The pain can extend down the arm and forearm, to the wrist, hand, middle fingers and thumb. It occasionally radiates into the neck, too. Trigger points in infraspinatus may make it painful and difficult to reach behind the back. It is important to methodically press on the entire surface of the shoulder blade. If you discover significantly tender spots, especially if pressing on them either produces the pain you have been experiencing or makes it feel better, do some massage and place the Imbue Pain Relief Patch here.

Serratus Posterior Superior:

In this diagram, the X shows where primary serratus posterior superior trigger points occur (on top of the ribs, just next to or slightly underneath the shoulder blade) and the red shading shows the pain it is capable of producing. Serratus posterior superior connects the spine of the upper back to the ribs underneath the shoulder blade. When it is irritated, it can produce a dull ache under the shoulder blade, and can also refer pain (sometimes a numbing pain) to the back of the shoulder joint, the tip of the elbow, the back of the forearm, the outside of the wrist, the pinky side of the hand, the pinky, and sometimes even the chest directly in front of the muscle. If you discover significantly tender spots, especially if pressing on them either produces the pain you have been experiencing or makes it feel better, do some massage and place the Imbue Pain Relief Patch here.

Subscapularis:

Subscapularis is a tricky muscle to find and a painful one to work on, but it’s sometimes the key to alleviating wrist pain. This muscle is primarily attached to the front surface of the shoulder blade – the side that faces the back of the rib cage – and it connects to the upper arm. The red shading in the diagram shows the areas of pain this muscle is capable of producing, which includes the area over the shoulder blade, the back of the shoulder, the shoulder joint itself, the underside of the arm, and the wrist.

The black X on the left points to the edge of the shoulder blade where it’s possible with some digging to feel a bit of subscapularis. This is easiest when the shoulder blade is made to protrude beyond the side of the rib cage, which can be accomplished by bringing your arm across your chest and then using the thumb of the other hand to feel for the edge of the shoulder blade a bit below the armpit. Another way to get to it is to sit in a chair and slump over, so that your arm hangs down at your side. This also brings the shoulder blade out over the side of the rib cage. With the other hand, you can get your fingers or thumb into the tight space between the edge of your shoulder blade and the rib cage. You’ll know you’ve got it when you find some very tender spots.

Massaging these spots is usually unpleasant but if subscapularis is implicated in wrist pain, releasing tension here can provide almost immediate relief. You can use the Imbue Patch on this area, or to the region of the transparent X’s on the right side of the diagram, which show where trigger points tend to occur on this muscle (beneath the bone). Due to the muscle’s somewhat inaccessible location, the Imbue Patch is not always effective at alleviating pain that’s coming from subscapularis.

Teres Minor:

Teres minor is a small muscle that connects the middle of the outer aspect of the shoulder blade to the upper arm. It usually produces localized pain at the back of the upper arm, but it can also produce a “zinging” sort of pain in the ring finger and pinky. If you are experiencing discomfort in this area, press firmly around the outer edge of the shoulder blade (being sure to cover several inches in all directions). If you find tender spots that reproduce (or alleviate) the sensation in your fingers, do some massage and place the Imbue Pain Relief Patch here.

Latissimus Dorsi:

Latissimus dorsi is a large muscle covering much of the middle to lower back. It has many possible trigger point locations producing several different pain patterns. The one implicated in wrist, hand, and finger pain is located below teres minor, off the shoulder blade and over the ribs. The X in this diagram shows the general area of this trigger point, and the red shading shows the pain pattern it can produce. This pain is typically felt at the lower portion of the shoulder blade and back of the shoulder, but it can also spread down the back and inside of the upper arm, forearm, hand, and even into the ring finger and pinky.

Press firmly on the area just to the outside of the lower tip of the shoulder blade (feel a few inches in all directions). You can often feel this area directly by reaching through your armpit with the opposite hand and using your fingertips to press on the back of the rib cage, although you may wish to enlist the help of a friend, a ball, or a Thera Cane. Place the Imbue Patch wherever you find significant tenderness, especially when it produces (or alleviates) the wrist, hand, or finger pain you have been experiencing.

 

Wrist/Hand/Finger Pain Due to the Muscles of the Chest and Side

Though somewhat less common, tension in the muscles of the chest (pectoralis major and minor), under the collar bone (subclavius), and a muscle over the side of the rib cage (serratus anterior) can also cause pain, tingling, and numbness in the wrist, hand, and fingers.

Subclavius:

Subclavius means “under the collarbone,” which is where it is located. In this diagram of the muscles and bones of the chest and arm, the collarbone is shown in yellow and subclavius is blue.

For such a small muscle, subclavius can produce an impressively broad pain pattern. In the trigger point diagram, the X indicates the general area of subclavius trigger points and the red shading shows its potential pain (and/or numbness pattern). This includes the biceps, forearm, thumb, index finger, and middle finger.

Starting below the innermost end of the collarbone (where it joins with the sternum), push in and up, as if trying to get your thumb or fingers under the collarbone. Gradually work your way outward toward the shoulder. The most common site of subclavius trigger points is about at its midpoint (halfway between the center of the chest and the armpit). When you find a tender spot, massage and apply the Imbue Patch here. Be sure to use a large enough piece of the Patch to cover above and below the collar bone by a couple inches (as if trying to wrap it around the bone).

Pectoralis Major and Minor:

Pectoralis major, or simply “pec major,” forms the bulk of the musculature of the chest. Pec minor lies beneath pec major, and runs from a protrusion of the shoulder blade (the coracoid process) down to the upper few ribs. Trigger points in these muscles, which often result from exercise, overuse in work, carrying a backpack, or having slumped posture, can set up trigger points that produce pain in the chest, front of the shoulder, arm, forearm, the pinky side of the hand, and the middle finger, ring finger, and pinky. Pec minor frequently causes numbness of the hand and these fingers.

The red X’s in this diagram show common locations of trigger points in pectoralis major that are capable of causing pain in the forearm. The blue X’s show common sites of trigger points in pectoralis minor that may cause forearm pain. The green X at the side shows the general location of the most prominent serratus anterior trigger point (see below). Rather than feeling only in the approximate locations of the X’s in this diagram, it is best to press around the whole general area where these trigger points occur. If you find significant tenderness that radiates to the hand or fingers or alleviates your pain, do some massage on this area, look into what activities might be contributing to poor posture or strain of these muscles, and place the Imbue Patch on the problem area.

Serratus Anterior:

These diagrams show the finger-like shape of this muscle, which wraps around the side of the upper rib cage. Its main site of strain, shown at the X (approximately), produces pain mainly at the side, but which can also spill over to the mid back and down the arm. The blue shading indicates this arm pain pattern, which actually occurs along the inside (unseen) aspect of the arm. This kind of arm pain is usually a vague dull ache or numb pain. Start by feeling directly below the armpit at the most prominent rib, about 4 to 6 inches down. Then press methodically, covering several inches in all directions. If you find any points of significant tenderness, especially if they produce pain in the forearm when pressed, do some gentle massage and apply the Imbue Pain Relief Patch here.

Spinal Disorders of the Neck:

Dermatomes_and_cutaneous_nerves_-_posteriorWhile we cannot make any claims that Imbue will cure hand, wrist, or finger pain due to issues with the bones and discs of the neck, it is worth touching on this area as a possible cause (and the patch may nonetheless provide some amount of relief). Nerves exit the spinal cord at the level of each vertebra (spinal bones) and these provide sensation and movement to a certain segment of the body. The “spinal nerves” of the neck and upper trunk serve the arm, hand, and fingers. When problems of the spine, such as arthritis or a compressed disc (the rubbery “spacers” between vertebrae), lead to pressure on one of these nerves, symptoms can occur anywhere along the pathway it serves (the sensory pathway is called a “dermatome” and the movement – or motor - pathway is called a “myotome”). The chart to the left shows some of these bands, each of which is labeled for the vertebrae at which it originates. (For instance, C1 starts above the first cervical - or neck – vertebra; C2 starts below the first cervical vertebra; C3 starts below the second cervical vertebra; and so on, down to C8, which exits below the seventh cervical vertebra. Twelve spinal nerves exit below each of the twelve thoracic – trunk – vertebrae, labeled T1 – T12. Five exit below each of the five lumbar - lower back – vertebrae, labeled L1 – L5. Six more exit through the sacrum (S1 – S5) and coccyx – the “tailbone.”)

With a true bone or disc problem, we recommend seeing an acupuncturist, chiropractor, or osteopath (though be aware that many doctors of osteopathy don’t practice osteopathic medicine – ask first). Meanwhile, drink lots of water, practice good posture, and try an Imbue patch.

 

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