Small Muscles of the hand - How to treat "triggers"? | Niel Asher Education Blogs and Articles blog

Hand Muscles and Trigger Points - Dry Needling

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Small Hand Muscles

Latin dorsum, back; interosseus, between bones; lumbricus, earthworm; abducere, to lead away from; digitus, finger; minimi, smallest

Comprising: dorsal interossei, lumbricales, and abductor digiti minimi. The four dorsal interossei are about twice the size of the palmar interossei.

The lumbricales are composed of small cylindrical muscles, one for each finger. The abductor digiti minimi is the most superficial muscle of the hypothenar eminence.

Origin

Dorsal interossei: by two heads, each from adjacent sides of metacarpals.
Lumbricales: tendons of flexor digitorum profundus in palm. Abductor digiti minimi: pisiform bone. Tendon of flexor carpi ulnaris.

Insertion

Dorsal interossei: into extensor expansion and to base of proximal phalanx.
Lumbricales: lateral (radial) side of corresponding tendon of extensor digitorum, on dorsum of respective digits.

Abductor digiti minimi: ulna (medial) side of base of proximal phalanx of little finger.

Action

Dorsal interossei: abduct fingers away from middle nger.
Assist in flexion of fingers at metacarpophalangeal joints.

Antagonist: palmar interossei. Lumbricales: extend interphalangeal joints and simultaneously flex metacarpophalangeal joints of fingers.

Abductor digiti minimi: abducts little finger.

Nerve

Dorsal interossei: ulnar nerve, C8, T1.
Lumbricales: lateral—median nerve, C(6), 7, 8, T1; medial—ulnar nerve, C(7), 8, T1.

Abductor digiti minimi: ulnar nerve, C(7), 8, T1.

Basic Functional Movement

Examples: spreading fingers; cupping hand; holding a large ball.

Hand Muscle Trigger Points

hand Muscle Trigger Points

Referred Pain

1st dorsal interossei: strong finger pain in dorsum of index finger (lateral half), with vague pain on palmar surface and dorsum of hand.

Other dorsal interossei: referred pain to specific associated finger. Lumbricales: pattern is similar to interossei.

Abductor digiti minimi: pain in dorsum of little finger.

Indications

Finger pain/stiffness, pain when pinching/gripping, associated with Heberden’s node(s) - (e.g. in professional musicians, especially pianists), “arthritic” finger pain, also seen in artists/sculptors, Bouchard’s nodes (middle knuckles).

Causes

Repetitive grasping, occupational, computer mouse, post wrist fracture and/or splinting, grasping, carrying shopping, typing, massaging, fine handiwork (e.g. writing, sewing, knitting, artwork, painting, airbrushing), playing musical instruments (e.g. piano, violin, guitar), sports (e.g. golf, archery, fencing).

Differential Diagnosis

Cervical radiculopathy. Ulnar neuritis. Thoracic outlet syndrome. Digital nerve entrapment. Articular dysfunction.

Connections

Intrinsic thumb muscles, scalenes, latissimus dorsi, long finger flexors/ extensors, pectoralis major, lateral/ medial head triceps brachii.

Self Help

Self-massage/pressure techniques can be really helpful. Simply locating trigger points and pressing with other thumb can be enough; remember to hold trigger point until it softens.

Alternatively, a range of pressure devices can be used, or even a pencil with a rubber (never use the "sharp" end!).

General Advice

Take a break from repetitive activities and stretch out. Stretching and exercising. Examine work postures/ergonomics. Explore sporting activities (e.g. grip in golf). Use of ergonomic pens/cutlery.

Common Techniques

Spray and Stretch	YES
Dry Needling	YES
Deep Stroking Massage	YES
Compression	YES
Muscle Energy	YES
Positional Release	YES
Wet Needling	YES

Links

Find a Trigger Point Professional in your area

More Articles About Psoas Trigger Points

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This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell.