Hand Muscles and Trigger Points - Dry Needling
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.
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.
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.
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.
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.
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.
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).
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).
Cervical radiculopathy. Ulnar neuritis. Thoracic outlet syndrome. Digital nerve entrapment. Articular dysfunction.
Intrinsic thumb muscles, scalenes, latissimus dorsi, long finger flexors/ extensors, pectoralis major, lateral/ medial head triceps brachii.
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!).
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.
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