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Trigger Point Therapy - Palmaris Longus

Posted by Judith Winer on

Palmaris Longus Trigger Points

Palmaris Longus - Common Trigger Point Site


Pain from the palmaris longus is experienced as a needle-like sensation

The Palmaris Longus decelerates extension of the hand at the wrist while decelerating supination of the hand against gravity and extension of the forearm at the elbow.

A focal point of pain from the palmaris longus is experienced as a needle-like sensation, rather than the deep aching pain of myofascial trigger points in many other muscles. Pain can extend to the base of the thumb and the distal crease of the palm. A residue of this pain can travel to the distal volar forearm.

Part of the superficial layer, which also includes the pronator teres, flexor carpi radialis, and flexor carpi ulnaris. The palmaris longus muscle is absent in 13% of the population.


Common flexor origin on anterior aspect of medial epicondyle of humerus.


Superficial (front) surface of flexor retinaculum and apex of palmar aponeurosis.


Flexes wrist. Tenses palmar fascia. Antagonists: extensor carpi radialis brevis, extensor carpi radialis longus, extensor carpi ulnaris.


Median nerve, C(6), 7, 8, T1. BASIC FUNCTIONAL


Examples: grasping a small ball; cupping palm to drink from hand.


Palmaris Longus Trigger Points Pain Map

Palmaris Longus - Typical Referred Pain Pattern


Trigger Point Referred Pain Patterns

Diffuse pain in anterior forearm; intense pain zone 2–3 cm in palm of hand, surrounded by a superficial zone of prickling and needle-like sensations.


Pain and “soreness” in palm of hand, tenderness in hand/palm, functional loss of power in grip, tennis elbow.


Direct trauma (e.g. fall on outstretched arm), occupational, racquet sports, digging in palm.

Differential Diagnosis

Neurogenic pain. Dupuytren’s contracture. Carpal tunnel syndrome. Complex regional pain syndrome (reflex-sympathetic dystrophy). Scleroderma. Dermatomyositis.


Flexor carpi radialis, brachialis, pronator teres, wrist joints (carpals), often associated with middle head of triceps brachii.

Self Help

Self-massage techniques can be helpful, especially using balls.


Avoid prolonged “gripping,” especially of power tools. Stretching and heat. Regular breaks.

Trigger Point Treatment Techniques

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











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. 




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