Two common and MISTAKEN diagnoses involving the arm and hand

This is just a little summary from a book that I’m reading, The Trigger Point Therapy Workbook, written by Clair Davies and Amber Davies.

Two common but unfortunately mistaken diagnoses concerning the arm and hand are carpal tunnel syndrome and lateral epicondylitis- a.k.a. tennis elbow.

Often, the cause of pain in your arms and hands is due to trigger points in the scalenes (neck muscles), brachialis, and muscles of the forearm. When worse pain is experienced, all the muscles of the neck, upper back, shoulder, arm, and hand may be involved and require therapeutic attention by use of trigger point therapy. Carpal tunnel syndrome is experienced when the passageway through which nerves and tendons passing through the wrist are restricted. These restrictions can be due to swelling of the muscles or other restrictions, such as impingement in the thoracic outlet. When the nerve that travels through the thoracic outlet is impinged, one may have carpal tunnel symptoms. The nerve and blood vessels pass behind the collarbone and go up and down the arm. When impinged, the return of blood and lymph flow is impeded, and can cause swelling. This causes carpal tunnel symptoms, and surgery for this may be recommended. The surgery may help somewhat, but it doesn’t help the real cause which is in the thoracic outlet.

When trigger points are present, the thoracic outlet’s size is smaller due to shortened scalene (neck) muscles.  Often the problem of tingling or numbness in the hands and feet is merely named “peripheral neuropathy”. This doesn’t help the problem. The root cause of pain is pressure on the nerves that pass between the collarbone and first rib, often a side-effect of having tight scalenes. Other muscles such as the pectoralis minor, triceps, brachialis, and a select few of the forearm muscles can also cause compression of the forearm.

Tightness in muscles that cause problems such as these are usually caused by trigger points that are located throughout the muscle. They are extremely common tender points and are the sources of pain and they cause the muscle to even shorten, causing a variety of issues and making the problem worse over time.

I’ve read that the root of most problems involving the neck, arms, and hands is tightness of the scalene muscles. It’s wise to check these for trigger points first. Often, the scalenes may hold trigger points that can cause secondary trigger points in the chest, shoulder, and down rhe arm, not helping the situation.

The diagnoses of tennis elbow, or lateral epicondylitis, may be the wrong one unless you have suffered from an obvious physical injury. The diagnoses has reviews of having suffered microscopic tears by overuse or injury. In my research and reads by Davieses, I have dicovered that they are in agreement with Travell and Simmons and think that trigger point in the forearm cause pain and weakness in the elbow. Other muscles can contribute to this pain. When trigger point massage helps this situation, the tendinitis can simply be ruled out. (1999, 736)

When it’s apparent that trigger points exist, rest isn’t the best therapy. It may put the trigger points into a latent state, not ridding one of them. When the original activity and pain are resumed, they’re not gone. Inactivity such as rest may cause stiffness in the forearm muscles, perpetuating the trigger points and therefore pain.

If one tries to stretch the pain away , without first treating the sole problem that trigger points cause, the situation can be just as bad. A stretch for a weakened elbow is ineffective because the present and active trigger points are trying to protect the muscle from more abuse. Once the trigger points are treated, stretches are possible again.

Inner elbow pain, golfer’s elbow, is caused by trigger points in a different set of muscles. It’s a less common condition than tennis elbow. Golfer’s elbow can be caused by golfing, but is more commonly caused by overexcercise, workplace abuse, etc. When troubleshooting these problems, be thorough and mindful of these two sets of muscles.

There is a trigger point therapy guide presented in this book, The Trigger Point Therapy Workbook. This is something that can be referred to when treating their own muscles. Please keep in mind of the way that you’re massaging youself and arms, as you don’t want to stress the muscles out even more.                        When massaging your arms, one wants to avoid using one’s fingers working in opposition with the thumbs.

Picture taken from the workbook

When you give support to your fingers and thumbs with the opposite hand, you are working in a safer manner for your arms and hands. Having short nails will help to massage in a more relaxed way.  With the help of a tennis or lacrosse ball against the wall, you can treat the trigger points on your own. The ball isn’t as sensitive as one’s fingers, but it remains a useful tool however.

Picture taken from workbook

The knobble can be used to apply pressure to the thick forearm muscles. The use of a knobble should be applied with the force coming from the shoulder and held loosely with the hand. Use the knobble through a layer of cloth instead of on bare skin.

Picture taken from workbook

Here’s a few examples from the workbook concerning working on your own forearms…

Picture taken from workbook
Picture taken from workbook

If you have been diagnosed with carpal tunnel or tennis elbow or know someone who has, this therapy can help. It’s not a cure all, and I recommend going to the physician when it’s necessary. But, pain is not convenient for anyone, and I hope that this information can empower anyone suffering from trigger points. Many a times, that’s where the pain is coming from. Eliminate it!!!

Published by Ashleigh Moon

Hello, I am a massage therapist and I live in Gray, TN.. I love working with others and helping them on their healing journey.

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