Flexor Carpi Radialis

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The Flexor carpi radialis is a superficial anterior muscle of the forearm.

Anatomical Attachments:

• Origin: Attaches to the medial epicondyle of the humerus, and the fascia of the forearm.
• Insertion: Attaches to the base of the 2nd and 3rd metacarpals.

Action: Flexes the wrist, aids in pronation and abduction of the hand, in addition to forearm adduction.

Synergist: Flexor carpi ulnaris, Palmaris longus.  

Antagonist: Abductor pollicis longus, Flexor digitorum superficialis and profundus, Flexor pollicis longus.

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Nerve Supply: Median Nerve (C6, C7).

Nerve Entrapment: Entraps the ulnar nerve.

Vascular supply: Muscular branches of the radial artery.

• Primary: The pain refers to the lateral aspect of the volar crease of the wrist into the forearm and the palm.
• Satellite or associated triggers: According to Travell and Simons, frequently, triggers within this muscle are activated secondarily, to primary active TrPs in the Pectoralis minor and Scalenes, or as a result of a cervical nerve compression. The Flexor carpi radialis can develop independent triggers especially observed following significant trauma to the elbow.

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Trigger Point Signs and Symptoms: Pain during activities requiring gripping and wrist flexion.

Trigger Point Activating and Perpetuating Factors: Persistent or sustained gripping with wrist flexion, e.g. a person seated with their hands cupped over the ends of the arm of a chair; skiers, as a result of gripping poles or handles; construction workers who use hand tools, which are either heavy or has persistent vibration such as jackhammers, saws and drills.

Differential Diagnosis: Medial epicondylitis, Ulnar neuropathy, Subacute meningitis or Peripheral neuropathy, Dupuytren’s contracture, Polyneuropathy, Carpal tunnel syndrome, Fibromyalgia, Charcot’s arthropathy, Rheumatoid arthritis, Osteoarthritis of wrist, Systemic Lupus Erythematosus, (Segmental, Subluxation, Somatic dysfunction) C5 or T1 Radiculopathy, Cubital tunnel syndrome, Diabetic neuropathy, Raynaud’s Phenomena, Raynaud’s Disease, Complex regional pain syndrome (Reflex sympathetic Dystrophy), Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication.

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