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Pain referral
Trigger points
Cranial nerve
Spinal nerve
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The Lumbricals are muscles of the hand.
Anatomical Attachments: Action: Flex the fingers at the MP joints and extend the 2 distal phalanges.
Nerve Supply: Median nerve (C6, C7) innervates the two (2) radial fingers; Ulnar nerve (C8) innervates the two (2) ulnar fingers.
Nerve Entrapment: Entrap the digital nerves that cause cutaneous hypoesthesia along side of the finger
that is affected.
Vascular supply: The superficial and the deep volar arches artery.
Trigger Point Signs and Symptoms: Pain or stiffness of the fingers, impairment of hand motion and tenderness of the joints.
Trigger Point Activating and Perpetuating Factors: Repetitive pincer grasp; knitting, coloring, drawing or writing for long periods of time.
Differential Diagnosis: (Segmental, Subluxation, Somatic dysfunction) C6 radiculopathy, Ulnar neuropathy, C8 or T1 radiculopathy, Thoracic Outlet Syndrome, Articular Dysfunction, Carpal tunnel syndrome, De Quervain’s stenosing tenosynovitis, Carpometacarpal dysfunction, Osteoarthritis, Paronychia (Ingrown fingernail), Bone cancer, Bone fracture, Strain/Sprain, Rheumatoid Arthritis, Dupuytren’s Contracture, Ganglion cyst, Mixed Connective Tissue Disease, Raynaud’s Phenomenon, Frostbite, Diabetic Neuropathy, Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication.
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Pain referral
Trigger points
Cranial nerve
Spinal nerve
Historical
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Lumbricals
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Travell and Simons Trigger Point Pain Referral: