Muscles
Extensor Digitorum Trigger Points
Symptom Area: Forearm and Hand
Extensor Digitorum Trigger Points are explored here through their location and referred pain pattern. Muscle knots is an everyday term used for tender muscular spots; myofascial pain describes pain involving muscle and its surrounding connective tissue. Extends the fingers and assists wrist extension.
Where you feel it
When the Extensor Digitorum holds active trigger points, you usually notice it as dorsal finger pain, lateral epicondylar pain and painful weak grip. Where the pain spreads: Dorsum of the hand and into the middle three fingers. What often sets it off: Keyboard use, racquet sports, sustained gripping.
Overview
Extends the fingers and assists wrist extension. Trigger points here are common in everyday and athletic populations and frequently contribute to the referred pain patterns described below.
Trigger point locations
Dorsal forearm along the middle third.
Referred pain pattern
Dorsum of the hand and into the middle three fingers.
Palpation & testing
Palpate the muscle belly along its accessible course. Reproduction of the patient's familiar pain on palpation supports involvement.
Common causes
Keyboard use, racquet sports, sustained gripping.
Self-care & clinical treatment
Eccentric finger extension, hand stretches. Clinically: needling.
Treatment protocol
For Extensor Digitorum, the general protocol applies: sustained pressure release on the taut band, then stretch and active movement in the newly gained range.
Position and palpation: Palpate the muscle belly along its accessible course.
Regional precaution for clinicians: In the forearm and hand the median nerve at the pronator teres, the ulnar nerve at the cubital tunnel and Guyon's canal, the radial nerve in the supinator arcade and the radial artery at the wrist are all superficial and must be avoided; needles are short and angled away from the neurovascular bundles.
Primary Symptoms
Secondary Symptoms
Often confused with
These muscles cause the same primary symptoms, so they are checked together:
Related muscles in this region
Related articles
- A grip that hurts and gives way: forearm trigger points
- Tennis elbow that will not heal: the trigger points behind outer elbow pain
- Lateral Epicondylar Pain: which trigger points cause it and how to treat them
- Dorsal Finger Pain: which trigger points cause it and how to treat them
- Painful Weak Grip: which trigger points cause it and how to treat them
References
- • Travell & Simons — Myofascial Pain and Dysfunction
- • Effectiveness of dry needling for upper-quarter myofascial pain: a systematic review and meta-analysis — J Orthop Sports Phys Ther 2013;43(9):620-34
- • The effectiveness of trigger point dry needling for musculoskeletal conditions by physical therapists: a systematic review and meta-analysis — J Orthop Sports Phys Ther 2017;47(3):133-49
- • Effectiveness of trigger point dry needling for multiple body regions: a systematic review — J Man Manip Ther 2015;23(5):276-93
- • A systematic review of manual therapy techniques, dry cupping and dry needling in the reduction of myofascial pain and myofascial trigger points — J Bodyw Mov Ther 2019;23(3):539-46
- • Physiologic effects of dry needling — Curr Pain Headache Rep 2013;17(8):348
- • Trigger point dry needling for the treatment of myofascial pain syndrome: current perspectives within a pain neuroscience paradigm — J Pain Res 2019;12:1899-911
- • Myofascial trigger points then and now: a historical and scientific perspective — PM R 2015;7(7):746-61
- • Pertinent dry needling considerations for minimizing adverse effects — Int J Sports Phys Ther 2016;11(5):651-62
- • Adverse events associated with therapeutic dry needling — Int J Sports Phys Ther 2020;15(1):103-13
- • Lidocaine injection versus dry needling to myofascial trigger point: the importance of the local twitch response — Am J Phys Med Rehabil 1994;73(4):256-63
- • Myofascial Pain and Dysfunction: The Trigger Point Manual (2nd ed.) — Williams & Wilkins, Baltimore
Medically reviewed by: Marco Aruffo — physiotherapist since 2006, specialised in myofascial pain · Last reviewed:
