This is the beginning of a series on arm and hand pain which will include thumb pain, hand pain, finger pain, wrist pain, forearm pain and elbow pain. General physiological considerations will be reviewed that affect all of these conditions and syndromes. As a Neuromuscular Therapist practicing in the Metro West Boston area, I have treated many patients successfully with a variety of arm and hand pain complaints paying attention to these considerations. Specific muscular causes, syndromes and conditions that cause pain will be addressed as well as information about which muscles most commonly cause symptoms. Self treatment tips and stretches will be included as well as ideas about what you can do to feel better and heal faster.

General considerations beyond medical conditions:
1) Upper body and shoulder girdle/chest tension
2) Neurovascular entrapment
3) Local overuse for prolonged periods of time
4) Posture, muscle imbalances, back weakness
5) Tissue deterioration and atrophy (incl. enthesopathy and active Trigger Point physiology)
6) Nerve irritation, hypersensitivity and nerve compression

7) Trigger Points

Muscular causes of arm and hand pain:
1) Unaccustomed overuse
2) Accumulated tension
3) Life and the affects of aging for those over age 45
4) Structural asymmetry like a leg length discrepancy
5) Old injuries or surgeries
6) Repetitive stress
7) Posture and positional stress
8) Emotional stress

Muscles most commonly causing arm and hand pain:
1) Extensors of the fingers, esp. middle finger and index finger
2) Flexors of wrist and fingers esp. the common tendon at inner elbow (medial              epicondyle)
3) Thumb muscles, both intrinsic and extrinsic
4) Shoulder muscles, esp. those that move the arm

5) Scalene muscles in the neck

6) Supinator and pronators

7) Pinkie abductor and two opponens muscles

8) Palmaris longus and brevis

Conditions and syndromes that can be treated:
1) Carpal tunnel syndrome
2) Cubital tunnel syndrome
3) DeQuervain’s syndrome
4) Repetitive stress/strain injury (RSI)
5) Tennis elbow (lateral epicondylitis)
6) Golf elbow (medial epicondylitis)
7) Blackberry thumb
8) Trigger thumb and finger

Conditions that can be helped:
1) Dupuytrens contracture
2) Reflex sympathetic dystrophy
3) Reynauds disease