Doral Interosseus Trigger Point

First Dorsal Interosseus Trigger Point

The origin of the first dorsal interosseus muscle is the metacarpals, and the insertion is located at the proximal phalanges and extensor expansions. The first dorsal interosseus muscle is innervated by the deep branch of ulnar nerve.

The trigger point is located in the back of the hand by the thumb and causes referred pain in different areas of the hand and fingers. The primary symptoms are dorsal finger pain and volar finger pain, and the secondary symptoms are dorsal wrist and hand pain, as well as thumb and radial hand pain. The dark red markings on the image below shows that the referred pain greatly affects the dorsal finger.

Conservative Treatments

Therapeutic treatments for addressing soft tissue injuries involve massage therapy, manual therapy, trigger point therapy, Graston Technique, or Active Release Technique. These treatments increase blood flow, decrease muscle spasms, enhance flexibility, speed healing, and promote proper tissue repair.

When these treatments are incorporated into a treatment plan patients heal faster and are less likely to have long-term pain or soft tissue fibrosis or scar tissue in the injured muscle. These soft tissue treatments are incorporated with therapeutic exercise and flexibility programs.

Hand muscle injuries often occur in people with severe or chronic elbow injuries. People begin trying to alter their elbow motions to protect it. Unfortunately these altered body mechanics tend to overwhelm the muscles and tendons around the hand. People often develop a secondary cubital tunnel syndrome, lateral epicondylitis, tricep tendonitis, medial epicondylitis, pronator teres syndrome, double crush, carpal sprains, wrist tendinitis, de quervain's tendonitis, finger extensor strains, or carpal tunnel syndrome.

Medical Treatments

NSAIDs are often prescribed for the initial acute injury stages. In severe cases that involve multiple joint regions, muscle relaxers or oral steroids can be given. Trigger point injections, botox, or steroid injections can be treatment options. Pain management is not usually required unless stronger medications or joint injections are required for treatment.

MRI and X-rays will not usually be ordered to evaluate mild to moderate muscle, tendon, and ligament injuries. Severe cases may utilize advanced imaging to rule out bone fractures, edema, nerve entrapments, tendon or muscle ruptures. NCV testing may be utilized in cases that also involve muscle, sensory, or reflex loss.

Many people do have arthritis or degenerative changes in their elbow, wrist, finger, or thumb joints. Arthritis does not mean you will always have pain in the joints. Degenerative arthritis means the structural Integrity of the bones have changed which alters its gliding, sliding, and hinging motions. The more severe the arthritic changes the easier it becomes to aggravate the joint and produce pain.

Osteoarthritis and rheumatoid arthritis will also slow healing and recovery time. People with severe arthritis can have no pain in a joint. In fact many times people blame their arthritis pain on tendinosis or tendonitis of the tendons that attach around the joint. Conservative treatment can improve hand and wrist pain; and people will have dramatically less pain in joints that have arthritic changes.

Conclusion

The upper extremity works as a comprehensive unit performing many of the repetitive tasks at home, work, and recreational sports. Injuries to one area of the musculature often indicate that additional damage has been incurred by other muscles.

Many therapeutic exercises can help restore proper strength and endurance to the elbow flexor muscles. Isometric exercises are often the initial treatment exercises.

Followed by single plane rubber band exercises for elbow flexion, extension, pronation, and supination movements. Dynamic exercises involving stability ball push-ups can be performed on the wall or floor. The more unstable of the surface the more effort and stabilization is required of all the upper extremity muscles.

Our Chandler Chiropractic and Physical Therapy clinic treats patients with a variety of muscle, tendon, joint, and ligament injuries. The clinic provides treatment for runners, tri-athletes, and weekend warriors in addition to common headache, neck, and back patients traditionally seen in Chiropractic, Physical Therapy, Massage Therapy clinics. We work with all ages and abilities of the residents in Phoenix, Tempe, Gilbert, Mesa, and Chandler AZ.