Oppoens Pollicis Trigger Point
Opponens Pollicis Trigger Point
The trapezium and transverse carpal ligament are the origin of the opponens pollicis, and the insertion is the metacarpal bone of the thumb on its radial side. The recurrent branch of the median nerve innervates the opponens pollicis.
The trigger point, shown in the diagram below, causes referred pain in the forearm and in the hand. The primary symptoms are handwriting difficulties, thumb and radial hand pain, thumb pain and tingling numbness (Dysesthesia).
Your thumb is a very strong. Think about all of the stress and strain you place upon it whenever you open a jar, grab something heavy, or lift weights. The thumb is also an incredibly mobile joint.
The wrist and finger bones make a very unique joint for the thumb. The carpal bone, called the trapezium, and the first metatarsal form a unique joint that allow for an incredible range of motion. This range of emotion comes at a cost of a lack of structural support, which is why thumb injuries are fairly common. Especially anything that pulls the thumb backwards or causes a sudden twisting.
Many people who have occupations that require repetitive activities develop tendonitis across the thumb joint over years. They initially feel tightness, fatigue, and muscle achiness in their hands. This eventually becomes more of a dull ache as the weeks go by. Eventually people feel sharp stabbing pain with certain motions and movements.
Opponens pollicis trigger points are very common in these individuals. Often times people believe their thumb pain is the result of ligament damaged, carpal tunnel, or arthritic changes to the joints. When actuality the muscle is causing radiating pain down the thumb. Treatment for opponens pollicis trigger points is very effective with soft tissue techniques, especially manual therapy and massage therapy.
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.
Elbow injuries often occur in people with severe or chronic shoulder injuries. People begin trying to alter their shoulder motions to protect it. Unfortunately these altered body mechanics tend to overwhelm the muscles and tendons around the elbow. 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.
Treatment for hand injuries can be extensive if the tendinosis is severe. Mild strains can be treated at home with PRICE, home stretches, and exercises. Don’t wait for damage to both the shoulder and elbow to seek treatment and therapy.
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 to evaluate for carpal tunnel syndrome.
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 & 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.