We take our marvelous hands for granted, don’t we? When our hands ache or are injured we realize how precious they are.

In the hand there are 26 bones,  over 33  ligaments between the bones, over 25 muscle tendons that attach to the bones in hand, over 15 muscles from the forearm that move the hand in different directions and over 20 muscles just in the hand itself. Three 3 major nerves – the medial nerve, the ulnar nerve, and the radial nerve serve the hand.

Treating pain in the hand by just focusing on the hand itself is like trying to stop a leak by just cleaning up the water. To effectively find the cause of hand pain it is important to check out its entire soft tissue pathway originating at the neck,  then along the shoulder girdle, down through the upper arm and forearm and then into the hand itself.

One must examine posture, entrapped or impinged nerves, tight muscles with swollen tendons, compromised joints, and repetitive work patterns.

Sometimes a dysfunctional muscle in one part of the body will send pain down into another area of the body. This is called a trigger point referral pain. I will examine four areas of tight muscles that cause pain radiating down into the hand.

The first sets of muscles I will examine are muscles in the front of the neck, the scalene muscles. Smokers, violinists, people who do tons of abdominal crunches without holding their head or people who are shallow breathers often have tight scalenes.

As you can see in the picture, a tight scalene muscle in the front of your neck may send referral pain down into your back, arm and even into your hand!

A tight scalene muscle might pinch the nerves or arteries that travel under the scalene muscle and over the first rib. The medial nerve passes under the scalene muscle and eventually goes over the carpal tunnel area of the hand. A skilled massage therapist knows how to gently release the muscle belly of the scalenes if they get tight or scarred.

A second cause of pain in the hand could be from tight muscles in your forearms.

Working out holding tight weights, hard physical labor holding tools tightly, or work done by dental hygienist, cosmetologists or bank tellers can really tighten the forearm muscles.  Never stretching out these over worked muscles and never strengthening the opposite or reciprocal muscle of the hand or arm may create an imbalance in the hand. When a muscle becomes too tight or shortened, the tendons of that muscle often become stretched out, inflamed and swollen. An inflamed tight tendon of the forearm may attach to one of the 26 six bones in the hand. These tight tendons may then pull on these small hand bones causing nerve impingement and/or joint stress. It is a vicious snowballing effect that can often be nipped in the bud by a skilled focused therapeutic massage to relax the muscle belly of the tight forearm muscles.

A third cause of hand pain can be caused by tight muscles in the hand itself. A person who is holding their hands in the same position for long periods of time (typing, painting, hair cutting and texting) will keep their hands in a curled position. Consequently the muscles within the hand may become tight. A person may not take the time to stretch out their hand. Over a long period of time their hand may feel like it is locking up into a curled position. Gentle massage to the hand can once again often stop this snowball effect by softening the tight muscles within the hand thus allowing for more movement in the hand itself.  

 Finally we will examine the postural muscles. As we get older certain muscles in the body tighten (postural muscles) and other muscles weaken (phasic muscles). The most recognizable postural muscles to tighten are the muscles between the ribs. The ribs begin to collapse down causing the back to round. To compensate for the curved back a person may tighten the back of their neck to lift up their head to look forward. (We all do this a lot when we sit at the computer.) When the muscles in the back of the neck tighten, the back of the neck may compress. This may eventually cause the nerve coming out between the vertebrae to become pinched. This is called nerve root impingement and it can cause problems to the entire area that the nerve serves.

According to Cannon’s Law, nerve impingement over a period of time may cause abnormal functioning of the tissue that the nerve innervates precipitating chronic pain and the disease cycle. Consequently nerve root impingement may cause hand pain or numbness. Nerve root C6, 7 or 8 could have become impinged causing radiating pain down into her hand. A skilled massage therapist can soften the tight muscles in the back of the neck.

Nerve root entrapment also causes muscles to shorten. When muscles shorten painful bands and trigger points appear within the muscle belly and the tendons of that muscle may lengthen and become inflamed, swollen and thick. The tight muscle may cause further distress and strain to the joints to which it attaches. They can also relax any other muscles that have become tight as a result of nerve root entrapment.

So the next time you feel hand pain, ask your doctor if it would be okay to try a skilled therapeutic massage.

I would also love to come to your place of work to offer gentle forearm and hand massage to you and your fellow staff members. What a perk!