The page you are trying to access does not exist.

Knuckle Pain


These extremely common problems in the fingers, hands, knuckles, thumbs, and wrists are most often caused by myofascial trigger points, tiny contraction knots in overworked or traumatized muscles. This comes from decades of research of Doctors Janet Travell and David Simons, authors of the widely acclaimed medical textbook, Myofascial Pain and Dysfunction: The Trigger Point Manual.

Mistaken Diagnoses

The trouble with having pain, numbness, tingling, stiffness, burning, or swelling in your wrists, hands, fingers, and thumbs is that it will be too quickly labeled arthritis, bursitis, tendinitis, carpal tunnel syndrome, or peripheral neuropathy. Too often, say Travell and Simons, these are mistaken diagnoses.

Pain Referral

It may surprise you to learn that these abnormal sensations rarely originate in the fingers and hands but are almost always the effects of trigger points in muscles of the neck, chest, upper back, shoulders, upper arms, and forearms. This is called “referred pain.” Trigger points typically send their pain elsewhere.

Conventional Therapies

Because of this displacement of symptoms, treating the wrists and hands with magnets, wrist splints, pressure straps, electro-stimulation, ultrasound, and acupuncture is likely to give only temporary relief at best.

Painkillers, of course, only mask symptoms and never address the cause. The benefits of pain medication are felt only while the drug is in your system. It goes without saying that surgery is entirely inappropriate when trigger points are the cause of the problem.

Wrist and Hand Pain

You can understand why conventional medical practice can be so off the mark and ineffective if you know some of the basic facts about referred myofascial pain.

For example, wrist pain, which makes you feel like you have a wrist sprain, very often comes from trigger points in extensor carpi ulnaris or flexor carpi ulnaris muscles of the forearm.

Finger pain, thumb pain, and pain in the web of the thumb can also come from muscles of the forearm, although it’s not uncommon to trace the trouble to more distant muscles in the shoulder, neck, and upper arm.

Stiff Fingers and “Arthritis”

One of Travell and Simons' more profound discoveries was that trigger points in the extensor digitorum, a forearm muscle that operates the fingers, are the prime cause of stiff fingers.

These same trigger points contribute to the pain of tennis elbow and send pain to the second knuckles of the third and fourth fingers. Knuckle pain referred from this muscle feels just like the pain of arthritis. You may have believed for years that you suffer from arthritis and it simply may not be true.

Writer’s Cramp

Sometimes, the hand muscles themselves can be the unrecognized source of problems in the hand. Writer’s cramp, for instance, is caused by trigger points in certain thumb muscles and the tiny interosseous muscles between the bones of the hand.

Heberden’s Nodes

Heberden’s nodes, bumps on the sides of the last knuckles, also originate with trigger points in overused interosseous muscles. It is possible to eliminate Heberden’s nodes with trigger point therapy if intervention comes early enough.

Even if fully developed, nodes can often be reduced. Travell and Simons believe that the same stresses in the interosseous muscles that create nodes on the knuckles may promote the development of genuine arthritis in the finger joints.


When trigger points are the source of the problem, they must be addressed directly and specifically to have any real and lasting effect. Unfortunately, few doctors have taken the time to study Travell and Simons. Most physicians are still basically uninformed about trigger points and aren't equipped to treat them. But don't be dismayed. Trigger point therapy is something you can do for yourself.

trigger points workbook

In The Trigger Point Therapy Workbook, nationally certified massage therapist Clair Davies has simplified Travell and Simons's monumental work on trigger points and made it accessible to the layman.

His innovative methods of self-applied trigger point massage will get rid of pain, numbness, tingling, stiffness, burning, and swelling in wrists, hands, and fingers when trigger points are the cause.

To find out more about the book and the method, please visit the homepage. To read a growing number of reviews by people who have been helped by the book, take a look at the book’s page at Amazon.com.

Share this Information

Join Our Mailing List

Contact Us

New Day Myopain Center
1813 Brownsboro Road
Louisville, KY 40206

This email address is being protected from spambots. You need JavaScript enabled to view it.