Patients with neck pain may present with muscle pain and pain in the wrist area. They may have difficulty with making a fist and picking the wrist up so that the front (palm aspect) of the wrist is toward the face. This may be related to pain, spasm or tightness of the muscles that perform this movement.
Although it is the wrist flexors that seemingly have a problem, it is usually the tightness of the wrist dorsiflexors that initiate muscle pain in the wrist flexors. In treating problems with the wrist flexors, the entire upper limb evaluation should be done including the neck for muscle strength and range of motion.
Treatments must first begin with the large and powerful muscles that must perform lengthening contractions to stabilize the joints of the shoulder, elbow and wrist.
The main muscles that perform wrist flexion (palmar flexion) are:
- flexor carpi radialis supplied by the median nerve (C6, C7)
- flexor carpi ulnaris supplied by the ulnar nerve (C8, T1)
- abductor pollicis longus supplied by the radial nerve (C7, C8)
- flexor digitorum superficialis supplied by the median nerve (C8, T1)
- flexor digitorum profundus supplied by the ulnar nerve (C8, T1)
- palmaris longus supplied by the median nerve (C6, C7)