Brachioradialis pain can significantly impact your daily activities and limit your forearm's functionality. In this blog post, we will delve into the anatomy, actions, and trigger points of this muscle. Moreover, we will explore how acupuncture and dry needling can effectively alleviate pain and restore optimal function in individuals experiencing elbow, wrist, and forearm pain.

About the brachioradialis muscle

The brachioradialis is located in the forearm and plays a crucial role in forearm movement. Positioned along the lateral aspect of the forearm, this muscle runs from the distal end of the humerus bone to the styloid process of the radius.

The primary action of the muscle is flexing the forearm at the elbow joint. It also assists in pronation and supination of the forearm, contributing to overall forearm stability and coordination during various functional activities.

Brachioradialis origin and insertion

Brachioradialis origin:

The origin of the brachioradialis muscle is at the proximal two thirds of the lateral supracondylar ridge of the humerus

Brachioradialis insertion:

The insertion of the brachioradialis muscle is at the styloid process of the radius

The brachioradialis attaches from the upper arm (humerus) to the base of the wrist (styloid process) so when the muscle contracts it brings those two structures closer together which results in elbow flexion.

Brachioradialis muscle actions

• Flex elbow

• Assist to pronate and supinate the forearm when these movements are resisted

Synergists and antagonists of the brachioradialis

Brachioradialis synergists:

• Biceps brachii

• Brachialis

Brachioradialis antagonists:

• Triceps brachii

• Anconeus

The brachioradialis muscle, located in the forearm, has a significant role in elbow flexion. It works together with other arm muscles, such as the biceps brachii and brachialis, to ensure smooth and controlled movements of the forearm. These muscles aid in elbow flexion, mid-pronation, and mid-supination, which are necessary for many daily activities.

On the other hand, the triceps brachii and anconeus muscles act as antagonists, facilitating elbow extension. These muscles provide the necessary counterbalance, allowing the arm to perform a wide range of movements efficiently.

Having a comprehensive understanding of how these muscles interact can assist in the development of specific physical therapies and treatments, such as dry needling and acupuncture, to manage forearm and elbow pain and enhance overall upper limb functionality.

The brachioradialis shares a connection to six other muscles in the forearm which also originate from the lateral epicondyle and supracondylar ridge of the humerus. These include the extensor carpi radialis longus, extensor carpi radialis brevis, extensor digitorum, extensor digiti minimi, extensor carpi ulnaris, and the anconeus muscle.

Brachioradialis Trigger Points

Main complaints related to brachioradialis muscle trigger points include:

• Elbow Pain

• Tennis Elbow - Lateral Epicondylar Pain (Lateral Elbow Pain)

• Painful Weak Grip

• Radial Forearm Pain

• Thumb & Radial Hand Pain

The muscle can refer pain to the lateral elbow, as well as down to the wrist and thumb, and into the webbing between the thumb and index finger.

Associated trigger points include the extensor carpi radialis longus and brevis, extensor digitorum, supinator, and medial head of the triceps muscles since they work together during gripping or forearm rotation.

Brachioradialis Trigger Point Locations

Brachioradialis trigger points can be located along the belly of the muscle - generally in the upper one third of the forearm (closer to the elbow).

Signs and symptoms of brachioradialis trigger points

• Tennis elbow

• Lateral elbow pain that may spread down the wrist and thumb

• Writer's cramp (long hours at the computer)

• Weak grip

• Pain and limited movement of elbow

• Ulnar deviation triggers the pain

What causes brachioradialis muscle pain?

• Repetitive forceful gripping like using a screwdriver, wringing out towel, handshakes, or scraping ice off a windshield

• Long hours writing or typing on the computer

• Playing tennis excessively or other sports that involve gripping and twisting motions

• Wringing out a towel

Travell and Simons' extensive research reveals that the brachioradialis muscle can develop trigger points from various causes such as repetitive forearm movements, sustained gripping activities, and direct impact or trauma to the muscle. Engaging in activities that require constant forearm rotation and gripping, such as using a computer mouse, can lead to latent or active myofascial trigger points due to frequent contraction of the muscle. Overworked muscles can pull the elbow into a semi-flexed position, resulting in strain to the more delicate structures of the forearm.

Vladimir Janda suggests that prolonged periods of flexing the elbow, such as during desk work, can result in an imbalance of the arm and forearm muscles known as "computer arm" syndrome. This can cause the forearm muscles to shorten, while the triceps and wrist extensor muscles may become weakened and lengthened.

These changes can increase muscle tension and stress in the forearm and elbow, leading to pain, decreased function, and even nerve root involvement that can affect the entire upper limb.

The pain pattern caused by trigger points in the brachioradialis muscle may appear similar to that of lateral epicondylitis (tennis elbow), but usually does not involve the wrist or hand. A taut band in this muscle can be easily differentiated from neighboring muscles by examining the direction of its fibers. The fibers of the brachioradialis muscle run diagonally downwards, while the fibers of the adjacent extensor carpi radialis longus and brevis muscles run more vertically.

Brachioradialis muscle pain treatment for trigger points

Brachioradialis trigger points can cause pain and frustration. However, the right treatment can bring relief and enhance quality of life. Acupuncture and dry needling are safe therapy options for treating these trigger points.

Your acupuncturist will locate trigger points and taut muscle bands. These could be the source of pain in your lateral elbow, wrist, or thumb. Trigger point therapy uses an acupuncture needle to relax the muscle. These techniques can help reduce pain, improve muscle function, and restore mobility.

Other modalities like electroacupuncture, cupping, gua sha, and tui na can also help with pain and muscle tightness.

Over to you

If you liked this article, please share with friends and family who may be suffering with lateral elbow, wrist, or thumb pain.

Sources:

• Travell, J. G., Simons, D. G. (1993). Myofascial pain and dysfunction: The trigger point manual. London: Lippincott Williams & Wilkins.

• Biel, A., & Dorn, R. (2010). Trail guide to the body: A hands-on guide to locating muscles, bones and more. Boulder, CO: Books of Dicovery.

• Janda, Vladimír. “Muscle Function Testing.” (1983).

• Lung BE, Ekblad J, Bisogno M. Anatomy, Shoulder and Upper Limb, Forearm Brachioradialis Muscle. [Updated 2022 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.

• Aparisi Gómez MP, Aparisi F, Battista G, Guglielmi G, Faldini C, Bazzocchi A. Functional and Surgical Anatomy of the Upper Limb: What the Radiologist Needs to Know. Radiol Clin North Am. 2019 Sep;57(5):857-881. doi: 10.1016/j.rcl.2019.03.002. Epub 2019 May 8. PMID: 31351538.

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