Trigger Points – Stiff, Swollen Hands in the Morning

Client’s Description

referral - scalene - posterior1People complain about awakening with stiff and swollen hands. Some of them have problems with tingling and sleeping hands in the night. They often get up and move their arms around until the tingling stops, and the arms are awake again. Sometimes, they have pain or tingling when they hold their arms near shoulder level as when driving, putting on make-up or cutting hair.

The pattern does not usually occur in full as illustrated but as part of that pattern. As the illustration indicates, the pain, tingling and “numbing” is most likely to occur in the areas of darkest red. When there are stiff, swollen hands, the sensations around the index finger and thumb are a greater focus, although the tension behind the shoulder is often there. If I press into the muscle at the base of the neck, the client almost always describes sensation between the shoulder blades and down the arm.

When you awake with stiff, swollen hands, try this standard test for scalenes. Try to bend your second and third knuckle so that your fingertips touch the base of your fingers while holding the first knuckle straight. If you can’t do this, scalenes are indicated as the problem.


See how the pad of the index finger can touch the base of the finger while the first knuckle stays straight? This is an indicator that scalenes are not involved in thoracic outlet restriction and contribute to swollen hands.

This person is unable to touch the pad of the index finger to the base of the index finger while the fingers are held straight at the first knuckle. This stiffness is a strong indicator that scalenes are contributing to thoracic outlet dysfunction.

Click here for relief with things you can do at home.

This post discusses what may have caused your condition or what you’re doing that perpetuates it. It offers exercises often create immediate relief. It has helpful information about what to do when you awaken with swollen hands or numb arms.

Click here to Sharpen your Skills as a therapist.

Great information for the therapist about palpation, structure, and thoracic outlet syndrome. Ther are treatment techniques from Integrative Somatic Mobilizations and The workbook of Classical Neuromuscular Therapy as well.

and some related posts…

Tony Preston has a practice in Atlanta, Georgia where he sees clients. He has written and taught about anatomy, trigger points and cranial therapies since the mid-90s.

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