The extensors of the hand and the wrist include extensor carpi ulnaris, extensor carpi radialis longus, and extensor carpi radialis brevis. All three run most of the length of the forearm. Collectively, along with brachioradialis, they extend the hand at the wrist. Their chief function is to prevent wrist flexion, working synergistically with the finger flexors, during hand grasp.

The extensor carpi radialis longus deviates the hand to the thumb side at the wrist. The extensor carpi ulnaris deviates the hand at the wrist to the pinky side.

Pain from extensor carpi radialis longus and brevis trigger points resembles brachioradialis referrals. They occur on the outside of the forearm, near the elbow, and progress down the arm toward the base of the thumb and hand.

Extensor carpi ulnaris trigger points are uncommon but refer to the top, base of the hand on the pinky side. They occur most often after gross trauma or a frozen shoulder syndrome.

Hand extensor trigger points are typically activated from a combination of repetitive, forceful gripping, and twisting motions. This can include activities as diverse as weeding, using a screwdriver or handwriting. Once initial soreness develops, the tendency to “test” the muscle for improvement tends to worsen it.

The functional unit of the hand extensors includes the brachioradialis. Corrective actions include trigger point pressure release, stretching, and avoiding activities that overload the muscle.