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myofascialpain.com
Atlas · Forearm

Flexor Carpi Ulnaris

Ulnar volar wrist aching from flexor carpi ulnaris trigger point near pisiform bone

Body region
Forearm
Trigger points
2
documented in this muscle
Common symptoms
8
patterns cataloged
Common causes
9
contributory factors

Trigger points

TrP 1

TrP1

Location. Inner forearm, little finger side

Pain referral. Inner wrist, little finger side

  • Inner wrist
  • Little finger side palm
  • Forearm
TrP 2

TrP2

Location. Proximal fibers near medial epicondyle

Pain referral. Medial elbow and ulnar wrist

  • Medial epicondyle area
  • Ulnar wrist
  • Pisiform bone area
  • Medial forearm (proximal)
  • Hypothenar eminence (mild)

Symptoms patients report

Wrist pain. Ulnar volar wrist aching from flexor carpi ulnaris trigger point near pisiform bone

Ulnar palm discomfort. Hypothenar palm pain from trigger point referral along ulnar wrist flexor pathway

Weakness in flexion. Impaired ulnar wrist flexion from flexor carpi ulnaris trigger point force inhibition

Medial elbow pain (golfer elbow-like). Medial epicondyle ache from proximal FCU trigger point mimicking medial epicondylitis symptoms

Ulnar wrist ache. Referred pain to ulnar wrist and pisiform from FCU trigger point at medial epicondyle origin

Weak grip (ulnar deviation). Inhibited FCU contraction reduces wrist ulnar deviation and flexion power during grip

Medial forearm tightness. Taut FCU fibers along medial forearm create restriction and aching during wrist movements

Pisiform area tenderness. Referred tenderness at pisiform bone from FCU trigger point tension through its distal tendon

Common causes

Typing. Sustained keyboard use with ulnar deviation creates cumulative flexor carpi ulnaris overload

Gripping. Forceful gripping requires flexor carpi ulnaris co-contraction for ulnar wrist stabilization

Wrist flexion. Repetitive wrist flexion with ulnar deviation directly overloads flexor carpi ulnaris fibers

Sports. Racket and club sports requiring wrist flexion overload flexor carpi ulnaris muscle repeatedly

Golf (trailing hand). Golf swing creates high wrist flexion and ulnar deviation forces overloading FCU at medial epicondyle

Repetitive wrist ulnar deviation. Chronic ulnar wrist deviation during tasks overloads FCU as a primary ulnar deviator

Typing with ulnar deviation. Keyboard positioning that promotes ulnar wrist deviation chronically overloads FCU muscle fibers

Throwing sports. Throwing creates valgus stress at elbow and wrist flexion overloading FCU at medial epicondyle

Weightlifting (press movements). Heavy pressing movements with wrist flexion load FCU at its proximal attachment significantly

Treatment & self-care

immediate

Ulnar wrist stretch

Extend your arm in front of you with the palm facing down. Use your opposite hand to gently bend the wrist toward the thumb side (radial deviation), creating a stretch along the ulnar (pinky) side of the forearm. Hold without bouncing. Then reverse by gently bending the wrist toward the pinky side while the palm faces up to stretch the opposing direction.

Duration
20-30 seconds per direction, 3 repetitions
Frequency
Every 1-2 hours during typing or gripping activities
Expect
Reduced ulnar forearm tightness and wrist pain within several days of consistent stretching
immediate

Self-massage along ulnar forearm border

Using the thumb of the opposite hand, apply firm pressure along the fleshy muscle on the pinky side of the inner forearm, from near the elbow down to the wrist. When you find a tender knot, hold steady pressure for 20-30 seconds until the tenderness diminishes. Work slowly and methodically along the entire muscle length.

Duration
3-5 minutes per session
Frequency
2-3 times daily
Expect
Gradual reduction in forearm tenderness and referred wrist pain over 1-2 weeks
exercise

Finger abduction and adduction exercises

Place your hand flat on a table. Spread all fingers apart as wide as possible, hold for 5 seconds, then bring them back together. Repeat 10-15 times. For added resistance, loop a small rubber band around all five fingers and spread against it. This strengthens the intrinsic hand muscles that support ulnar wrist stability.

Duration
2 sets of 10-15 repetitions
Frequency
Once daily, 5 days per week
Expect
Improved hand and wrist stability and reduced pain during gripping within 3-4 weeks
lifestyle

Keyboard position modification to avoid ulnar deviation

Position your keyboard directly in front of you, centered with your body (not offset to one side). Keep your wrists straight — avoid angling your hands outward toward the pinky side during typing. Consider a split or tented ergonomic keyboard that allows your wrists to remain in a neutral alignment. Use a keyboard tray at elbow height to prevent wrist flexion.

Duration
Ongoing — set up once and maintain
Frequency
Daily during all computer work
Expect
Reduced ulnar wrist strain and decreased end-of-day pain within 1-2 weeks of proper positioning
exercise

Ulnar nerve glide exercises

Stand or sit upright. Extend your arm to the side at shoulder height, palm facing the ceiling. Flex your wrist so your fingers point toward the floor. Then bend your elbow, bringing your hand toward your ear. Slowly straighten the elbow again. Move smoothly and gently through the full range. This glides the ulnar nerve through its pathway and reduces nerve irritation.

Duration
10 repetitions per arm, slow and controlled
Frequency
2 times daily
Expect
Reduced tingling in ring and little fingers within 2-3 weeks if related to nerve mobility restriction
professional

Professional nerve conduction study if numbness persists

If numbness or tingling in the ring and little fingers persists beyond 3-4 weeks of self-care, or if you notice hand weakness or muscle wasting, consult a neurologist or hand specialist. Nerve conduction studies and electromyography can determine whether the ulnar nerve is compressed at Guyon's canal or the cubital tunnel, guiding appropriate treatment.

Duration
Testing appointment typically 30-60 minutes
Frequency
As needed based on symptom persistence
Expect
Definitive diagnosis of nerve involvement versus muscular trigger point referral, with a targeted treatment plan
Key Takeaways
  1. Ulnar volar wrist aching from flexor carpi ulnaris trigger point near pisiform bone
  2. Hypothenar palm pain from trigger point referral along ulnar wrist flexor pathway
  3. Impaired ulnar wrist flexion from flexor carpi ulnaris trigger point force inhibition
  4. Medial epicondyle ache from proximal FCU trigger point mimicking medial epicondylitis symptoms
  5. Referred pain to ulnar wrist and pisiform from FCU trigger point at medial epicondyle origin