Pronator Teres: Pain Pattern and Treatment
The pronator teres crosses the front of the upper forearm from the inner elbow to the middle of the radius. It turns the palm down. Its documented pattern is deep pain in the front of the forearm and wrist on the thumb side. The median nerve runs between its two heads, so a tight pronator teres can also make the thumb, index and middle fingers, and the palm go numb, a picture that is regularly called carpal tunnel syndrome. This is a sub-page of the forearm flexor group page.
Attachments and action
Origin: Two heads: the medial epicondyle of the humerus, and the coronoid process of the ulna. The median nerve passes between them.
Insertion: The middle of the outer surface of the radius.
Action: Pronation of the forearm, turning the palm down; it assists elbow flexion.
Where the pain is felt: Deep in the front of the forearm on the thumb side. At the front of the wrist on the thumb side. Up toward the inner elbow. With nerve involvement, numbness and tingling in the thumb, index and middle fingers, and the palm.
Common causes: Repeated turning of the palm down under load, as in screwdriver work, wringing, and racquet sports; a mouse held with the forearm rotated; carrying a laptop bag; a fall onto the outstretched hand; a cast or brace that held the forearm turned for weeks.
Patients say: "They said carpal tunnel, but the splint did nothing and my palm is numb too." A deep ache in the front of my forearm that the wrist stretches do not reach. "Turning a screwdriver sets it off." Tingling in three fingers after a long day at the mouse.
When to get evaluated: Hand numbness with wasting of the thumb muscles, weakness pinching, or symptoms that wake you every night needs a nerve conduction study. Forearm pain after a fall with swelling or deformity needs an X-ray first.
How this muscle is examined and treated
Examination tests pronation against resistance with the elbow bent and straight, presses the muscle just below the inner elbow for the point that reproduces the forearm and wrist pain and the finger tingling, and checks the palm for numbness to separate this from the carpal tunnel. Needling here addresses the muscle in the front of the upper forearm, with the median nerve's course respected. Assessment and treatment happen in the same visit.
Related conditions
TendinitisChronic Pain PatternsSports & Performance Injuries
This page is educational. It describes muscle referral patterns commonly associated with pain; it does not diagnose your condition. Individual patterns vary. For evaluation of your specific pain, see a licensed clinician. Seek immediate medical care for emergencies. Eugene Baek, L.Ac. · New Jersey License 25MZ00080600