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NailPro Magazine Feature – Tunnel Vision

Tunnel Vision

For those who work with their hands, carpal tunnel syndrome can be downright debilitating. Here, expert advice and treatment options to ease the pain.

According to the American College of Rheumatology, carpal tunnel syndrome (CTS) is relatively common, affecting 4 to 10 millions Americans. The good news? It’s usually treatable. In this month’s Nail Clinic, we’ll delve into the causes and symptoms of this condition as well as ways to combat the pain it causes.

WHAT IS CTS? According to Kevin Cronin, president and owner of ARC Physical Therapy in Chicago, CTS is a medical condition that occurs when the median nerve, which runs from the forearm to the palm of the hand, becomes pressed or squeezed at the wrist. The median nerve controls sensations to the palm side of the thumb and fingers (excluding the pinkie finger), as well as impulses to some small muscles in the hand that allow the fingers and thumb to move. “The carpal tunnel-a narrow, rigid passageway of ligament and bones at the base of the hand-houses the median nerve and tendons,” says Cronin. “In the case of CTS, thickening from irritated tendons or other swelling narrows the tunnel and causes the median nerve to be compressed.”

This compression can cause symptoms that include tingling and numbness and/or pain in one or more fingers, or in the entire hand, says Vivian Eisenstadt, CEO and physical therapist at Vivie Therapy in Los Angeles, who notes that repetitive activities, like those done by a nail tech, can aggravate symptoms. “CTS can occur when individuals use their hands too much for too long, such as by working on nails, because you hold your fingers and hands in certain positions for hours on end, “she says. CTS isn’t always work related, though, says Barbara Bergin, an orthopedic surgeon in Austin, Texas. “Many of us are predisposed to carpal tunnel syndrome, either genetically or because we live a long time and do a lot of movements, both heavy and repetitive, with our hands, ” she says, adding that the majority of her CTS patients do not perform particularly heavy or repetitive work, but rather routine and low-level amounts of lifting, manipulating and typing.


If you are experiencing pain, tingling or numbness, the first step to recover is to see a physical therapist or doctor. The symptoms of CTS can mimic other conditions, such as repetitive strain injury, so proper diagnosis can rule out any additional problems. While surgery is available to help extreme cases of CTS, for less severe symptoms, Eisenstadt recommends physical therapy, which relaxes and stretches the carpal tunnel area. The following tips can also counteract tingling and numbness in the hands:

  •  Take regular breaks throughout the day, making sure to stretch your forearms, hands and wrists. Cronin recommends a wrist flexor stretch every two or three hours, holding the position for six seconds on each wrist.
  •  Stretch your neck and your shoulders. Many times, numbness and tingling in the hand originates from the shoulder or neck as a result of sitting in a poor position for too long.
  • Place an ice cube where your fourth finger meets the palm, flex and rub the area with the ice for 5 to 10 minutes. This increases blood flow and releases pressure on the palm.
  •  Have a massage therapist perform deep-tissue strokes on your forearms and hands.
  • Put your hands in warm water for five minutes, then very cold water for five minutes, switching back and forth for 20 to 30 minutes. This improves circulation in your hands.

Bergen also recommends wearing gloves, which will help loosen your grip on implements and other items. additionally, wearing a wrist brace, during the day or at night, will prevent hyperflexion, or flexing the wrist beyond its normal limits, “Sometimes, simply doing these small things will keep you from having symptoms during your workday,” he says. If do-it-yourself tactics don’t alleviate your symptoms, additional treatments may help. Cronin recommends fascia strain and counterstrain, a gentle procedure that focuses on relieving tightness in the fascia, or connective tissue. “Tightness in the fascia and/or the muscles can spasm higher up in the arm, and even to the neck, causing tension in the nerves of the forearm and wrist, which contributes to CTS,” he explains.

During fascial strain and counterstrain, the medical professional identifies tender points in the hand, arm or neck which are associated with tight facial structure. Then, using her hands, the practitioner will manually shorten the tight fascia and hold that position for 30 seconds. This action eliminates the tender points and tightness thus releasing tension in the tissue. ” When the adverse tension on the nerve is removed, the irritation of the nerve lessens, and so do the symptoms,” says Cronin, who notes that most patients begin to feel relief almost immediately. Proper treatment for CTS, in addition to taking the necessary steps to reduce your discomfort throughout the day, will help you continue to be a successful and productive nail tech for years to come.


Carpal Tunnel Facts*

  • Carpal tunnel syndrome (CTS) is the most expensive of all work-related injuries. Over a lifetime, a carpal tunnel patient loses about $30,000 in medical bills and time absent from work.
  • Studies have shown that vitamin B 6 supplements may relieve CTS symptoms.
  • CTS typically occurs in adults, and women are three times more likely to develop it than men.
  • CTS usually affects the dominant hand first, and the pain is typically severe.

*Source: American Chiropractic Association (acatoday.org)

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