hand and wrist therapy for pain free workAs a massage therapist at one of the busiest day spas in the country, working five days a week and doing around 20 to 30 massages per week for several years, I experienced pain and discomfort in my hands. No surprise there.
Massage requires repetitive movements of the hands and arms under considerable force for a prolonged period of time. Pain would seem inevitable.
Learning to use your hands efficiently, using elbows and fists instead of fingers and thumbs, for example, can help you to achieve a pain-free experience. Good posture defined as bending the knees, keeping your feet, hips and shoulders in line, as well as keeping your shoulder, elbow, wrist and hand in a straight line so that your body weight is transferred through your arms while breathing deeply, are all important practices.
Many online resources have information and videos on body mechanics. If you didn’t learn this in school, please research this topic and always employ good body mechanics.

The Recipe For a Pain-Free Career

Techniques such as deep tissue, shiatsu and trigger point therapy require more use of hands and thumbs. As a shiatsu practitioner, I was blessed with strong thumbs, but those hours can add up and cause strain.
You can use elbows or fists for deep tissue, but sometimes the area you’re working may be too small, or you want the finer touch of using thumbs and fingers, so even if we know we shouldn’t overuse our digits, we often end up doing just that.
Over the years, I have seen many colleagues fall victim to repetitive strain and carpal tunnel syndrome, and take leave from work or even retire from massage therapy permanently. Many filed workers’ compensation claims or worked at a front desk until their hands improved.
Fortunately, the company I worked for realized that self-care was important to protect their employees’ longevity, and eventually added self-care and body mechanics to their training and orientation programs. However, it is ultimately the therapist’s responsibility to take care of his or her health.
From my experience as a therapist, and later as a massage educator, I saw a need for self-care to alleviate tightness and inflammation of the extensor and flexor muscles and tendons that control hand movement. 
If you know your anatomy, you know that overworking these muscles can result in carpal tunnel-like symptoms, including pain, numbness, tingling and loss of dexterity in the hands and fingers.
At our spa, it was common to see therapists massaging each other’s arms and hands in the break room in between sessions with clients.
Of course, massage is a great way to reduce chronic hand pain. Unfortunately, we can’t always have a friend massage us and massaging your own hand with your other hand just makes the other hand more tight and achy, too. 
There are, however, things you can do every day that may help reduce hand and wrist symptoms, as well as help prevent them from happening in the first place.


Before you begin your work, one of the best things you can do is to apply heat therapy to your hands and forearms. One of the best ways to do this is to invest in a paraffin bath. This might seem to be an expensive option, but it isn’t. 
A paraffin bath is easy to use. Proper use involves dipping each hand in the paraffin four or five times with a few seconds in between each dip to get a good coating of the hot wax. Then, sit and let the warmth sink into the muscles of your forearms and hands.
Once the wax has cooled, peel it off. You can then squeeze the wax into a ball, which can be a good exercise to warm up the hands and forearms.
If you don’t want to invest in a paraffin bath set-up, you could also wrap hot towels around your arms and hands. Please be careful and test the heat of the towels first to avoid burns. Electric heating pads can also help.


We all know stretching is good for us, especially before and after running or working out; however, there are different schools of thought on this.
Take running, for example. Some say you must stretch before running, while others say it’s better to stretch afterwards.
For performing massage, however, stretching the hands, wrists and, frankly, the rest of the body, especially the shoulders, legs and neck, before work is essential, as is stretching between clients, and after your day is done.
Any of the following stretches are helpful. Try to get a deep stretch but pay attention to any pain you experience, and stop if anything feels uncomfortable. You can do all of these as a regimen, or use the ones that work best for you. Just remember to keep stretching and keep limber.
flex and extend the wristFlex and extend the wrist.  This can be done using one hand to help stretch the other, or using your table or other fixed object to provide resistance. You want to flex it as far as it will go and then extend it.  Repeat several times for each hand.
Twist the wristTwist the wrist. Twist gently to the limit in both directions, using the other hand to assist and maximize the stretch.
Flex and extend fingers and thumbsFlex and extend all fingers and thumbs several times.
Make tight fists then relaxMake tight fists, then relax, repeating several times.
Make a tight fist then flex downward at the wristDo wrist rotations several times in each direction for each hand.  Make a fist and flex it downward at the wrist, then make circles, slowly in each direction.
Again, stretching the wrist and hands is essential; however, don’t forget, if you’re massaging properly you are using your entire body, so make sure you stretch your legs, back, neck and shoulders, as you would before a full-body workout. Being a massage therapist is like being an athlete. Stretching prevents injury.

Ice After Work 

Ice is by far the most effective treatment for inflammation, and after a few hours of massaging, the muscles in your hands, wrists and forearms are inflamed, whether they hurt or not.

The best and easiest way to ice is with an ice bath. Any trough or cooler large enough to get your entire forearm and hand in is fine. A cooler is great, but anything of the right shape such as a plastic window planter that is long and narrow will do the trick. Fill your container with enough ice to submerge your forearm and hand and add water to the same level.

Some people like to submerge the arm in the ice bath, hold it for as long as they can, pull it out and repeat for 10 or more minutes.
Another way to ice that takes up less space and utilizes less ice, is an ice cup. Take a paper or Styrofoam cup and fill it almost to the top with water, then place in the freezer until solid. Then you take the cup out, tear off the top inch of the cup and massage your forearms and hands with the top of the ice.
Work the ice over the entire forearm, wrist and palm on each side for approximately 10 minutes or so.
This may not penetrate as quickly as an ice bath, but it is still very effective. There are several videos on Youtube illustrating the technique of using ice cups for self-massage, and also how to use it for clients with conditions like plantar fasciitis.
This complete regimen should be done every day that you work and even on those that you don’t work. While it may seem time-consuming, this regimen should take more no more than 20 to 30 minutes.
Your thumbs, hands and arms are your livelihood, and only you can take care of them. Taking these simple steps each day will help you extend your career, work pain-free and be the best therapist you can be.

Paul Kleiman headshotAbout the Author

Paul Kleiman, president of Massage U, Inc. (est. 2006) and U-Selfcare.com, is an inventor, writer, attorney, musician, massage therapist and former massage therapy program chair at a Long Beach college. Kleiman invented the Roleo Arm and Hand Massager. A new Roleo for feet is under development for 2017. He wrote, “How You Can Make Money Selling Self-Care Tools” for massagemag.com.