When to Say No to Massage

Although a massage can relax sore muscles and make you feel better, there are times when you should pass

Massage often tops the list of simple pleasures that can relieve muscular strain, knots and pain; improve mood; provide a brief respite from the grind of the outside world; and possibly contribute to healing in other ways. But like urban legends of alligators in sewers, everyone knows someone who told someone else that they know for a fact … that massage can spread disease or cause symptoms to worsen.
Case in point: a quick Internet search will come up with information that connects massage to the spread of cancer. The old theory was that massage forces cancer cells into the lymphatic system, or speeds up the metabolism, which also could force cancer to spread. Licensed massage therapist Kathleen Clayton of New York, who uses massage in her hospice work, affirms that’s “a total myth.” If cancer is already in your system, “you’re not spreading it” with massage.  
Although historically there has been a good deal of misinformation about the negative effects of massage, newer studies have refuted these ideas, according to Dr. Brent A. Bauer, director of the complementary and integrative medicine program at the Mayo Clinic in Rochester, Minn. Recently, “there has been tremendous growth in the quality of massage research,” he said. Therefore, a more accurate understanding has emerged. “For example, years ago the medical literature cautioned against massage after surgery,” he said,and it is now a regular part of some post-operative care to help reduce stress and pain.”
Nonetheless, there are times when massage might cause more harm than good, so in certain circumstances, it should be avoided.
Chronic conditions require caution
Experts in complementary and integrative medicine, who use massage, yoga and other non-surgical approaches along with traditional medical therapies to treat cancer patients and others with serious conditions, have found that gentle Swedish-style massage can help reduce anxiety and pain.
“Just like for well clients, massage can reduce symptoms of pain, nausea, stress and anxiety,” without the possible side-effects of medication, says Dr. Richard T. Lee, assistant professor and medical director of the integrative medicine program at M.D. Anderson Cancer Center in Houston.
Clayton added: “Not only are we soothing the muscles, but for a half-hour or an hour we are thinking only of ourselves in a relaxed state of mind. There are no meds, just hands-on, quality touch.” Some of her patients who can’t feel their feet due to chemotherapy-related nerve damage have had improved sensation for 24 to 36 hours. So for that amount of time, “They’re not walking on pins and needles.”
Nonetheless, it’s important to avoid active sites of inflammation, metastasis or scarring. If you have active breast cancer, for example, the massage therapist should avoid putting direct pressure on the breast or surrounding lymph nodes.
Other conditions that require caution include:
  • Arteriosclerosis(hardening of the arteries) – Avoid in advanced stages to avoid dislodging clots or thrombi.
  • Autoimmune (Lupus, rheumatoid arthritis, scleroderma) – Avoid during inflammatory stages or acute flare ups, when the skin can be painful to the touch.
  • Circulatory problems – Avoid any kind of body-warming massage, which could cause blood pressure to fall.
  • Deep-vein thrombosis – Avoid; massage increases the risk of a clot being released and traveling to the lungs.
  • Diabetes – Avoid if you have loss of sensation (diabetic neuropathy); avoid area of recent insulin injection because massage may accelerate insulin uptake.
  • Herpes – Avoid infected area because blister fluid could spread virus to the massage therapist.
  • HIV-AIDS – OK for patient, but massage therapist should wear gloves if there are skin lesions and avoid these areas.
  • Low platelet count – only very gentle massage to avoid bruising or hematoma.
  • Osteoporosis – Check with your doctor; if osteoporosis is moderate or severe, massage can cause bones to break.
  • Varicose veins – Avoid affected veins because they can be painful and the protruding area of the vein should not be manipulated

Massage also should be avoided if you’re taking certain medications. Pain medications reduce sensation, so you may not feel pain if the therapist massages a sensitive area or inadvertently presses hard enough to cause bruising or nerve damage. Blood-thinning medications such as warfarin may make you vulnerable to bruising and bleeding.
The right credentials
Whether you have a chronic condition or not, you should seek a massage therapist who has passed a massage training program and has a license– LMT (licensed massage therapist), LMP (licensed massage practitioner) or national certification–NCTM (national certification for practicing therapeutic massage) or NCTMB (national certification for practicing therapeutic massage and bodywork). Chiropractors, physical therapists, and other healthcare professionals may be trained in massage.
If you have a serious or chronic illness, be sure to check with your doctor before getting a massage, and inform the massage therapist
If you are considering massage, talk with your health care provider if you aren’t sure whether massage therapy might carry risks for you. Also inform the massage therapist about your condition, as well as any open or healing wounds, skin infections or recent surgery.
Judith Schoolman is a freelance journalist and adjunct professor of journalism at New York University and City University of New York.

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