Cautions and Contraindications

What is a Contraindication?
Contraindication: Any (medical) condition that renders a particular treatment (massage) improper or undesirable. Contraindications are health conditions, which may predispose people to being harmed when they are massaged. Massage is contraindicated when it could cause an adverse or undesirable reaction of a particular condition, unwanted tissue destruction, or spread of disease.

A hospital or emergency room is preferred to a massage table for the following conditions:

Anaphylaxis Appendicitis Cerebrovascular Accident (Stroke) Diabetic coma Insulin shock Epileptic seizure Myocardial infarction (heart attack) Pneumothorax Atelectasis

Severe asthma attack Syncope (fainting) Contagious Diseases Significant Fever (101F or 38.3C and higher) Shock (all types) Thyroid storm Undiagnosed tumors or lumps Acute intracranial hemorrhage Recent skull fracture

Systemic, Local & Medical contraindications

Systemic Contraindication signifies that massage should be generally avoided. Modification may be allowed with Medical consultation. Please let your massage therapist know if you have any of the following conditions:

Acute-stage pneumonia Acute pelvic inflammatory disease Acute respiratory condition:      Asthma      Emphysema      Pneumonia Advanced organ failure Aneurisms deemed life threatening, thrombophlebitis or arteritis Ascites Bacterial Infections (staphylococcal, Scarlet fever) Bronchiectasis Chronic active hepatitis Coma Contagious or Infectious Diseases/Conditions (systemic) Diabetes Mellitus 1 - 2 w/complications:     Advanced heart disease     Advanced kidney disease     Advanced vascular complications (atherosclerosis &/or advanced hypertension) Endocarditis/pericarditis (infective and non-infective) Fever (101ºF/38.3ºC) Headache (sudden onset of severe undiagnosed) Heavy intoxication-Drugs &/or Alcohol Hemophilia Hemorrhage or any internal bleeding (not menses)

Hyper/Hypoglycemia     (stupor/confusion/inappropriate behavior) Hypertension   (severe and unstable high blood pressure) Hypoxemia Inherited Connnective tissue Disorders (Osteogenesis Imperfecta, Marfans syndrome) Kidney/liver failure Lung abscess or tumor Osteomyelitis Parasitic infections Pitting edema due to complications with:      Heart      Kidney      Cancer Post cerebrovascular accident-CVA or stroke (unstable condition) Post myocardial infarction-MI or heart attack (unstable condition) Pregnancy Complications      Ectopic      Eclampsia      Pre-eclmapia      Toxemia Pulmonary edema/hypertension Recent skull fracture Respiratory failure (advanced) Shock Sepsis Severe atherosclerosis/arteriosclerosis Severe unexplained internal pain Undiagnosed mole(s) Undiagnosed lump

Regional (Local) Contraindications

Massage can be provided with special care to avoid a particular area or region. A physician should be consulted for a more complete evaluation and to rule out any underlying conditions. Acute inflammatory condition Acute disc herniation Acute flare-up of inflammatory arthritis (rheumatoid, lupus, ankylosing spondylitis) Acute neuritis Acute Trigeminal Neuralgia Aneurysm; life threatening (abdominal aorta) Anti-inflammatory treatment site (24-48hrs) Buerger’s disease Contusions

Deep Vein Thrombosis Diabetes with loss of sensation Ectopic/High risk pregnancy Endometriosis Esophageal varicosities Fracture    (casted or directly after cast removal) Frostbite Goiter (acute & subacute) Hernia Joint Dislocation    (instability or hypermobility) Kidney Infection (stones) Local contagious/infections condition Local irritable skin condition

Malignancy (unstable) Mastitis Meningitis Minor surgery Open wound or sore Pelvic Inflammatory Disease Phlebitis, phlebothrombosis, arteritis Pitting Edema Radiation therapy (during treatment) Recent Burn Severe varicose veins Superficial Thrombosis    (chronic or long-standing) Temporal arteritis Undiagnosed lump

Medical (Adaptive) Contraindications

Conditions that are indicated for massage but require treatment adaptation &/or medical consultation.

AIDS Amyotrophic Lateral Sclerosis (ALS) Asthma Chronic pneumonia Hemiplegia Cerebral palsy Multiple Sclerosis (MS) Spinal cord injury Parkinson Radiation therapy (after several weeks) Congestive heart failure Chronic kidney disease Immunosuppressed patients Coma (w/ Physician’s referral) Debilitation Diagnosed atherosclerosis Drug withdrawal Chronic Emphysema Hyper/Hypotension Inflammatory arthritides Major Surgery Osteoporosis Osteomalacia Cancer

Moderate diabetes mellitus Post-cerebrovascular accident or     myocardial infarction Recent head injury Chronic angina (chest pain) Severe varicose veins Diverticulitis Chronic ulcerative colitis/Crohn’s disease Mastitis Endometriosis Unexplained hematomas Disk herniation Contusion Flaccid paralysis or paresis Fracture (while casted) Hernia Joint instability Chronic pelvic inflammatory disease Diarrhea/Constipation Irritable Bowel Syndrome (IBS) Gestational Diabetes Seizure disorders Inflammatory conditions (acute/chronic)

Important Considerations:

When in doubt, please consult your doctor, contact us or refer to the resources on our Web Search page for more information about your specific condition or situation. Different medications, such as anti-inflammatory, muscle relaxants, and analgesics may require modifications of the massage treatment. Emotional and psychiatric conditions vary in their magnitude, types and responses to massage. Decisions will be made according to individual circumstances. Please inform your therapist of any allergies to any lotions, oils, scents (aromatherapy), cleansers and disinfectants. The presence of prosthetic devices; pins, staples, plates, artificial joints, etc. may alter the way we apply massage techniques.

Fritz, Sandy: Mosby’s Fundamentals of Therapeutic Massage, ed 3, St. Louis, 2004.