COLLEGE OF MASSAGE THERAPISTS OF BRITISH COLUMBIA

CONTRAINDICATIONS TO MASSAGE THERAPY

(A working document of the College, intended as a guideline and support tool for massage therapy educators and students, and for practising RMTs.  This version current to April 2010) 

MEDICAL EMERGENCIES (requiring First Aid and/or send to Doctor/hospital)

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 tumours or lumps, Acute intracranial hemorrhage, Recent skull fracture 

PALLIATIVE CARE:

PLEASE NOTE THAT PATIENTS DIAGNOSED AS TERMINALLY ILL MAY BE TREATED BY AN RMT.  CONSULTATION WITH THE TREATING PHYSICIAN IS ADVISED.  


CONTRAINDICATIONS TO MASSAGE THERAPY:  (A & B)

A: GENERAL (SYSTEMIC) CONTRAINDICATIONS  
  • ƒDiabetes Mellitus 1 or 2 with advanced heart or kidney disease or advanced vascular complications (atherosclerosis and/or advanced hypertension)  
  • ƒSevere and unstable high blood pressure (hypertension) 
  • ƒFever
  • ƒSudden onset of severe undiagnosed headache 
  • ƒUndiagnosed mole(s) 
  • ƒUndiagnosed lump(s)
  • ƒAdvanced organ failure
  • ƒPitting edema – heart, kidney, cancer
  • ƒContagious or Infectious Diseases/Conditions 
  • Chronic active hepatitis 
  • Severe atherosclerosis/arteriosclerosis
  • Pre-eclampsia/eclampsia or toxemia in pregnancy 
  • Hemophilia
  • Hemorrhage or any bleeding internally (not menses)  
  • Cor Pulmonale  
  • Endocarditis/pericarditis (infective and non-infective) 
  • Any Unstable conditions e.g. (post Cerebrovascular accident and post myocardial infarction) 
  • Aneurisms deemed life threatening, thrombophlebitis or arteritis 
  • ƒAcute Emphysema  
  • ƒAcute Pneumonia  
  • ƒPulmonary edema/hypertension 
  • Hypoxemia 
  • ƒEctopic pregnancy 
  • ƒBronchiectasis  
  • ƒLung abscess or tumour
  • ƒHeavy intoxication – Drugs and/or Alcohol 
  • ƒAcute Pelvic Inflammatory Disease 
  • ƒComa
  • ƒSepsis
  • ƒAscites
  • ƒSevere unexplained internal pain
  • ƒInherited Connective Tissue Disorders i.e. Osteogenesis Imperfecta, EhlersDanlos Syndrome, Mixed connective tissue disease, Marfans syndrome 
  • ƒHyper/hypo glycemic (stupor/confusion/inappropriate behaviour) 
  • Osteomyelitis
  • Positive occlusion signs 
  • ƒRecent skull fracture
  • ƒHigh risk pregnancy: can be both general and local depending on the symptoms

Skin 

  • ƒInflammatory conditions of the skin (may be local as well) 
  • ƒParasitic infections 
  • ƒGeneralized Exfoliative Dermatitis
  • ƒAcute Psoriatic arthritis  

 Bacterial: 

  • (impetigo, staphylococcal, scalded skin syndrome, folliculitis, carbuncles) 

Group A streptococcus

  • Cellulitis 
  • Erysipelas  
  • Scarlet fever  
  • Bacteremia (blood stream infections) 
  • Toxic Shock Syndrome 
  • Necrotizing Fasciitis (sometimes called flesh-eating disease) 

 Group B streptococcus (GBS) 

  • Sepsis (blood infection) and meningitis (infection of the fluid and lining surrounding the brain) in newborns 

Viral 

  • Warts (could be local contraindication as well) 

 B: CONTRAINDICATIONS TO LOCAL AREAS 

  • ƒ Local contagious/infectious conditions 
  • ƒ Acute flare-up of inflammatory arthritides (e.g. Rheumatoid Arthritis, Systemic Lupus Erthematosus, Ankylosing Spondylitis, Reiter’s Syndrome)
  • Cancer (highly metastic) – may be an absolute C.I. to the whole body depending on case 
  • ƒRadiation therapy during treatment 
  • ƒPhlebitis 
  • ƒSevere varicose veins 
  • ƒDeep vein thrombosis 
  • ƒThromboangiitis Obliterans (Buerger’s disease) 
  • ƒHigh Risk Pregnancy 
  • ƒAcute Neuritis
  • ƒAcute Trigeminal Neuralgia 
  • ƒMeningitis 
  • ƒSevere Causalgia 
  • ƒEsophageal varicosities
  • ƒCold applications in acute Raynaud’s 
  • Acute and subacute goiter 
  • ƒAny undiagnosed internal bleeding  
  • ƒSevere unexplained internal pain 
  • ƒAcute Ulcerative Colitis / Crohn’s disease – if patient has a fever it becomes a general contraindication. 
  • ƒVenomous bites or stings
  • ƒHypothermia  
  • ƒNo abdominal massage in hypertension
  • ƒAcute Diarrhea

Skin 

  • ƒInflammatory conditions of the skin (may be general) 
  • ƒCellulites 
  • ƒStasis Dermatitis 
  • ƒSuperficial fungal infections (ringworm) 
  • ƒViral infections – warts (may be general) 
  • ƒAcute psoriasis   
  • ƒOpen wounds/sores or acute or infected scar
  • ƒRecent burn 
  • ƒLocal irritable skin conditions
  • ƒFrostbite 
  • ƒOpen wound, sore, decubitus ulcers
  • ƒSkin cancer