You expect to get your medical history taken when you go in to your physician’s office for your regular checkup. But what about when you get a massage? The fact is, it is important that your massage therapist is aware of certain conditions you have or medications you may take, as they may be contraindicated with massage.

In this month’s feature, “Why Your Massage Therapist Should Take Your Medical History,” Dianne Polseno tackles some of the questions your therapist should be asking, as well as some things you should bring up with your therapist if he or she doesn’t ask.

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By Dianne Polseno

When you make an appointment for massage, the last thing you may be thinking about is whether or not your massage therapist should be taking a medical history. But it is an important part of your massage session.

Massage therapists need to know about your current and past health status in order to ensure a safe massage experience. Therefore, you should expect to be asked questions about your medical history and medications before you receive massage. This information helps the massage therapist determine how massage might affect and influence you physically, and if there are any medical reasons why massage cannot be done safely at that present time.

The extent, content and amount of questions asked are in part determined by the circumstances and setting of the massage. For example, seated chair massage at a health fair will afford a different time frame for the health history interview than at a massage therapy office.

Regardless of the setting, certain fundamental information is vital. The following questions, in various ways and combinations, should be asked.

Are you currently being treated by a doctor for any medical conditions?

At the very least, a massage therapist would want to know if you have a condition that requires assistance getting on or off the massage table, such as dizziness or joint problems. Beyond logistics, certain medical conditions are considered precautionary and others are considered contraindicated for massage.

Getty Images A massage therapist should be aware of any medications their clients are taking, as they indicate the presence of a condition that may be contraindicated with massage.

Precautionary means that the massage therapist needs to either investigate further to determine the safety of massage, or that the massage needs to be modified, i.e., that certain techniques aren’t safe for this condition. Examples include high blood pressure, cardiac problems, cancer, disc pathologies and multiple sclerosis. Avoiding heat application to a client who has multiple sclerosis is an example of a modification. In other cases such as cancer, cardiac problems and high blood pressure, the stability of the condition might require the physician’s affirmation, and medical clearance might be requested before a massage can be done.

Contraindication for massage means that any form of massage could put you in medical jeopardy or worsen the condition. In these conditions, massage is not advised while the condition is acute and needs to be postponed until the condition resolves. Infection and inflammation, internal bleeding, congestive heart failure, gout, blood clots and hives are examples of contraindicated conditions. The appropriateness of massage would be reevaluated once the symptoms subside, or once the condition is non-acute, as determined by a physician.

What medications are you taking?

Your medications are important for massage therapists to know about because they indicate the presence of medical conditions that may be precautionary or contraindicated for massage. For example, daily aspirin and blood thinners indicate clotting or cardiac conditions; steroids indicate local or systemic inflammatory conditions.

A therapist should be aware of your use of pain medications, muscle relaxants and anti-inflammatory medications because they alter the presentation of symptoms at the time of the massage. For example, when pain medication is taken before a massage appointment, it will lessen your pain and increase your tolerance for deep work, which would normally be avoided if the true pain level was obvious. In this case, you could feel worse once the effects of the pain medication wore off.

What is your past experience with massage?

Your previous massage history can be most informative when you have a medical condition; your response can indicate how you might be affected by massage now. For example, a client with fibromyalgia who has received massage many times in the past without negative affects is likely to respond similarly now.

Keep in mind that effects of past massage by no means offer conclusive information about the physical safety of future massage. Yet in conjunction with information obtained from other questions, the massage therapist can better infer how massage might affect you with medical conditions now.

Getty Images There are special considerations for a pregnant client. For example, deep-tissue work should be avoided on the expectant mother's lower extremities.

Have you had any recent trauma or accidents?

If you have been injured from an accident, fall, sporting incident, etc., the most appropriate action in the first 24- to 72-hour period would be medical evaluation, not massage. Sprain, fracture, dislocation, contusion and internal bleeding are examples of trauma-induced conditions that require medical evaluation and treatment. Massage could be effective once the condition is resolved or stabilized, which could be days or weeks later, when safety is affirmed by the treating medical professional.

Have you had any recent surgery?

Depending on the type and extent of surgery, massage could be contraindicated until significant healing occurs. A massage therapist may want medical clearance from a surgeon if surgery occurred within the past few months. The massage techniques used might have to be modified to avoid the surgical site even beyond that time frame.

Do you have a recent history of blood clots, aneurysm or phlebitis?

These are serious medical conditions, and if they are current or recent issues for you, massage is contraindicated. Because massage increases circulation in acute phases of these conditions, the increase could cause life-threatening effects.

Are you pregnant?

Pregnancy is not an illness or medical problem, but a therapist should know about the situation, in order to modify the massage for the safety of the mother and baby. Among the modifications for pregnant women are techniques that avoid deep-tissue massage to their lower extremities and points around the ankles.

Do you have any allergies?

Ingredients in massage products, oils and creams could cause a reaction if you have allergies to them. The most common examples are allergies to nuts or soy, since many oils and creams contain them.

Summary Thoughts

If your safety and well-being is to be ensured it is important that the massage therapist know your medical and health history. Furthermore, the clearance of the treating medical professional may be requested prior to massage. These measures provide the basis for effective massage treatment planning as well as your safety, comfort and maximum benefit.

~ Dianne Polseno writes a regular ethics column for Massage Therapy Journal. She is the former chair of the National Ethics Subcommittee, is a practicing massage therapist, practical nurse, academic director and teacher at the Bancroft School of Massage Therapy. She can be reached at: dpolseno@bancroftsmt.com.

Q: What does a massage therapist do that a physical therapist doesn’t?

A: A massage therapist focuses on the normalization of soft tissues affected by stress, injury, and illness through the use of manual techniques that improve circulation, enhance muscular relaxation, relieve pain, reduce stress, enhance immune function, or promote health and well-being. Massage therapists specialize in the use and application of therapeutic massage techniques. Generally, a physical therapist concentrates on rehabilitation of physical damage caused by illness and injury through the use of various modalities, including electrical, mechanical and ultrasound devices; therapeutic and rehabilitative exercise; and manual techniques.