THERAPIES & TRADITIONS · SAFETY
Massage Safety Quick Reference
One-page massage safety summary: emergency signs first, who should check with a clinician before massage, when to stop, consent and boundaries, with links to detailed pages.
Content last updated . This page has not been medically reviewed.
Back to Massage TherapyCall for Help First
In the US, call 911 for any of these, and do not drive yourself.- Possible blood clot with chest or breathing symptoms. Pain and swelling in one leg (usually the calf or thigh), with chest pain or shortness of breath. The NHS says DVT can be very serious because blood clots can travel to the lungs, a pulmonary embolism. [1] Signs of a pulmonary embolism include sudden difficulty breathing, chest pain that is worse when you breathe in, and coughing up blood. [2]
- Stroke signs, especially after any neck work. Face drooping, arm weakness or numbness, slurred speech or confusion, and a sudden severe headache. The NHS says to get help straight away even if symptoms stop after a short time. [3] NCCIH reports that strokes involving neck arteries have been linked to spinal manipulation of the neck, which is rare, and that there is disagreement about whether manipulation can actually cause them. [4]
- Severe or worsening pain, fainting or sudden weakness during or after a session. Stop the session first.
Contact a doctor promptly for dark, red or cola-colored urine, reduced urine, and muscle weakness or severe aching after deep or vigorous work. These are symptoms MedlinePlus lists for rhabdomyolysis, the breakdown of muscle tissue, which can damage the kidneys. [5] A single published case report described rhabdomyolysis following a 2-hour deep-tissue massage in a man who also had influenza A, and the authors described only a possible temporal association. [6] If you are in emotional crisis after a session, call or text 988 in the US.
The Short Version
NCCIH says the risk of harmful effects from massage appears to be low, but there have been rare reports of serious side effects such as a blood clot, nerve injury or bone fracture, some involving vigorous massage like deep tissue or people at higher risk of injury such as older adults. [7] NCCIH also says not to use massage to postpone seeing a health care provider about a medical problem. [7] Massage is at most an add-on to medical care. Do not stop or change any medicine because of massage.Check With a Clinician First
The list below follows New York State's precautions for massage therapists, plus Cancer Research UK for cancer. Rules differ by state and country, so treat this as a starting point to share with your doctor and therapist.| Situation | What the source says | Detailed page |
|---|---|---|
| Blood clot or clot history, acute phlebitis | New York State lists acute phlebitis and/or deep venous thrombosis as a time for caution. [8] | More about Blood clot or clot history, acute phlebitis → |
| Blood thinners or bleeding problems | Caution if medication would be expected to enhance bleeding. [8] | More about Blood thinners or bleeding problems → |
| Fragile bones | Caution with medication expected to weaken bone structure or connective tissue. [8] | More about Fragile bones → |
| Cancer | Cancer Research UK says people with cancer should avoid very deep massage and should talk to their cancer doctor or specialist nurse first. [9] | More about Cancer → |
| Radiotherapy area, broken or bruised skin | Avoid massaging where radiotherapy is given and where skin is broken, bleeding or bruised. [9] | More about Radiotherapy area, broken or bruised skin → |
| Swollen limbs from lymphoedema | Avoid general massage of swollen arms or legs; a specialist type (MLD) is used instead. [9] | More about Swollen limbs from lymphoedema → |
| Fever or contagious illness | Caution when the therapist or client has a fever or contagious disease. [8] | More about Fever or contagious illness → |
| Swelling from heart or kidney failure | Caution with edema due to chronic heart failure or kidney failure. [8] | More about Swelling from heart or kidney failure → |
| Reduced skin sensation (for example diabetes) | Caution when sensation is decreased. [8] | More about Reduced skin sensation (for example diabetes) → |
| Recent injury or surgery | Caution after acute trauma or recent surgery. [8] | More about Recent injury or surgery → |
| Open wounds, hematomas, varicose veins, burns, implanted hardware | The local sites should be avoided. [8] | More about Open wounds, hematomas, varicose veins, burns, implanted hardware → |
| Pregnancy | In the first trimester, no deep sacral work or abdominal massage should be done, according to New York State. [8] | More about Pregnancy → |
Not described in the sources we read: a universal list of safe and unsafe conditions. Ask your own clinician.
Before, During and After a Session
- Expect the therapist to ask about your health, lifestyle and medical history at the first visit, [9] and ask about their training, experience and credentials. [7] See preparing for a massage.
- Cancer Research UK says to tell your therapist if you feel uncomfortable and want them to stop at any time, and that you can stop the session and leave. [9]
- Afterward, Cancer Research UK says some people feel lightheaded, sleepy, tired, thirsty, emotional or tearful for a while. [9]
- If pain, bruising, numbness or new symptoms follow, see when to seek care after massage and the warning signs checklist.
Consent, Boundaries and Reporting
The regulator in Ontario, Canada says treatment only begins after the patient has given consent and the patient can withdraw consent at any time. [10] Cancer Research UK says a therapist should never massage your genital area or touch you in a sexual way. [9] The Federation of State Massage Therapy Boards says state licensing boards or agencies are where you can learn a state's requirements and check a practitioner's license status. [11] See boundaries, misconduct and reporting. Reporting routes beyond the state board: not described in the sources we read for this page.Neck Work Needs Extra Care
Thrusting spinal manipulation is mostly done by chiropractors, although osteopathic physicians and physical therapists also use it, according to NCCIH, and it is different from massage. [4] NCCIH links a type of spinal manipulation focused on the neck to rare tears in neck arteries that can lead to stroke. [4] We give no neck technique here. See neck massage and neck manipulation.Frequently asked questions
Is massage safe?
NCCIH says the risk of harmful effects appears to be low, with rare reports of serious side effects such as a blood clot, nerve injury or bone fracture. [7]
When should I not get a massage today?
Fever or a contagious illness is one time for caution according to New York State's precautions. [8] See when not to book a massage today.
Can massage move a blood clot?
Rare reports of blood clots after massage exist. [7] UCLA Health says lymphatic massage can potentially increase circulation, dislodge a clot or spread infection in people with certain conditions. [12] See the claim check on clots and cancer.
Can massage spread cancer?
Cancer Research UK says some people worry about this, but no research has proved it to be true. [9] It still advises that people with cancer avoid very deep massage and check with their cancer team. [9]
Who do I tell if a therapist crossed a boundary?
You can stop a session at any time. [9] The FSMTB points people to their state licensing board or agency. [11] Other reporting routes are not described in the sources we read here.
References
- NHS (UK), DVT (deep vein thrombosis) (reviewed 30 April 2026). Read 2026-10-22.
- NHS (UK), Pulmonary embolism. Read 2026-10-22.
- NHS (UK), Symptoms of a stroke (reviewed 12 September 2024). Read 2026-10-22.
- NCCIH, Spinal Manipulation: What You Need To Know (page last updated September 2022). Read 2026-10-22.
- MedlinePlus, Rhabdomyolysis. Read 2026-10-22.
- Dickey B et al., Influenza A-induced rhabdomyolysis with acute renal failure following a deep tissue massage (case report). Proc (Bayl Univ Med Cent) 2021. Abstract read 2026-10-22.
- NCCIH, Massage Therapy: What You Need To Know (page last updated May 2019). Read 2026-10-22.
- New York State Education Department, Office of the Professions, Precautions for Massage / Bodywork Therapy. Read 2026-10-22.
- Cancer Research UK, Massage therapy (complementary and alternative therapies). Read 2026-10-22.
- College of Massage Therapists of Ontario (Canada), Standard of Practice: Consent (updated September 8, 2026). Read 2026-10-22.
- Federation of State Massage Therapy Boards (US), Consumer Information. Read 2026-10-22.
- UCLA Health, Lymphatic drainage massage: separating fact from fiction. Read 2026-10-22.