Preparing for a Massage: Health Conditions and Medicines to Mention

Why your health history matters

On a first visit the therapist usually asks general questions about your health, lifestyle and medical history, according to Cancer Research UK (CRUK). [1] The College of Massage Therapists of Ontario (CMTO), the regulator in Ontario, Canada, says therapists should only collect information reasonably needed for safe and effective treatment. [2] Rules differ elsewhere; what other regulators require is not described in the sources we read.

The aim is not to scare you off. Most people have no problems, and NCCIH says the risk of harm appears low, though rare serious cases of blood clot, nerve injury or bone fracture have been reported. [3] A good history lets the therapist adjust or skip things. It is not a substitute for medical advice: if you are unsure whether massage suits you, NCCIH suggests discussing it with your health care provider. [3]

A checklist of things to mention

The Ontario standard lists topics a therapist may ask about, which makes a useful checklist.

• Why you are coming. The standard says therapists ask for the reason you are seeking care and any allergies. [2]
• Recent or current injuries. The standard lists strains and similar injuries. [2]
• Symptoms of injury, infection or illness. It names bruising, fever, pain, swelling, dizziness, muscle weakness and a raised heart rate or palpitations. [2]
• Conditions of the skin, muscle, joint, bone, heart, circulation or lungs. [2]
• Greater sensitivity to pain or pressure. [2]
• Pregnancy. The standard lists it among stage-of-life topics. [2]
• Cancer or cancer treatment. The standard mentions cancer status where you choose to share it. [2]

CRUK says techniques may need adapting if you are having cancer treatment, are very weak, have bone fractures, have heart problems or arthritis, or are pregnant or breastfeeding. [1] It also advises avoiding areas of broken, bleeding or bruised skin, areas treated with radiotherapy, and general massage on arms or legs swollen by lymphoedema. [1] The same page says people with cancer should avoid very deep massage. [1]

Medicines and substances to mention

The Ontario standard says therapists may ask about pain medicines, anti-inflammatory medicines, corticosteroids, muscle relaxants, anti-coagulants (blood thinners), inhalers, heart and blood-pressure medicines, and medicines or recreational drugs that change how you sense pain or sensation. [2] The NHS explains that anticoagulants are medicines that help prevent blood clots. [4] Specific massage rules for people on blood thinners: Proper evidence not found in the sources we read, so ask your prescriber and therapist; do not change a medicine on your own. See massage with blood thinners and bleeding disorders.

The same standard asks therapists to consider whether alcohol or cannabis affects how you perceive pain or pressure. [5] Arriving sober helps you give accurate feedback.

What you do not have to share

The CMTO standard says patients have the right to give, withhold or withdraw consent to collection of their health information, and that therapists must explain why they ask when you want to know. [2] It also says therapists must not ask about unrelated personal life. [2] In Ontario you can ask why a question matters. Elsewhere, ask the same question.

Preferences worth stating

Tell the therapist your pressure comfort and areas to avoid. CRUK says to let the therapist know if you feel uncomfortable and want them to stop at any time. [1] CMTO's consent standard says patients can withdraw consent at any time. [5] More on talking to your therapist and what to expect at a first massage.