Soreness or Injury After Massage: When to Seek Care

Urgent signs first

After a massage, get urgent medical help rather than waiting. Call 911 (or your local emergency number) for breathlessness with chest pain, stroke signs, or the back-pain emergency signs; for the others, seek same-day medical care or call emergency services if you cannot get it. Signs:

• Sudden shortness of breath, chest pain, or coughing up blood. These can be signs of a clot in the lung. [1]
• A painful, swollen leg with red, blue or darkened skin. The NHS lists throbbing pain in one leg, usually in the calf or thigh, as a symptom of a blood clot (DVT). With breathlessness or chest pain, it says to call 999 (the UK number) or go to A&E. [2]
• Back pain with pain, tingling or numbness in both legs, loss of feeling around the genitals or anus, or bladder or bowel changes. The NHS lists these as emergency signs. [3]
• Sudden face drooping, arm weakness, slurred speech, or a severe headache. These are stroke signs; see neck massage and neck manipulation. [4]
• Dark, red or cola-coloured urine, much less urine than usual, or marked muscle weakness. MedlinePlus lists these as symptoms of rhabdomyolysis, a muscle breakdown that can harm the kidneys. [5] See rare serious harms after massage.

What the trials say about ordinary soreness

Soreness is the side effect that trials report most. The Cochrane review of massage for low-back pain (25 trials, 3,096 people) found increased pain was the most common adverse event, reported in 1.5% to 25% of participants, and no serious adverse events in those trials. [6] Its authors rated the evidence low to very low, partly because massage cannot be blinded. [6]

The 2024 Cochrane review of massage for neck pain was less certain. It could not tell whether massage increases adverse events such as treatment soreness, sweating or low blood pressure, said serious events data were not available, and said reporting was inadequate. [7]

A single-session study of Swedish massage in 101 pregnant women, summarised in a 2021 review, had no control group. In it, 40% reported one or more effects: muscle soreness, headache, worse musculoskeletal symptoms, tiredness or dizziness. [8]

How long does normal post-massage soreness last? Proper evidence not found. We looked in the trials and reviews above and in MedlinePlus and NHS pages and found no massage-specific time limit. MedlinePlus says muscle pain is most often related to tension, overuse or injury. [9] Its general advice, not specific to massage, is to contact a provider if muscle pain lasts more than 3 days or is severe and unexplained. [9]

Soreness or injury? A guide to the difference

If you were already injured

The NHS advises avoiding heat, alcohol and massages for the first couple of days after a sprain or strain, to help prevent swelling. [14] Postpone a session and ask a clinician if you have a new injury, a possible fracture, or a fever.

What to do next

1. Stop activity that makes it worse, and do not "work through" sharp or worsening pain.
2. Note what happened and when. This helps a clinician.
3. Tell the therapist or the business what happened. Concerns about conduct or injury can also go to the licensing body in your area. See reporting adverse events from therapies.
4. Do not stop prescribed medicines because of a massage problem. Talk to your prescriber.

See also what is normal after a massage and the warning signs checklist.