When You Should Not Get a Massage

Massage is safe for most people most of the time, which is exactly why the exceptions are worth knowing. Some are absolute. Most are not - they are situations where the answer is a different therapist, a different technique, or a phone call to your doctor first, rather than no massage at all.

This is general information, not medical advice. Anything on this page that applies to you is a conversation with your clinician.

Do not book today

These are the straightforward ones. Rebook when they have passed.

• You have a fever or an active infection. Massage will not help and you will share it with the therapist and the linens.
• You have a contagious skin condition - impetigo, active shingles, scabies, an untreated fungal infection.
• You are acutely unwell with anything - vomiting, a significant migraine, a flare of something.
• You have been drinking. Reputable practices will decline to treat you, and they are right to.
• You have a fresh injury, in the first 48 hours. A new sprain, strain or contusion wants rest and ice, not hands.
• You have severe unexplained pain. Get it looked at first.

The one that matters most

Suspected deep vein thrombosis. A blood clot in a deep vein, usually in the leg, presenting as swelling, redness, warmth and pain typically on one side only. Massage over a clot can dislodge it, and where it goes next is your lungs.

If you have those signs, particularly after a long flight, surgery, immobility or with any known clotting risk, that is an urgent medical assessment, today, not an appointment for a leg massage. A well-trained therapist will screen for this and decline. It is one of the clearest reasons the training requirement exists.

Ask a clinician first

Not prohibitions. Situations where you should get clearance and then tell the therapist.

Anticoagulants and bleeding disorders. Deep pressure causes bruising and bleeding under the skin. Light to medium work is usually fine. Say so at booking so nobody has to discover it.

Cancer, during or after treatment. Massage is not off the table and is often actively helpful for the fatigue, anxiety and pain that come with treatment. What it needs is a therapist with oncology massage training - a real qualification covering pressure, positioning, lymphoedema risk, and areas to avoid around ports, radiation fields and surgical sites. The Society for Oncology Massage maintains information on the training. Clear it with your oncology team, who may have specific instructions about timing around chemotherapy cycles.

Pregnancy. Not a contraindication, but it changes the positioning, the pressure and the training required. Our prenatal massage guide covers what should be different.

Osteoporosis and fragile bones. Deep pressure and joint mobilisation need adjusting. Say so.

Uncontrolled high blood pressure or a recent cardiac event. Ask. This applies with more force to heat, sauna and cold plunge than to massage.

Recent surgery. Get your surgeon's clearance and keep work away from the site until they say otherwise. Manual lymphatic drainage is sometimes specifically recommended post-operatively, and the timing for that should come from the surgical team, not the spa.

Diabetes with neuropathy. Reduced sensation means you may not feel pressure that is too much. Tell the therapist so they can work more conservatively and inspect the skin.

Lymphoedema, or lymph nodes removed. Specific technique territory. General massage on an affected limb can make things worse.

Areas to flag rather than avoid entirely

Varicose veins, recent scars, moles that have changed, unexplained lumps, areas of numbness, a joint replacement, an implanted device such as a pacemaker or an insulin pump. None of these means no massage. All of them mean the therapist works around or adjusts, and they can only do that if they know.

Trauma and comfort

Worth saying plainly, because it goes unsaid. If being touched, being undressed, or being face down with someone behind you is difficult for you - for any reason, including reasons you do not wish to explain - there are options, and none of them requires disclosing anything.

You can stay clothed and book Thai, shiatsu or reflexology. You can request a therapist of a specific gender. You can ask to stay face up for the whole session. You can ask the therapist to say what they are about to do before they do it. You can bring someone who waits in reception. And you can end the appointment at any point, without a reason.

All of these are ordinary requests that practices accommodate regularly.

During the session

Stop and say something if you feel dizzy or nauseous, if you get sharp or radiating pain rather than the dull good-hurt of pressure, if you feel numbness or tingling, or if anything at all makes you uncomfortable. None of that is something to push through, and "I need to stop" is a complete sentence.