When You Should Not Have a Massage

This is general guidance, not medical advice. If you have a health condition, are recovering from surgery or are under a specialist, their advice comes before anything here.

Massage is safe for most people most of the time. But there are times to cancel, times to have a massage with some areas left alone, and times to check with your GP before you book at all. Therapists call these contraindications.

Here is the quick version. Cancel if you are ill, feverish or have a stomach bug. Avoid the area if it has a fresh injury, a wound, a rash or a lump nobody has checked. Ask your GP first if you have a suspected clot, a heart condition, cancer, recent surgery, or take blood thinners.

Cancel and rebook: short-term reasons to skip

These are the easy ones. Rebook once you are better, and most therapists will be glad you did.

• Fever, flu or a heavy cold. Massage can make you feel worse, and you will pass it on to the therapist and their next client.
• A stomach bug. The NHS advises staying away from others until 48 hours after the last bout of sickness or diarrhoea. Apply the same rule to a massage.
• Anything contagious on the skin, such as cold sores on the face for a facial massage, impetigo, scabies or a fungal infection.
• Too much alcohol. You will not feel pressure properly and may feel sick or faint.
• Feeling very unwell and not sure why. See a doctor first. Massage can wait.

Most therapists have a cancellation policy, but a genuine illness is the one reason nearly all of them will be flexible about. Call as early as you can.

Leave these areas alone, but massage elsewhere

Some problems only rule out the area they affect. The therapist works around them and treats the rest of you as normal.

• Open wounds, cuts, burns and recent sunburn
• Fresh bruises, and anywhere that bruises unusually easily
• Acute injuries, such as a sprain in its first 48 to 72 hours, while it is hot and swollen
• Recent fractures, until your clinician says the bone has healed
• Varicose veins, which should get light touch only, never deep pressure
• Rashes, infected skin or a flare-up of eczema or psoriasis
• Lumps you have not had checked, which need a GP, not a massage
• A hot, red, swollen joint, such as during a gout flare

Tell your therapist about all of these before you start, even the small ones. They cannot work around something they do not know about.

Check with your GP or specialist first

These conditions do not always rule massage out. But the right type and pressure depends on your situation, and your care team is best placed to say.

Suspected blood clot: do not have a massage

This is the most important one on the list. Deep vein thrombosis (DVT) usually shows up as throbbing pain, swelling and warmth in one leg, often the calf. Massaging a clot could dislodge it.

If you have these symptoms, contact your GP or NHS 111 the same day. The NHS DVT guidance says to call 999 if they come with breathlessness or chest pain. The risk of clots is higher after surgery, long flights, and in pregnancy and the weeks after giving birth.

Heart, blood pressure and circulation

Uncontrolled high blood pressure, a recent heart attack or stroke, heart failure, or a pacemaker all need a conversation with your GP or cardiac team first. Gentle massage is often fine once things are stable.

Cancer, surgery and other long-term conditions

• Cancer and cancer treatment. Massage can often be adapted, but only with your care team's agreement and a therapist trained in oncology massage.
• Recent surgery. Wait for your surgical team's go-ahead, and keep well away from the wound until it has fully healed.
• Osteoporosis. Firm pressure and some positions can risk a fracture, so lighter work is usual.
• Diabetes with nerve damage. Reduced feeling means you may not notice if pressure or heat is too much.
• Pregnancy. Usually fine with a trained therapist, but see our guide on whether pregnancy massage is safe for the details by trimester.

Medications that change what is safe

Some medicines do not stop you having a massage, but they change how it should be done. Mention them on your health form.

• Blood thinners, such as warfarin, apixaban or daily aspirin, raise the risk of bruising. Lighter pressure is usual.
• Strong painkillers can hide pain that would normally tell you the pressure is too much.
• Steroids taken long term can thin the skin and weaken bones.
• A recent injection, such as a steroid injection or a vaccine, means that spot should be left alone for a few days.

Why your therapist asks so many questions

The health form is not red tape. It is how a therapist spots the issues above before they put their hands on you. A good one will ask follow-up questions and may ask you to check with your GP before going ahead.

That is a sign they know what they are doing. A therapist who skips the questions altogether is a warning sign. Our guides on what to expect at your first massage and checking a therapist is qualified explain what a proper consultation looks like.

Be honest, even if something feels embarrassing or unrelated. Everything on the form is confidential, and the therapist has heard it all before.

Things people often leave off the form, but should mention:

• a recent long-haul flight, which raises the risk of a clot
• a new mole or lump you have been meaning to get checked
• a recent fall, even if nothing seemed broken
• any change to your medication since your last visit

If you see the same therapist regularly, update them each time something changes. A form filled in two years ago is not much use today.

What if you feel unwell after a massage?

Mild soreness for a day or two after firmer work is normal. Our guide on soreness after a massage explains what to expect.

Some reactions are not normal. Get medical advice if you notice:

• swelling, heat and pain in one calf or thigh
• breathlessness or chest pain, which needs a 999 call
• severe pain, numbness or weakness that was not there before
• heavy bruising that keeps spreading

Tell your therapist too, so they can adjust things next time.

Unsure? Ask before you book

If you are not sure whether a condition affects your massage, call or message the therapist before you book. Most will talk it through, and a good one will tell you honestly if a different treatment, a lighter touch or a GP check comes first. Our FAQ page covers more common booking questions.

When you are ready, you can search for qualified, insured therapists near you in our massage therapist directory.