Pathology H for Massage Therapists

Hair Loss (other than normal baldness)

Definition: loss of hair including facial hair and body hair

Causes: hormonal changes, high fever, stress, thyroid problems, vitamin deficiencies, toxicity

Indications: Massage to increase circulation, eliminate toxins

Contraindications: Refer to appropriate health care practitioner for nutritional support and lifestyle changes.

Headache  (see also Migraine)

Definition: pain or dull ache in the head; May be due to vascular change, muscle tension or more severe underlying pathology such a tumors.

Causes: stress, neck and shoulder tension, TMJ, food allergies (wheat, dairy, chocolate, vinegar, bananas ), hormonal disturbances, trauma, nutritional deficiencies, exposure to irritants or food additives such as MSG, anemia, bowel problems, hypoglycemia, spinal misalignment, tooth grinding, withdrawal from drugs or caffeine, sinus problems, eyestrain, fatigue, whiplash.

Indications: Massage to head, neck and shoulders.  Check occipital ridge, levator scapula, jaw, temporal area and trapezius for triggerpoints.  Teach diaphragmatic breathing and work on diaphragm. Decompress cranial and facial structures. Steam inhalation, heat to cervical area and chest to promote sinus drainage.  Migraines may sometimes be alleviated if caught at the right moment, but you will never know when that may be.  Massage if tolerated.

Contraindications: Refer to other health care provider if persistent, severe and reoccurring headaches to rule out serious illness.  Refer to Acupuncturist/Naturopath/Chiropractor for other support.

Trager Work Reduces Headache Frequency

Massage Reduces Headache Frequency

Basic Clinical Massage Therapy: Integrating Anatomy and Treatment (Lww Massage Therapy & Bodywork Series) (Hardcover) – by James H. Clay, David M. Pounds

Clinical Massage Therapy: Understanding, Assessing and Treating Over 70 Conditions (Paperback) – by Fiona Rattray (Author), Linda Ludwig (Author)

Travell & Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual (2-Volume Set) (Hardcover) – by David G. Simons, Janet G. Travell, Lois S. Simons, Barbara D. Cummings

Head Injury

Definition: trauma to head resulting in a contusion, laceration or other injury

Signs/Symptoms:  disorientation, nausea, disturbed vision, pain, black out, uneven pupil dilation

Indications: Upon referral of physician massage to reduce tension and pain

Contraindications: Refer to Physician for diagnostics.

Heel Pain

Heel Pain by Ben Benjamin

Heart Attack (Myocardial Infarction)

Definition:  when blood supply to heart is sharply cut off or reduced depriving it of oxygen

Causes: partial or complete blockage of artery by blood clot or plaque, aneurysm (weak spot in blood vessel) may rupture, arrhythmia

Signs/Symptoms: stress, high blood pressure, chest pain, shortness of breath, sweating, nausea, vomiting; pain in left arm , neck, jaw or area between shoulder blades

Indications: Refer to Physician Immediately:  Massage beneficial in recovery process for stress reduction

Contraindications: Refer to Physician: Recovery may be assisted by Naturopath or Acupuncturist.

Heel Spur

Definition: pointed growth consisting of bone (calcium deposits) on the heel of foot

Causes: arthritis, neuritis, alkalosis, tendinitis, improperly balance posture (weight on heels), shortened achilles tendons, high heel or other improperly fitting shoes, overweight, stress on heel area

Signs/Symptoms: pain in heel or fascia of foot

Indications: Stretching for calf, assess posture and treat accordingly, Ice, hot linseed oil packs

Contraindications: None


Definition: a tumor or swelling filled with blood

Causes: trauma

Signs/Symptoms: lumpy feeling, sometimes surrounded by bruising

Indications: Massage above area

Contraindications: Refer to physician.


Definition: disorder of the blood clotting mechanism, blood does not clot

Causes: hereditary deficiency of or defective blood proteins that are needed for repair

Signs/Symptoms: cuts bleed somewhat longer than usual, may have complications due to internal bleeding

Indications: Use only light work under the supervision of a physician

Contraindications: Work only under supervision of physician

Turning Hurt into Relief Touching the Hemophilia Community By Karrie Mowen, Editor


Definition: inflammation of the liver:  Type A in usually in children transmitted by fecal matter and food and usually does not cause lasting damage.  Type B through contact with infected blood and body fluids. Type B may last from 2-6 months and may lead to cirrhosis or other liver problems. Type C contracted through the blood and transfusions may lead to chronic problems. Toxic Hepatitis caused from exposure to toxic chemicals

Causes: viral infection, toxic chemicals

Signs/Symptoms: liver tender and enlarged, unable to function normally, build up of toxins in the body results: fever, weakness, vomiting, headache, muscle aches, flu like symptoms

Indications: Use caution: Highly contagious; Get physicians approval.

Contraindications: Work with Physicians recommendations for hygiene and sanitation

Hepatitis B Info

Hepatitis C- The Silent Epidemic by Ruth Werner

Herpes simplex (Type I, ii)

Definition: painful, fluid filled blisters; usually of the mouth or around eye or genital area

Causes: virus; weakened immune system, stress

Signs/Symptoms: painful, blisters that rupture and crust over; Highly contagious!

Indications: Avoid contact with affected area; Use strict sanitation practices. Massage to reduce stress.

Contraindications: Avoid contact with affected area. Refer to appropriate health care practitioner. Nutritional supplements may be beneficial in reducing outbreaks.

Herpes Simplex Simplified by Ruth Werner

Herpes zoster (Shingles)

Definition: shingles; viral infection of the nervous system; fluid filled blisters form on the nerve endings

Causes: chicken pox virus; may lie dormant and reactivate when the immune system is compromised from stress, poor diet and lifestyle; environmental toxins

Signs/symptoms: pain, blisters; most often along intercostal nerves occasionally trigeminal nerve or optic nerve which may be cause damage to the eye.

Indications: Avoid lesions; Most likely to painful to work on or client may be unable to lie down on.

Contraindications: May be on steroids to reduce inflammation. Wait until lesions are healed.

Herniated disc

Definition: compression of intervertebral discs usually in the low back but can be in the neck, leading to protrusion of disc or rupture of disc

Causes: trauma, weakened ligaments, improper posture, tight muscles, weak muscles, inactive muscles

Signs/Symptoms: back pain, pain down leg, tingling in foot, calf or thigh, foot drop

Indications: Postural rebalancing; release and balance psoas, adductors, realigning hips

Contraindications: Refer to Naturopath for Peat pack treatments, Chiropractic, Acupuncturist.
Surgery should be last resort.

Book Resource : Healing Back Pain (link to  by John Sarnos

Hernia (inguinal, hiatial)

Definition:  Hiatial- stomach pushes upward through an opening in the diaphragm into the thorax
Inguinal- protrusion of the hernial sac containing the intestine into the inguinal opening

Causes: congenital defect, gastroesophageal reflux, vertebral subluxation, stress, improper diet, excess acidity

Signs/Symptoms: heartburn, exertion

Indications: Massage for stress reduction, postural alignment therapy; hydrotherapy- drink as much water as possible upon awakening and jump up and down to pull stomach back down.

Contraindications: Refer to physician for inguinal to eliminate the possibility of strangulation. For Hiatal refer to appropriate health care practitioner  for diet modification and treatment.

HIV/AIDS (Human immunodeficiency virus/Acquired Immune Deficiency Syndrome)

Definition: immune system disorder; body is unable to defend itself.

Causes: virus spread by sexual or blood to blood contact

Signs/Symptoms: may get flu like symptoms 2-4 weeks after exposure; diarrhea, fever, fatigue, loss of appetite, night sweats, swollen lymph nodes, enlarged liver and spleen, cancers, Kaposi’s sarcoma, herpes simplex

Indications: Massage for stress reduction, pain reduction. Use universal precautions. (protective barriers, disinfect with thorough washing, proper needle disposal, use ventilation devices of mouth to mouth resuscitation, avoid contact if you have openings in skin) Use 10% bleach solution; wash immediately with antiviral agent

Contraindications: Refer to appropriate health care practitioner  for treatment of immune system. Use gloves if you have broken skin on the hands. If patients have breaks in skin, lesions, rashes also use gloves.

Massage for HIV-Positive Children Massage Magazine

Massage Improves Immune Function in HIV-Positive Adolescents
Boosting Immunity Against HIV Massage Therapy Offers Hope By Shirley Vanderbilt

Chakra Man AIDS, Bodywork and Inspiration By Stephanie Mines, Ph.D.

High Blood Pressure – see hypertension

Hodgkin’s disease

Definition: chronic infectious disease that may start as an inflammatory disorder and progress to a neoplastic disorder; cancerous growth of cells in lymph system

Causes: unknown; immune disorder, infection, Epstein-Barr virus

Signs/Symptoms: enlarged lymph glands and nodes (usually in axilla, neck, or inguinal area), spleen, liver and sometimes kidneys, weakness, fever, night sweats, weight loss, fatigue, itching, loss of appetite; diagnosed only by biopsy

Indications: Massage for stress reduction.  There is much controversy over massage in cancer patients.  I believe it can only be helpful to awaken the person to the needs of their body and assist in deeper healing.  Proceed

Contraindications: Work under physician referral. Treatment may include radiation/chemotherapy.

Book resource- Medicine Hands: (link takes you to Massage Therapy for people with Cancer – by Gayle MacDonald

Huntington’s Disease

Definition: degenerative disease of the nervous system

Causes: unknown;  genetics

Signs/Symptoms: dementia, muscular twitching, cerebral cortex affected

Indications: Massage for stress reduction

Contraindications: Work under supervision of physician.


Definition: increased sensitivity to sensory stimuli such as pain or touch

Causes: may be a side effect of drug, fibromyalgia, herpes, carpal tunnel, neuritis; stress – emotional or physical.

Signs/Symptoms: pain with slightest touch

Indications: Massage lightly; May help desensitize, Be aware of client at all times; Ask for constant feedback

Contraindications: Refer to physician to determine cause and proceed accordingly.


Definition: high blood pressure

Causes: stress, improper diet, lack of exercise, caffeine use, high sodium intake, water retention, hereditary, arteriosclerosis, athlersclerosis

Signs/Symptoms: headaches, sweating, rapid pulse, flushed skin, dizziness, shortness of breath, visual disturbances

Indications: Massage for stress reduction, relieve tightness that may be adding to restricted flow of blood especially forearm tightness. Massage may momentarily increase blood pressure.

Contraindications: Refer to appropriate health care practitioner for lifestyle, diet and nutritional treatments. Have physician monitor in extreme conditions

The Ups and Downs of Blood Pressure: Effects of Varying Types of Massage Therapy Somatic Research By Shirley Vanderbilt.  Massage and Bodywork Magazine

Reiki Reduces Heart Rate, Diastolic Blood Pressure Massage Magazine

High Blood Pressure Reduced by Massage Therapy Massage Magazine

Medical Massage and Control of Arterial Hypertension
A Pilot Study By Boris Prilutsky Massage and Bodywork Magazine

Nutritional Treatments for HypertensionAlex Vasquez, ND, DC


Definition: eyesight problem; parallel rays come to focus behind the retina

Causes: flattening of eye, eyestrain, disturbance in fluid systems of body

Signs/Symptoms: blurry vision

Indications: Massage for stress reduction; eye exercises

Contraindications: Refer to Bates vision specialist


Definition: overproduction of thyroid hormone resulting in overactive metabolism. Most common form of this disease is Graves’ Disease.

Causes: infection or inflammation of thyroid gland, improper diet

Signs/Symptoms: nervousness, weight loss, usually too hot, increased bowel movements, rapid heartbeat, hand tremors, less frequent menstruation

Indications: Massage for stress reduction, relaxation and detoxification.

Contraindications: Refer to appropriate health care practitioner

Working with clients who have Hypothyroidism by Ruth Werner


Definition: Increased muscle tone that if prolonged could lead to injury

Causes: exercise, stress, food allergies, over exertion, trauma

Signs/Symptoms: pain, tightness, stiffness, reduced elasticity, extensibility and contractility, ischemia, tissue colder than normal, numbness due to impingement

Indications: Massage to lengthen muscles, increase circulation, restore elasticity and extensibility

Contraindications: Refer to Physician if no known cause


Definition: low blood sugar

Causes: over secretion of insulin by pancreas, poor diet, excess sugar, carbohydrates, alcohol, caffeine, soft drinks in diet, stress, adrenal insufficiency, thyroid disorders, kidney disease, immune deficiency and candidia overgrowth

Signs/Symptoms: fatigue, headache, irritability when hungry, anxiety, constant hunger, swollen feet, insomnia, short temper

Indications: Massage for stress reduction; Have snacks available if you know the person is highly hypoglycemic.

Contraindications: Refer to appropriate health care practitioner for treatment.


Definition: underproduction of thyroid hormone

Causes: Hashimotos’ disease (body becomes allergic to thyroid hormone), iodine absorption, tumor, pituitary problems, lack of progesterone

Signs/Symptoms: fatigue, cold, painful menstrual periods, muscle weakness, dry skin, yellow bumps on eyelids, hair loss, anxiety, bulging eyes

Indications: Massage for stress reduction

Contraindications: Refer to appropriate health care practitioner  for treatment. Extreme cases may need immediate attention of physician.


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