Pathology P for Massage Therapists

Paget’s Disease

Definition: disease of bones; bones are replaced with structurally deficient bone deficient in calcium and weaker than normal

Causes: unknown; may be viral infection, heredity; often confused with hyperthyroidism, bone cancer;  must be diagnosed with bone scans, CT scans, MRI, urine tests, and bone biopsy

Signs/Symptoms: mild to moderate pain, worse with exertion, unexplained bone fractures, headaches, dizziness, ringing in the ears, impaired mobility, may cause deformities such as bowed legs, bent spine

Indications: N/A; Reiki

Contraindications: Massage not recommended because of the lack of structure of the bones


Definition: inflammation of the pancreas; usually from an obstruction of the pancreatic duct

Causes: gallstones, scarring from alcohol damage, cancerous tumor, viral infection, injury, obesity, poor nutrition, drug use

Signs/Symptoms: pain around navel area and back, nausea, vomiting, abdominal swelling and distention, fever, sweating , muscle aches, digestive difficulties

Indications: Massage for stress and pain reduction

Contraindications: Refer to Physician: Refer to appropriate health care practitioner after stabilized for treatment


Definition: diminished or total loss of motor function

Causes: trauma, injury, nerve impingement or compression, tumors

Signs/Symptoms: weakness, loss of movement, loss of muscle tone

Indications: Massage for relief of impingement or compression: movement reeducation for complete paralysis

Contraindications: Caution: unable to feel pain

Parkinson’s Disease

Definition: degenerative disease of the nervous system

Causes: unknown; related to lack of dopamine in brain, dopamine receptors blocked; chemical toxicity
Sign/Symptoms: tremor of hand or hands, fatigue, muscular stiffness, muscular rigidity, shuffling gait, impaired speech, depression, dementia

Indications: Massage to reduce stiffness, stress

Contraindications: Medications for this disease can cause kidney, liver problems, more stiffness, discoloration of skin, nightmares, fatigue. Refer to Naturopath and Acupuncturist for detoxification and treatment


Trager For Parkinson’s Disease and Rigidity – Massage Magazine

Massage Reduces Symptoms of Parkinson’s Disease Parkinsonism by Ruth Werner

Parkinsonism Redux: The Movers and the Shakers of the World by Ruth Werner

Spa Therapy Benefits Parkinson’s Patients

Alexander Technique Benefits People with Parkinson’s Disease

Massage and Parkinson’s Disease: A Few Lessons Learned By John Slavin, PhD, LMT
Bodywork and Parkinson’s Patients A Strong Combination By Dietrich W. Miesler, MA, CMT

Pelvic Inflammatory Disease

Definition: inflammation of the uterus, fallopian tubes, and surrounding tissue

Causes: bacteria introduced through intercourse, gonorrhea

Signs/Symptoms: pelvic pain, painful abscesses of the reproductive organs, vaginal discharge, fever

Indications: N/A

Contraindications: Refer to Physician

Peripheral Neuropathy

Definition: disturbances and/or pathological changes in the peripheral( lies outside the central nervous system) nervous system

Causes: diabetic neuropathy, ischemic neuropathy, trauma

Signs/Symptoms: numbness, burning, pain

Indications: Massage Ok

Contraindications: Have underlying condition diagnosed by appropriate health care practitioner


Definition: acute inflammation of the serous membrane lining the abdominal cavity and covering the abdominal viscera

Causes: bacterial infection, bacterial contamination from surgery or trauma

Indications: N/A

Contraindications: Refer to Physician as it may spread to other organs


Definition: inflammation of a vein

Causes: blood clot, trauma, weakening of the vein due to aging

Signs/Symptoms: edema, stiffness, pain, red streak in vein; often found in leg


Contraindications: Refer to Physician

Piriformis Syndrome

A Case Report of the Treatment of Piriformis Syndrome Applying Modalities of Therapeutic Bodywork – By Peggi Honig

Piriformis Syndrome by Whitney Lowe Massage Magazine

Plantar Fasciitis – see medical massage treatments
Understanding Overpronation  By Whitney Lowe, LMT, NCTMB


Definition: serious infection of the lungs

Causes: viral, bacterial, fungi, protozoa, upper respiratory infection, immune deficiency

Signs/Symptoms: fever, shortness of breath, wheezing, chills, sore throat, muscle aches, enlarged lymph nodes

Indications: Massage at your own risk; may be contagious. Massage for stress reduction

Contraindications: Refer to Physician if symptoms worsen or persist.

Poliomyelitis (Polio)

Definition: infection of the central nervous system

Causes: viral

Signs/Symptoms: fever, headache, stiff neck and back, deep muscle pain, weakness, loss of somatic reflexes, paralysis, difficulty swallowing, breathing and speaking, lower body paralysis,

Indications: Massage ok

Contraindications: None. Some one with childhood polio can have symptoms later in life. Caution advised when working with infant who just had polio vaccine as virus may be transmitted in bodily fluids.

Post Traumatic Stress

Post-Traumatic Stress Disorder from the Touch Research Institute.

Massage therapy decreased the anxiety, depression and stress hormone levels (cortisol) of children who had post-traumatic stress disorder following Hurricane Andrew. In addition, their drawings became less depressed.

Field, T., Seligman, S., Scafidi, F., & Schanberg, S. (1996). Alleviating postraumatic stress in children following Hurricane Andrew. Journal of Applied Developmental Psychology, 17, 37-50.

Recovering Body and Soul from Post traumatic Stress disorders    Pamela Fitch, Massage Therapy Journal

Postural Deviations (Lordosis, Kyphosis, scoliosis)

Definition: structural abnormalities

Causes: due to weakness, tightness

Signs/Symptoms: poor posture

Indications: Massage for realignment, postural re-education

Contraindications: None


Definition: time between conception and birth

Signs/Symptoms: nausea, vomiting, fatigue

Indications: see section on Pregnancy Massage Guidelines

Contraindications: See section on Pregnancy Massage Guidelines

Perineal Massage May Reduce Third-Degree Tears, Labor Time

Maintaining Core Integrity During Pregnancy and Postpartum Recovery By Elaine Stillerman, LMT

The Truth About Pitocin By Elaine Stillerman, LMT
Prenatal Massage During the First Trimester By Elaine Stillerman, LMT


Definition: inflammation of the pleural membrane

Causes: from surgical procedure, persistent coughing, trauma

Signs/Symptoms: pain at sides of ribs, pain with breathing

Indications: Massage to relieve pain, intercostal work; breathing exercises

Contraindications: Caution if from trauma

Premenstrual Syndrome

Definition: disorder in women before menstruation

Causes: hormonal fluctuations and imbalances, poor diet consisting of sugar and processed foods, food allergies, hypoglycemia, malabsorption

Signs/Symptoms: abdominal bloating, fatigue, cramps, headaches, insomnia, joint pain, mood swings, depression

Indications: Massage for stress reduction, headache relief, removal of toxins, reduce tension

Contraindications: touch sensitivity may be heighten during this time, also may be more easily
bruised.  Refer to appropriate health care practitioner. Nutrition and diet need to be addressed.

Massage Relieves Symptoms of Premenstrual Syndrome
Massage and PMS Help for the Monthly Blues By Shirley Vanderbilt


Definition: skin disease

Causes: heredity, trauma, infections, seasonal, stress, illness, viral or bacterial infection, overuse of drugs or alcohol, reaction to medications, faulty utilization of fat, weakened immune system, build up of toxins in colon

Signs/Symptoms: silvery scales or red area on skin, ridges on nails, itching

Indications: Massage for detoxification and stress reduction

Contraindications: Avoid infected area; Refer to Naturopath and Acupuncturist for detoxification, diet modification and treatment


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