Pathology S for Massage Therapists


18Definition: skin infection

Causes: parasites; mites

Signs/Symptoms: itching, persistent itchy rash, dry scaly skin, highly contagious by skin to skin contact

Indications: N/A

Contraindications: refer to Physician for diagnosis


Definition: inflammation of the sciatic nerve

Causes: nerve root impingement caused by disc protrusion or herniation, adhesions at the nerve root, fibrosis, degenerative joint disease, piriformis syndrome, fibromyalgia

Signs/Symptoms: pain in buttocks, referring down leg, low back pain, burning, tingling

Indications: Massage to relieve spasm in piriformis, psoas, adductors, iliotibial band; balance pelvis, structural realignment.

Contraindications: Refer to appropriate health care practitioner to diagnose disc problems. Refer to appropriate health care practitioner for nutritional, diet and lifestyle changes.

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


Definition: disease of the connective tissue of the body primarily the skin, but can affect many organs such as the gastrointestinal tract, heart, lungs, kidneys; normal tissue is replaced with fibrous connective tissue.

Causes: metabolism disorder of connective tissue and its ground substance, microvascular abnormalities, autoimmune system

Signs/Symptoms: pain and stiffness in finger and knee joints, edema and thickening of the skin, cold or cold sensitive hands and feet, difficulty breathing, hypertension, hyperthyroid, flexion contracture,  yellow or white round or oval plaques with red and blue hyperemia at the edge of them; plaques often follow the distribution of a cutaneous nerve; may have Raynaud’s phenomenon or renal disease
Indications: Massage to warm skin, maintain skin elasticity, reduce pain, elicit parasympathetic response

Contraindications: ROM may be limited due to tension of the skin. If breathing is difficult, may have to treat sitting up. Cold therapy and extreme heat should be avoided. Check medications.  Refer to appropriate health care provider.


Definition: mental illness

Causes: unknown; stress, complications during birth, head injury, virus, environmental poisons, nutritional deficiencies, heredity, neurotransmitter imbalances in the brain

Signs/Symptoms: disordered thinking and perception, depression, behavioral disturbances, delusions, loss of contact with reality

Indications: Massage for stress reduction and removal of toxins

Contraindications: Check for Medications


Definition: lateral curvature of the spine

Causes: muscular tightness, muscular weakness, poor posture, emotional trauma, injury, degeneration of the spine, bony abnormalities, congenital

Signs/Symptoms: rotation and lateral flexion of the spine accompanied with fixed rotation of the vertebrae, poor posture, muscle pain due to imbalances

Indications: Massage to correct and reduce curvature, decompress structures, movement re-education

Contraindications: None

Scoliosis : A Case Study of Deep Tissue Massage by Erik Dalton

Symptomatic Scoliosis (PDF) by Erik Dalton

Getting it Straight Scoliosis and Structural Integration by Lana Lensman

Seasonal Affective Disorder

Definition: depression that occurs in the winter due to shorter and darker days

Causes: lack of sunlight, poor diet, stress

Signs/Symptoms: loss of energy, anxiety, sleep often, reduced sex drive, weight gain due to overeating

Indications: massage for stress reduction and relaxation of tense muscles

Contraindications: None; refer to appropriate health care practitioner.

Sebaceous Cyst

Definition: skin growth that contain a mixture of sebum (oil) and skin proteins

Causes: toxins, bacterial or viral infection

Signs/Symptoms: whitehead, swellings on the face, scalp and back

Indications: Massage for detoxification and stress reduction

Contraindications: Avoid inflamed area

Seborheic dermatitis

Definition: skin disorder of the sebaceous glands (oil secreting glands)

Causes: unknown; but may be nutritional deficiencies, yeast infection, stress, anxiety, oily skin, Parkinson’s disease, immune deficiencies, food allergies

Signs/Symptoms: occur mainly on the scalp, face and chest, may or may not itch, scaly bumps

Indications: Massage for stress reduction

Contraindications: Avoid any inflamed areas

Seborrheid Keratosis ( Basal cell papilloma)

Definition: benign superficial epithelial tumors

Causes: nutritional deficiencies, toxin build up

Signs/Symptoms: yellow to tan to brown to black lesions that are raised above the skin

Indications: Massage for stress reduction

Contraindications: None

Seizure – see Epilepsy

Separations (joints)

Definition: separation of the joints in a side to side manner

Causes: trauma, consistent overuse of joint

Signs/Symptoms: pain, swelling, loss of ROM, excessive scar tissue formation around the joint during healing. Common area – Acromioclavicular; head of humerous forced into the acromion process tearing the acromioclavicular ligament.

Indications: Massage  for inflammation according to your level of training.

Contraindications: Refer to physician for complete separations characterized by complete displacement of the joints

Shingles (Herpes Zoster)

Definition: skin inflammation

Causes: virus; immune deficiencies, stress, cancer

Signs/Symptoms: chills, fever, achiness, blistering of skin, with excruciating pain, sensitivity to touch, numbness, depression, headache, blisters scab over and fall off

Indications: N/A

Contraindications: Highly contagious

Comforting Clients with Postherpetic Neuralgia Pathology Perspectives By Ruth Werner

Shin Splints Understanding Overpronation  By Whitney Lowe, LMT, NCTMB

Shoulder Pain Soft-tissue Massage for Shoulder Pain

Sinusitis ( acute/chronic)

Definition: inflammation of the nasal sinuses

Causes: excess mucus production from poor digestion, bacterial or viral production, hay fever, food allergies

Signs/Symptoms: fever, cough, headache, facial pain, cranial pressure, tenderness in the forehead and cheekbones, stuffy nose, runny nose

Indications: Massage for detoxification and stress reduction. Sinus pressure points in upper, medial corner of eyes, along ridge of cheekbone; cervical misalignment, TMJ, cranial misalignment.

Contraindications: Refer to appropriate health care practitioner.

Sjogrens Syndrome

Definition: autoimmune connective tissue disorder

Causes: hormonal changes, stress

Signs/Symptoms: dryness of the mouth and eyes, salivary gland enlargement may be present, rheumatoid arthritis; mainly in menopausal or postmenopausal women

Indications: Massage for stress reduction

Contraindications: Refer to appropriate health care practitioner

Skin Cancer

Definition: cancer of the skin

Basal cell carcinoma- most common, prevalent in fair skinned people, pearly looking bump that may bleed and never heal.

Squamous cell carcinoma- lump or tumor under the skin, appearance of a wart or small ulcerated spot that never heals, may be from overexposure to sun

Malignant Melanoma-most dangerous, tumor grows from the pigment producing cells of the deeper layers of the skin; most from moles.

Causes: overexposure to sun and tanning salons, environmental pollutants, destruction of the ozone layer

Signs/Symptoms: skin problems that don’t heal, moles that bleed, moles that change in size and color, reddish irritated spot, smooth growth with an elevated border and indented center, shiny scar like area that is white, yellow or waxy.

Indications: Massage for stress reduction and detoxification

Contraindications: Lesions may be removed with cryotherapy; Use caution around these areas.
Refer to appropriate health care practitioner.

Skin Conditions

Spotlight on Research: Massage Effective in Treating Young Children’s Skin Conditions  By Michael Devitt, contributing edito

Sleep apnea

Definition: sleep disturbance; apnea means without breath.

Causes: high blood pressure, nutritional deficiencies such as calcium and magnesium, lack of exercise, poor diet, excess mucus, blocked nasal passageways (deviated septum), adrenal distress, hormonal changes

Signs/Symptoms: irregular breathing, snoring, oxygen deprivation, fatigue, feeling unrested after sleep, TMJ, cervical and cranial misalignment

Indications: Massage for stress reduction and relieve tension in neck, shoulders and back, cranial realignment, cervical realignment

Contraindications: none; Refer to appropriate health care practitioner; Bach Flower Remedies, Homeopathy, Naturopath

University of Maryland Medical Center – Information on using homeopathy and alternative medicine.

Medline Plus Polycystic Ovary Syndrome Is Associated with Obstructive Sleep Apnea and Daytime Sleepiness: Role of Insulin Resistance*

Sleep Research and Treatment Center (A.N.V., E.O.B., A.K.), Department of Psychiatry,

The Journal of Clinical Endocrinology & Metabolism Printed in U.S.A. Copyright © 2001 by The Endocrine Society


Definition:  sudden painful contraction of muscle

Causes: trauma, injury, nutritional deficiencies, food allergies

Signs/Symptoms: pain, tightness

Indications: Massage to relieve tightness

Contraindications: none

Spina bifida

Definition: congenital disorder of the vertebral column in which the lamina do not unite at the midline

Causes: disease or sickness during pregnancy

Signs/Symptoms: protrusion of the spinal cord, urinary difficulties, absence of reflexes

Indications: Massage ok


Web resources: Spina

Spinal Cord Injuries

Working with clients with Spinal Cord Injuries by Ruth Werner

Massage for Spinal-Cord Injury

Spondylothesis/spondylosis- see arthritis

Spondylolisthesis: An Elusive Cause of Low Back Pain By Whitney Lowe, LMT, NCTMB


Definition: injury to ligaments (may also involve muscles or tendons); tears in ligaments

Causes: injury, overexertion, over stretching, unexpected movement

Signs/Symptoms: pain, inflammation, bruising, swelling; gradual or sudden onset; hyper-mobile and unstable- joint, sharp pain. Common areas – ankle, knee, wrist, whiplash, joint separation or dislocation.

Indications: Massage according to your level of training. Reduce inflammation, vascular flush, Trigger point to regain flexibility, movement re-education

Contraindications: Traction may aggravate injury if it involves the injured ligaments. Traumatic injuries should be assessed by physician to determine severity.  Naturopath and Acupuncturist to speed healing with natural anti-inflammatories.


Definition: eye disorder in which optic axes cannot be directed to the same  object

Causes: lack of muscular coordination

Signs/Symptoms: squinting

Indications: Massage for stress reduction; eye exercises

Contraindications: Refer to appropriate health care practitioner; Bates vision specialist.


Definition: injury to muscle or tendon; rupture or tear

Causes: overexertion, over stretching, not enough rest after exertion, pushing a weak muscle beyond its abilities

Signs/Symptoms: spasm, pain, swelling, loss of movement; gradual or sudden onset.

Level 1 – 1% to 50% partial tear of fibers; some loss of function, can hold against resistance with pain, swelling, muscle guarding

Level 2 – 50%-90% fiber tear; cannot hold against moderate resistance but may hold against gravity, pain, swelling, edema, muscle guarding

Level 3 – 100% tear of fibers; snap heard at time of injury, no resistance possible, may or may not have pain

Indications: Massage according to your level of training. Reduce inflammation,  Trigger point to regain flexibility, movement re-education

Contraindications: Traumatic injuries should be assessed by physician to determine severity.  100% tear needs to be referred to physician immediately. Naturopath and Acupuncturist to speed healing with natural anti-inflammatories.

Muscle Strains By Whitney Lowe, LMT, NCTMB

Hamstring Strain by Whitney Lowe Massage Magazine


Definition: any physical, mental, emotional, chemical, stimulus that interferes with the body’s natural balance

Causes: nutritional deficiencies, work, holidays, family, noise, traffic, temperature, overwork, lack of sleep, illness, drug and alcohol abuse. improper breathing; increase of cortisol in body weakens immune system.

Signs/Symptoms: fatigue, insomnia, muscle tension, high blood pressure, irritability, anxiety, stomach disorders, all physical, mental and emotional illnesses, sexual dysfunction, muscle aches, headaches

Indications: MASSAGE

Contraindications: None. Refer to appropriate health care practitioner to assist with eliminating the cause of stress and changing lifestyles.

The Mind Is the Source of Our Stress  By Dale G. Alexander, PhD, LMT and Lansing Barrett Gresham

Robert Sapolsky on

 “Jangled” Adults Touch and the Stress Response System By Ruth Werner

Depression and the Stress Response System: Part I of III By Ruth Werner, LMP, NCTMB
Part II , Part III

Stroke (CVA/TIA)- see CVA  Massage Benefits Stroke Patients Massage Today – Pictures of results of using massage with stroke patients.

Systemic Lupus Erythematosus – see Lupus

Subluxation/ fixation

Definition: deviation in articular cartilage; vertebral misalignment

Causes: muscular tightness, stress, food allergies, injury, trauma, inadequate muscle tone and awareness

Signs/Symptoms: pain, muscle spasm, muscle strength imbalance

Indications: Massage to relieve muscle spasm and tension, movement re-education and awareness exercises

Contraindications: none

Substance Abuse

Definition: addiction to drugs, alcohol, smoking

Causes: nutritional deficiencies, stress, emotional disturbances

Signs/Symptoms: their life is a mess

Indications: Massage for stress reduction

Contraindications: Be aware of side effects of medications. Refer to appropriate health care practitioner.


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