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The Answer Should Be Yes

By Ruth Werner

Originally published in Body Sense magazine, Autumn/Winter Copyright 2008. Associated Bodywork and Massage Professionals. All rights reserved.

If you're like the vast majority of American adults, you may be taking one or more medications on a regular basis to help manage your health. And, if you're like a lot of American adults, you would also like to incorporate massage therapy into your healthcare strategies.

The trick is, those two interventions--medications and massage--aren't always a good match. The interaction between massage and medications is a field that is just beginning to be studied. We have a lot of information about how various drugs affect the way we function, and we have some good ideas about how different types of bodywork affect the way we function, but what happens when we overlap these two interventions is still being explored.

This is not to suggest that anyone who takes medication shouldn't receive massage. But it does point out that your practitioner may need to take some extra steps to design the best possible session for you, depending on what kinds of medications you take.

The following is a list of common classes of medications that people take either occasionally or on an ongoing basis, along with ways these substances might influence your massage or bodywork session. It is important to inform your massage therapist or bodywork practitioner not only that you take these medications, but also when your last dose was, and what the condition is that you are treating.

Painkillers and Anti-Inflammatories
Painkillers (also called analgesics) and anti-inflammatory drugs have a lot of overlap between them because many analgesics work by limiting inflammation, which takes some pressure off irritated nerve endings. These medicines are often classed as acetaminophen, salicylates, non-steroidal anti-inflammatory drugs (NSAIDs), and steroidal anti-inflammatories. Several of these drugs are available without prescription, but this does not mean they are risk free. (Steroidal anti-inflammatories have their own set of cautions and are discussed separately.)

Cardiovascular Disease Management Drugs
Cardiovascular disease is the leading cause of death in the United States today, and its earliest stages are often subtle or completely silent. Many people who want to reduce their risk of heart attack or stroke manage their condition with drugs that reduce the workload on the heart: angiotensin-converting enzyme (ACE) inhibitors, beta blockers, calcium channel blockers, and digitalis; drugs that decrease fluid retention (diuretics); cholesterol-lowering medication; or clot management drugs.

If you take any of these, it is important to inform your massage therapist because several of these drugs reinforce the relaxation response that massage brings about. In other words, you may be getting a double dose of stimulus that causes your blood pressure to drop or your heart to beat with less vigor. This doesn't mean you should skip your dose on the day of your massage! But it does mean that your massage therapist needs to know, so he or she can adjust your session for your best benefit.

Diabetes Management Drugs
Type 1 diabetes involves an inability to produce enough insulin. Type 2 diabetes can be related to low insulin secretion, insulin resistance, or both. Both type 1 and type 2 can cause dangerously high blood sugar, or hyperglycemia. If it is not carefully and consistently treated, diabetes can lead to amputations, blindness, heart attack, kidney failure, skin ulcers, stroke, and many other serious complications.

Antidepressants and Antianxiety Drugs
Antidepressants and antianxiety drugs are used to treat many disorders, including various types of depression, panic disorder, posttraumatic stress disorder (PTSD), eating disorders, fibromyalgia syndrome, and others. Several of them work by changing the way chemicals are secreted and reabsorbed in the brain.

Many people find that the side effects of their medications are especially severe when they first begin a treatment regimen. Side effects can include headaches, dizziness, and lightheadedness, which massage can make worse if a practitioner doesn't make appropriate adjustments. This is why it is important to let your massage therapist know if you use these medications. Furthermore, some of these drugs are associated with other health risks (liver problems, toxic reactions with other medications), so they must be monitored carefully.

Ruth Werner is author of A Massage Therapist's Guide to Pathology (Lippincott Williams Wilkins, 2005), to be released in its fourth edition in 2009. Werner is available at www.ruthwerner.com or wernerworkshops@ruthwerner.com.

Resources
Wible, J. 2004. Pharmacology for massage therapy. Philadelphia: Lippincott, Williams Wilkins.
Persad, R. 2001. Massage therapy and medications. Toronto: Curties-Overzet Publications, Inc.




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