Evidence standard
This article summarises research indexed by PubMed in plain language. It provides general information, not personal medical advice.
Why published reports need careful reading
A systematic review found 40 published reports describing 138 adverse events associated with massage or related manual treatments between 2003 and 2013. Reported problems included soft-tissue injury, neurological harm, spinal injury, and arterial dissection.1
Many serious reports involved spinal manipulation rather than ordinary massage. Because the review collected reports of harm without a reliable denominator, it cannot show how often these events occur.1
Possible blood clots need medical attention
A 2020 case report described a pregnant woman with an unrecognised deep vein thrombosis who developed a fatal pulmonary embolism shortly after leg and foot massage.2
This single case supports avoiding massage over a limb when a blood clot is known or suspected. It does not establish that pregnancy massage itself is unsafe.2
Medicines, injections, and strong percussion matter
A 2024 case report described a large abdominal and pelvic haematoma in a hospital patient receiving anticoagulant medicines. A handheld percussive device had been applied repeatedly over an abdominal injection site.3
The case supports sharing information about anticoagulant medicines, recent injections, unexplained abdominal pain, and current hospital treatment before strong or percussive techniques. One case cannot estimate risk from ordinary manual massage.3
Severe symptoms after exercise need assessment
A 2021 case report described severe rhabdomyolysis after strenuous cycling followed by percussion-gun treatment. The person developed severe thigh pain, multiple haematomas, and dark urine.4
The report describes why severe pain, marked bruising, weakness, or dark urine after intense exercise and percussion needs medical assessment rather than being treated as ordinary post-exercise soreness.4
Information worth sharing before massage
The available reports support sharing relevant pregnancy information, known or suspected blood-clot risk, anticoagulant use, recent injections, current injuries, severe unexplained symptoms, and active medical treatment before massage. They identify possible hazards but do not provide a complete contraindication list or a reliable estimate of risk.1234
Research sources
References
Yin Ping; Gao Ningyang; Wu Junyi; Litscher Gerhard; Xu Shifen. Adverse events of massage therapy in pain-related conditions: a systematic review.. Evidence-Based Complementary and Alternative Medicine. 2014.
What it supports: Systematic review of 40 published reports describing 138 adverse events associated with massage or related manual treatments.
Important limitation: The evidence came from reports of harm without a reliable denominator and cannot establish incidence, comparative risk, or causation.
View PubMed record 25197310Sutham Krongkarn; Na-Nan Sukumpat; Paiboonsithiwong Salilthip; Chaksuwat Pakorn; Tongsong Theera. Leg massage during pregnancy with unrecognized deep vein thrombosis could be life threatening: a case report.. BMC Pregnancy and Childbirth. 2020.
What it supports: Case report of fatal pulmonary embolism following leg massage in a pregnant woman with unrecognised deep vein thrombosis.
Important limitation: A single case cannot estimate frequency, establish general pregnancy-massage risk, or support a universal pregnancy restriction.
View PubMed record 32321459Kwon Lawrence. Portable Percussive Massage Device-Related Rectus Sheath Hematoma and Obstructive Uropathy: A Case Report.. Biomedicine Hub. 2024.
What it supports: Case report involving repeated percussive-device use over an injection site in an anticoagulated hospital patient with abdominal pain.
Important limitation: A medically complex single case involving a percussion device cannot quantify risk or be generalised to ordinary manual massage.
View PubMed record 39015201Chen Jian; Zhang Fan; Chen Haizhu; Pan Hui. Rhabdomyolysis After the Use of Percussion Massage Gun: A Case Report.. Physical Therapy. 2021.
What it supports: Case report of severe rhabdomyolysis after strenuous cycling followed by percussion-gun treatment.
Important limitation: A single case with preceding strenuous exercise cannot establish incidence or causation for percussion devices or manual massage.
View PubMed record 33156927