General Contraindications for Massage (EMBLEX)

Acne
Inflammation of the skin affecting the sebaceous gland ducts. Massage increases systemic circulation; may assist healing. Contraindication: Regional; avoid affected area; do not use ointments that clog pores

Carbuncle
Mass of connected boils. Indication: Massage may increase systemic circulation and may assist healing. Contraindication: Refer client to physician; regional; avoid affected area.

Cellulitis
Inflammation of the subcutaneous tissue with redness and swelling. Indication: Avoid. Contraindication: Regional; may be associated with erysipelas, a contagious condition; refer client to physician

Folliculitis
Inflammation of the hair follicles Indication: massage may increase systemic circulation and assist healing Contraindication: Regional; Refer client to physician,; avoid affected area

Furuncle (Boil)
Pus-filled cavity formed by infection of a hair follicle. Indication: massage may increase circulation and assist healing Contraindication: Regional; refer client to physician; avoid affected area

Impetigo
Highly contagious bacterial skin infection that occurs most often in children; begins as a reddish discoloration and develops into vesicles with a yellow crust Indication: Massage may increase systemic circulation and assist healing Contraindication: Regional; refer client to physician; avoid affected area

Syphilis
Primary stage: usually painless lesion (chancre) present on exposed skin; secondary stage: begins about 2 months after chancre disappears and produces a variety of symptoms, including skin rash. Indications: N/A. Contraindications: Rash; is contagious; refer to physician

Bell’s Palsy
Infection of the seventh cranial nerve; primary symptom is paralysis of facial features, including the eyelids and mouth. Indications: relaxation massage may facilitate healing. Contraindications: regional; refer client to physician

Herpex Simplex
Acute viral disease marked by groups of watery blisters on or near mucous membranes. Indications: recurrence is related to stress: massage may reduce stress levels. Contraindications: Contagious; regional; avoid the affected area

Herpes Zoster (Shingles)
Viral infection that usually affects the skin of a single dermatome; produces red, swollen plaque that ruptures and crusts. Indications: Condition is painful; general massage may ease pain. Contraindications: Regional; avoid affected area; may need to refer client to physician

Warts
Usually benign excess cell growth of the skin. Indications: N/A. Contraindications: Regional; avoid affected area; contagious; may become malignant; if any changes in wart occur, refer client to physician

Ringworm, athletes foot, fungal infection of the nails
Scaly and crusty cracking of the skin. Indications; keep area dry; do not use lubricants. Contraindications: Regional; do not use lubricants near the area because fungi thrive in a moist environment

Atopic Dermatitis (Eczema)
Common inflammation of the skin marked by papules, vesicles, and crusts. Indications: symptom of an underlying condition: refer client to physician for diagnosis. Contraindications: regional: avoid affected area

Contact Dermatitis
Inflammation that occurs in response to contact with an external agent. Indications: use unscented lubricants (scents often cause allergic reactions. Contraindications; regional, avoid the affected area.

Urticaria (Hives)
Red, raised lesions caused by leakage of fluid from the skin and blood vessels; primary symptom is severe itching. Indications: Do not use scented products; hives may have an emotional component. Contraindications: Regional; avoid affected area.

Mole
Pigmented, fleshy growth of skin. Indications: Watch for any change in a mole; refer client to physician if a change is noted. Contraindications: Regional; avoid mole

Psoriasis
Chronic inflammation of the skin; probably genetic; symptoms include scaly plaque and excessive growth rate of epithelial cells. Indications: May be stress-induced; massage reduces stress. Contraindications: Regional; avoid affected area

Scleroderma
Autoimmune disease that affects blood vessels and connective tissue of the skin; primary symptoms is hard, yellowish skin. Indications; N/A . Contraindications: Regional ,except in systemic cases, refer client to physician

Skin cancer
Squamous cell carcinoma, basal cell carcinoma, melanoma, kaposi sarcoma. Contraindications; watch for any change in a mole or existing skin condition; if this occurs, refer client to physician

Atonicity
Reduced ability to inability of the muscle to contract. Indications: Massage to tone; relaxation of opposing muscle groups. Contraindications: Regional; refer client to physician for diagnosis befor proceeding

Contracture
Fixed resistance to passive stretching of muscles; usually the result of fibrosis or tissue ischemia. Indications; Massage and stretch. Contraindications: Do not stretch past fixed barrier

Convulsion
Sudden, involuntary series of muscle contractions, sometimes called seizure. Indications: N/A. Contraindications: Refer client to physician immediately

Fibrillation
A small, local contraction of muscle that is invisible under the skin; results from spontaneous, synchronous activation of single muscle cells. Indications: massage, direct pressure. Contraindications: If continuous, refer client to physician for diagnosis.

Hypertonicity
Increased muscle tone. Indications: Massage and stretch. Contraindications: Recurrence without explanation; refer client to physician for diagnosis

Spasms (Cramp)
Sudden, painful onset of a muscle contraction. Indications: Use reciprocal inhibition; push muscle belly together and slowly stretch. Contraindications: If recurring and transient, refer client to physician.

Tic
Spasmodic twitching; often occurs in the face. Indications: May be stress-induced; massage is beneficial in reducing stress. Contraindications: Refer client to physician for diagnosis to rule out underlying pathologic condition

Dislocation
Displacement of a bone within a joined. Indications: N/A. Contraindications: Immediately refer client to physician

Sprains
Traumatic injury of ligaments that form a skeletal joint; may involve injury (strain) of muscles or tendons. Indications: PRICE (protection, rest, ice, compression, elevation) fist aid, gentle massage, and range of motion facilitate healing. Contraindications; Regional; all traumatic injuries should be evaluated by a physician.

Strains
Traumatic injury caused by overstretching or overexertion of muscle or tendon tissue. Indications: PRICE, first aid, gentle massage and range of motion may facilitate healing. Contraindications: regional; all traumatic injuries should be evaluated by a physician

Subluxation
Any deviation from the normal relationship in which the articular cartilage is touching any portion of its mating cartilage. Indications: Massage may help relive muscle spasm. Contraindications: Refer client to physician

Osteomyelitis
Bacterial infection of the bone; symptoms include deep pain and fever. Indications: N/A. Contraindications: General; immediately refer client to physician; difficult to diagnose and treat.

Ankylosing Spondylitis
Chronic inflammatory disease; can be progressive; usually involves the sacroiliac joint and spinal articulations; cause is unknown, appears to be genetic; if progressive, calcification of the joints and articular surfaces occurs; begins with feelings of fatigue and intermittent low back pain

Bursitis
Inflammation of a bursa. Indications:Massage may take pressure of the joint by relaxing and normalizing surrounding musculature; ice. Contraindications: Regional; avoid affected area: work above and below jointed area.

Fibromyalgia
General disruption in connective tissue muscle component; symptoms include tender point activity; vague symptoms of pain and fatigue. Indications: massage may be beneficial; work with physician. Contraindications: General; refer client to physician for diagnosis; do not use therapeutic inflammation methods

Gouty arthritis
Metabolic condition in which sodium urate crystals trigger a chronic inflammatory process. Indications: dietary adjustment necessary. Contraindications: Regional: avoid area of inflammation

Lupus Erythermatosus
Chronic inflammatory disease that affects many body tissues; common symptoms is a red rash on the face. Indications: Massage may be beneficial under physician’s close supervision. Contraindications: general; systemic disease

Osgood-schlatter disease
Osteochondrosis (inflammation of the bone and cartilage) of the tibial tuberosity. Indications: N/A. Contraindications: Regional; avoid affected area

Rheumatoid arthritis
Autoimmune inflammatory joint disease characterized by synovial inflammation that spreads to other tissues. Indications: stress responsive; massage can be helpful under medical supervision. Contraindications: General; work closely with physician.

Tendinitis
Inflammation of tendon and tendon muscle junction. Indications: Massage may assist healing; ice. Contraindications; Regional; avoid affected area; work above and below the area.

Tenosynovitis
Inflammation of a tendon sheath, usually from repetitive movement. Indications: massage may relieve muscle hypertension and assist healing of area; ice. Contraindications: Regional; avoid affected area; work above and below the area

Carpal Tunnel Syndrome
Inflammation in tendon sheaths in the carpal tunnel that creates pressure on the median nerve; symptoms include weakness and tingling in the hand Indications; Symptoms often are confused with thoracic outlet syndrome; massage is proving to be beneficial. Contraindications: regional; refer clients to physician for diagnosis.

Muscular Dystrophy
A group of muscle disorders characterized by atrophy of skeletal muscle without nerve involvement. Indications: Massage is beneficial; work closely with supervising physician. Contraindications: General

Osteoarthritis
Degeneration joint disease of the articular cartilage; age and joint damage are risk factors. Indications: massage is beneficial. Contraindications: Regional; avoid area of inflammation

Osteoporosis
Loss of minerals and collagen from bone matrix, resulting in reduced volume and strength of skeletal bone. Indications: Gentle massage is beneficial; use care and caution. Contraindications: General

Kyphosis
Abnormal increased convexity of the thoracic spine. Indications: Massage is beneficial as part of the treatment plan. Contraindications: regional; in severe cases proceed after obtaining physician’s recommendation.

Lordosis
Abnormal increased concavity in the curvature of the lumbar spine. indications: Massage is beneficial as part of the treatment plan. Contraindications: Regional; in severe cases proceed after obtaining physician’s recommendation.

Scoliosis
Lateral curve of the vertebral column. Indications: Massage is beneficial as part of the treatment plan. Contraindications: Regional; in sever cases proceed after obtaining physician’s recommendation.

Lower Back Pain
May be of many varieties: muscular, nerve entrapment, or disk problem. Indications: Massage can be beneficial as part of the treatment plan. Contraindications: Regional; important to refer client to physician to rule out serious conditions of the spine or viscera

Spasmodic Torticollis
A contracted state of the cervical muscles that causes pain and rotation of the head. Indications: Massage is beneficial. Contraindications: Regional; refer client to physician for diagnosis to rule out serious disease

Temporomandibular Joint (TMJ) Dysfunction
Disorder in functioning of the TMJ; pain and muscle contraction. Indications: Massage is beneficial; work closely with dentist and physician. Contraindications: regional; if painful.

Dyskinesia
Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movement and possibly pain. Indications: Massage is beneficial as part of physician directed treatment plan. Contraindications: General; refer client to physician for diagnosis and treatment plan.

Insomnia
Inability to sleep or interrupted sleep. Indications: Massage is beneficial. Contraindications: Regional; refer client to physician for specific diagnosis to rule out serious underlying condition.

Peripheral Neuropathy
General functional disturbances and pathologic changes in the peripheral nervous system caused by diabetic neuropathy, ischemic neuropathy, or traumatic neuropathy; symptoms include numbness, burning and pain. Indications: massage is beneficial as part of the treatment plan. Contraindications: Regional; refer client to physician for specific diagnosis.

Vertigo
Sensation of movement, not to be confused with dizziness. Indications: N/A. Contraindications: General; usually symptomatic of underlying condition; physician’s diagnosis required.

Tinnitus
Noise in the ear; symptoms include ringing, buzzing, roaring, or clicking. Indications: N/A. Contraindications: Regional; refer client to physician for specific diagnosis.

Cerebrovascular accident
Stroke; a disturbance in cerebral circulation; major causes include atherosclerosis (thrombosis), embolism, hypertensive intracerebral hemorrhage or ruptured saccular aneurysm; symptoms differ, depending where the disturbance of circulation occurs. Indications: Massage may be beneficial during recovery under physician’s supervision and during long-term care for continued support. Contraindications: Refer client to physician for diagnosis.

Headache
Pain or dull ache in the head and upper neck; can have a variety of causes, such as muscle tension, sinus pressure, pinched nerve, vascular disruption and toxins. Indications: Massage may be beneficial. Contraindications: Refer all clients with a persistent, severe headache to physician for specific diagnosis.

Head injury
Contusion (bump on the head); laceration (cut or break in the skin); subdural and apidural injury may produce disorientation, nausea, and uneven pupil dilatation. Indications; Immediately refer client to physician if any of the signs listed above are noted. Contraindications; general; all traumatic injuries must be evaluated by a physician.

Transient Ischemic Attack (TIA)
Definition/symptoms; Episodes of neurologic dysfunction that usually are of short duration (a few minutes ) but may persist for 24 hours; reversible; symptom pattern is the same with each attack, because the same vessel is involved; small strokes, seizures, migraine symptoms, postural hypotension, and strokes Allen syndrome may be misdiagnosed as TIAs. Indications: Massage may be beneficial under physician’s supervision. COntraindications: Refer client to physician for diagnosis.

Conjunctivitis
Inflammation and infection of the mucous membranes of the eye. Indications: N/A. Contraindications: Regional; refer client to physician; may be contagious; avoid affected area.

Parkinson’s Disease
Nervous disorder characterized by abnormally low levels of the neurotransmitter dopamine, resulting in involuntary trembling and muscle rigidity. Indications: Massage is beneficial as part of a physician directed treatment plan. Contraindications: General.

Poliomyelitis
Viral infection of the nerves that control skeletal muscles. Indications: Massage is beneficial as part of a physician-directed treatment plan. Contraindications: General

Postpolio Syndrome
Symptoms of fatigue and general muscle weakness that appear years after resolution of poliomyelitis. Indications: Massage is beneficial as part of a physician directed treatment plan. Contraindications: General

Multiple Sclerosis
Primary disease of the central nervous system marked by degeneration of myelin. Indications: massage is beneficial as part of a physician-directed treatment plan. Contraindications: General

Spinal Cord Injury
Traumatic injury or degenerative process of the spinal cord; may result from compression, cut, or tissue replacement in scarring. Indications; Massage is beneficial as part of a physician-directed treatment plan. Contraindications: Regional

Trigeminal neuralgia (Tic Douloureux)
Compression or degeneration of the fifth cranial nerve; primary symptom is recurring episodes of stabbing pain in face. Indications: Avoid entire area of trigeminal nerve innervation; massage may trigger pain response. Contraindication: Regional

Sleep Apnea
Cessation of breathing during sleep. Indications: Stress may be a factor; massage is beneficial in reducing stress. Contraindications. Regional

Thoracic Outlet Syndrome
Compression of brachial nerve plexus; primary symptom is pain that radiates to the shoulder and arm. Indications: Massage is beneficial as part of the treatment

Diabetes Mellitus
Metabolic disorder; body loses the ability to oxidize carbohydrates because of faulty pancreatic activity, especially of the islets of Langerhans, which affects insulin production; symptoms include thirst, hunger, and acidosis; sever symptoms include difficulty breathing and changes in blood chemistry that lead to coma. Indications: massage is given under supervision of the primary care physician; it is beneficial for circulation enhancement and stress reduction; exercise also is beneficial. Contraindications: General; work only under physician’s supervision.

Hyperglycemia
High blood sugar, resulting from inadequate insulin in the blood; symptoms are the same as those for diabetes mellitus. Indications: see Diabetes mellitus. Contraindications: See diabetes mellitus

Hyperthyroidism
Overproduction of thyroid hormone; can be caused by a tumor or by problems with the self-regulatory mechanism in the pituitary gland; symptoms include anxiety, bulging eyes, high metabolic rate, and nervousness. Indications: massage is beneficial for relaxing the client. Contraindications: General; work within physician’s recommendations

Hypothyroidism
Underproduction of thyroid hormone; symptoms include sensitivity to cold, weight gain, fatigue, and dullness. Massage is beneficial for stimulating metabolic function. Contraindications: General; work within physician’s recommendations.

Neuropathy
Functional disturbance or pathologic change in the peripheral nervous system; symptoms include numbness, burning, and tingling pain. Indications: Massage is beneficial under medical supervision; may calm hypersensitive nerves. Contraindications: General; work under physician’s direction.

Anemia
Reduced red blood cell count or hemoglobin; symptoms include fatigue and pallor. Indications: Massage can be beneficial as part of the treatment plan. Contraindications: General; refer client to physician for diagnosis and proceed under physician’s direction.

Aneurysm
Abnormal widening of the arterial wall; tends to form thrombi and also to burst; a pulsating bulge and pressure are felt with accompanying symptoms of pain. Indications: N/A. Contraindications: Regional; immediately refer client to physician; avoid direct heavy pressure into arterial vessels.

Angina Pectoris
Chest pain caused by inadequate oxygen to the heart (usually because of blocked coronary arteries) Indications: massage is beneficial as part of a lifestyle change. Contraindications: General: massage is performed under physician’s supervision.

Arteriosclerosis and Atherosclerosis
Hardening of the arteries; a type of coronary hear disease; symptoms may be mild to severe; may be mistaken for other problems. Indications: massage is beneficial as part of a lifestyle change. Contraindications: General: perform massage under physician’s supervision.

Congestive heart Failure
Left heart failure; inability of the left ventricle to pump effectively; one symptom is increased fluid retention. Indications: massage is beneficial in helping diuretics remove excess fluid. Contraindications: General; must work under physician’s supervision; client may have difficulty breathing in a supine position.

Deep Vein Thrombosis
Blood clot in deep veins; risk factor for pulmonary embolism (blood clot in the heart); often asymptomatic; symptoms may include swelling, edema, and pain described as aching and throbbing. Indications: N/A. Contraindications: Regional to general, depending on the severity of symptoms; always refer client to physician for unexplained pain; never massage over such areas.

Hemophilia
Blood clotting disorder; primary symptom is spontaneous bleeding resulting from an inability to form clots. Indications: Extremely light energy type of massage given only under physician’s direction. Contraindications: General; work only under physician’s supervision.

Myocardial Infarction (MI)
Death of cardiac muscle cells, usually from inadequate blood supply, often from coronary thrombosis or coronary artery disease; symptoms include severe pain in the chest or left arm, difficulty breathing and weakness. Indications: During rehabilitation, massage can be beneficial when supervised by physician. Contraindications: General; refer client to physician immediately.

Mononucleosis
Induced by Epstein-Barr virus; symptoms include fever, fatigue, and swollen glands. Indications: massage is beneficial as part of the treatment plan; care must be taken with contagious conditions. General; refer client to physician for specific diagnosis.

Phlebitis
Definition/Symptoms: inflammation of a vein; may be caused by a blood clot; symptoms include edema, stiffness, and pain; veins may streak red. Indications: N/A. Contraindications: Regional to general; see Deep Vein Thrombosis.

Raynaud’s Syndrome
Arteriospastic condition caused by vasospasms of the small cutaneous and subcutaneous arteries and arterioles; usually activated by cold but can be emotionally triggered; symptoms include skin pallor and pain. Indications: Care must be taken to avoid triggering the symptoms; interview client carefully; massage may be beneficial for stress reduction. Contraindications: refer client to physician for specific underlying diagnosis; condition may be symptomatic of serious disorder.

Syncope
Sudden loss of strength; fainting ; may be caused by a cardiac spasm resulting from closure of coronary arteries. Indications: N/A. Contraindications: General; immediately refer client to physician.

Varicose Veins
Enlarged veins in which blood pools; caused by collapse of valve system; tend to to form thrombi. Indications: N/A. Contraindications: Regional; avoid affected area.

Allergy
Hypersensitivity of immune system to relatively harmless environmental antigens; symptoms include increased mucous membrane inflammation, occasionally spastic bladder. Indications: Massag is beneficial. Contraindications: refer client to physician for specific diagnosis.

Autoimmune Disease
Disease in which the immune system attacks the body’s own tissues; symptoms include inflammation, fatigue, and allergy. Indications: massage is beneficial. Contraindications: Refer client to physician for specific diagnosis.

Chronic fatigue Syndrome
May be induced by a virus; symptoms include swollen glands, low-grade fever, muscle and joint aches, headache, and fatigue. Indications: massage is beneficial. Contraindications: General; refer client to physician for specific diagnosis.

Human Immunodeficiency (HIV) Infection
Viral infection transmitted by means of body fluids; causes immunosuppression. Indications: Massage is beneficial with physician’s recommendation; follow antiviral precautions for control of virus; 10% bleach solution: avoid body fluid contact. Contraindications: General; work with physician.

Lymphedema
Swelling of tissue caused by partial or complete blockage of lymph vessels. Indications: Massage is beneficial as part of the treatment plan and is given under the supervision of the primary care physician. Contraindications: refer client ot physician for diagnosis.

Asthma
Recurring muscle spasms in the bronchial wall accompanied by fluid retention and production of mucus; stress-specific condition. Indications: Massage is beneficial; monitor breathing closely. Contraindications: Work under direction of primary care physician.

Tuberculosis
Infectious disease caused by Mycobacterium tuberculosis; early stage requires testing to reveal infection; advanced cases are marked by lung destruction, coughing, fatigue, weakness, and weight loss; may be confused with bronchitis and pneumonia. Indications: Light massage may be beneficial to ease body ache; avoid heavy pressure; watch for contamination. Contraindications: Refer client to physician if symptoms are severe or persist longer than two weeks.

Upper Respiratory Infection─ Bronchitis, Common Cold, Sinusitis, Pneumonia
Viral or bacterial in origin; symptoms include increased production of mucus, fever, body aches, and headaches. Indications: Light massage may be beneficial to easy body ache; avoid heavy pressure; watch for contamination. Contraindication: Refer client to physician if symptoms are sever or persist longer than two weeks.

Constipation
Slow movement of bowels; hard, compacted, dry stool. Indications: massage is beneficial; increase fiber and water consumption and moderate exercise; may be drug related. Contraindications: refer Client to physician if sever or persistent or if a mass is left in the large intestine.

Diarrhea
Loose bowels; excessive loss of water in stool; can be caused by a virus or bacterium or can be a symptom of other disease processes. Indications: Loose stool is not uncommon 24 after vigorous massage. Contraindications: Refer client to physician if symptoms persist or if dehydration is present.

Flatulence
Intestinal gas. Indications: may be diet or stress related; massage may reduce stress. Contraindications: Refer client to physician if intestinal tract is painfully distended or to rule out severe underlying condition.

Halitosis
Bad breath; may indicate digestive problems or sinus infection. Indications: N/A. Contraindications: Refer client to physician for specific diagnosis.

Appendicitis
Inflammation of the mucosal lining of the appendix, caused by trapped food or fecal matter; more common in individuals under age 25; symptoms include mild periumbilical pain, nausea, vomiting, increasing pain in the lower right quadrant, muscle spasm, and rebound tenderness. Indications: N/A. Contraindications: Immediately refer client to physician.

Cholelihiasis and Cholecystitis
Gallstones formed as a result of inflammation; primary symptom is severe pain in upper abdomen radiating to back and right shoulder. Indications: N/A. Contraindications: Immediately refer client to physician

Cirrhosis of the Liver
Chronic disease that replaces liver tissue with connective tissue; major cause is alcohol consumption; early symtoms include gas, change in bowel habits, slight weight loss, nausea in the morning, and a dull, heavy ache in the right upper quadrant of the abdomen; advanced symptoms include jaundice, peripheral edema, bleeding, and red palms. Indications: massage is beneficial in stress reduction and drug withdrawal. Contraindications: Refer client to physician for diagnosis; work under physician’s supervision.

Colitis
Inflammatory condition of the large intestine; one type (irritable bowel syndrome) is brought on by stress. Indications: painful condition; massage may be helpful in general stress and pain reduction. Contraindications: Immediately refer client to physician; work with chornic conditions under direct supervision of physician.

Crohn’s Disease (Regional Enteritis)
Chronic relapsing inflammatory disease of the intestianl tract; symptoms include intermittent diarrhea, colicky pain in lower abdomen, fatigue, low-grade fever. Indications: Painful condition; massage may be helpful in general stress and pain reduction. Contraindications: Refer client to physician immediately; with chronic conditions, work under physician’s direct supervision.

Diverticulosis
Formation of small pockets in the large intestine, caused by herniation of the mucosa; if pockets become inflamed, conditions is called diverticulitis; symptoms include gas, diarrhea, and pain. Indications: Diet may need adjustment to include more fiber. Contraindications: Refer client to physician if pain or symptoms persist.

Duodenal Ulcer
Ulcer caused by hyperacidity in duodenal bulb; stress related; symptoms include burning pain that feels better after eating. Indications: Massage is beneficial for reducing stress; lifestyle and diet changes may be necessary. Contraindications: Refer client to physician for specific diagnosis; support physician’s treatment plan.

Hepatitis
Infectious disease that has generalized effects in the body but that predominantly affects the liver; type A is common in children and in people living in institutions; it is transmitted by fecal matter, orally through contaminated food and water; usual symptoms are mild and flu like; types B and C affect all age groups and are transmitted through blood, needles, the fecal/oral route, and sexual contact. Indications: Careful use of aseptic procedures. Contraindications: General; refer client to physician and work only with physician’s recommendation and guidelines concerning contagious condition.

Gastritis
Acute inflammation of the stomach; a common condition usually caused by irritants such as alcohol or aspirin; symptoms include pain, nausea, and belching. Indications: Massage is beneficial, because gastritis sometimes is tress related and massage may reduce stress. Contraindications: refer client to physician for specific diagnosis.

Hernia
Protrusion of a loop or piece of an organ or tissue through an abnormal opening; hiatal—protrusion of any structure (usually the esophagus or end of the stomach) through the hiatus of the diaphragm; inguinal— protrusion through the inguinal ring, causing swelling of the scrotum and possible a medical emergency; umbilical—protrusion at the umbilicus; in inguinal and umbilical hernias, weakness may be felt in the abdominal wall. Indications: N/A. Contraindications: refer client to physician; avoid area

Pancreatitis
Inflammation of the pancreas; may be present with diabetes and is aggravated by consumption of alcohol; one symptom is severe abdominal pain. Indications: Painful condition; massage may be helpful in general stress and pain reduction. Contraindications: refer client to physician immediately; with chronic conditions, work under physician’s direct supervision.

Stress Ulcer
Ulcer related to severe stress— trauma, burns, long-term illness—symptoms similar to those seen in gastritis. Indications: massage is beneficial for reducing stress; lifestyle and dietary changes may be necessary. Contraindications: Refer client to physician for specific diagnosis; support physician’s treatment plan.

Ulcer
Peptic Ulcer— break or open sore not covered by protective mucus in the gastrointestinal wall that is exposed to pepsin and gastric juice; often caused by alcohol, pepsin, bile salts, and stress. Indications: massage is beneficial to reduce stress levels; lifestyle and dietary changes may be necessary. Contraindications: Refer client to physician for specific diagnosis; support physician’s treatment plan

Cystic Fibrosis
Inherited disorder that disrupts cell transport and causes exocrine glands to produce thick secretions; thick pancreatic secretions may block the pancreatic duct. Indications: Massage is beneficial with specific training to loosen mucus with percussive techniques. Contraindications: General; work under direct care of physician

Malnutrition
Deficiency of calories in general and often in protein; malnutrition may be caused by increased nutrient demand on the body without sufficient food intake—severe burns, illnes, or lack of food, especially protein— symptoms include flaking skin, brittle hair, hairloss, slow-healing sores, bruising, susceptibility to infection, and fatigue; more common in children and the elderly and with drug and alcohol abuse; be aware of eating disorders. Note: Malnutrition also can be caused by insufficient or improper digestion and absorption of food. Indications: With anorexia or bulimia, massage may be beneficial for stress reduction. Contraindications: Refer client to physician for diagnosis and treatment plan.

Obesity
Excess body fat—over 30% of normal body weight—risks of obesity include diabetes, stroke, heart attack, gallstones, and high blood pressure. Indications: Morbid obesity—over 60% of normal body fat—may cause difficulty positioning client; fluid retention, risk of blood pressure fluctuation, and interference with breathing are other possible problems; may need to alter massage position. Contraindications: Refer client for nutritional and dietary consultation.

Breast Cancer
Abnormal, malignant tissue growth on or in the breast; most common cause of cancer in women; encourage monthly breast self-examination and regular checkups. Indications: be aware of changes in tissue around axillary region. Contraindications: If changes are noted, refer client to physician; early diagnosis is important.

Dysmenorrhea
Painful menstruation; may be caused by endometriosis—abnormal growth and distribution of uterine lining—symptoms include heavy periods and clotting. Indications: massage is beneficial for stress reduction and pain. Contraindications: Refer client to physician for diagnosis.

Pelvic Inflammatory Disease
Inflammation of the uterus, fallopian tubes, ovaries, and surrounding tissue; infection often is introduced by intercourse; symptoms include pain and tenderness in the lower abdomen, backache, pain during intercourse, heavy periods, and vaginal discharge. Indications N/A. Contraindications: Refer client to physician for diagnosis.

Premenstrual Syndrome (PMS)
Occurs approximately one week before onset of period; symptoms include breast tenderness and swelling, fluid retention, headache, irritability, anxiety, depression, and poor concentration. Indications: massage is beneficial. Contraindications: Refer client to physician if symptoms are severe.

Testicular Cancer
Malignant growth in the testicle; usually a slow-growing lump. Indications: N/A. Contraindications: Refer client to physician immediately if he mentions such a symptom.

Toxic Shock Syndrome
Staphylococcal bacterial infection that can arise from the use of tampons; can be life-threatening; initial flulike symptoms with red rash; can be prevented by changing tampons several times a day—this condition also has occurred in women who do not use tampons. Indications: N/A. Contraindications: Immediately refer client to physcican.

Urinary Tract Infection
Acute pyelonephritis— inflammation of the kidney and pelvis; usually occurs in women with abrupt onset of fever, chills, malaise, and back pain, also tenderness on palpation over the costovertebral region; cystitis—affects men and women, usually caused by transmission of bacteria through the urethra because of improper cleansing after bowel movement; may cause pain in lower abdomen above pubic bone and low back ache. Indications: N/A. Contraindications: Refer client to physician for diagnosis and treatment.

Genital Herpes
Viral infection; primary symptom is blister like lesions. Indications: N/A. Contraindications: refer client to physician; follow sanitation requirements.

Gonorrhea
Bacterial infection; may be asymptomatic, or symptoms may include painful urination an pus or cloudy discharge. Indications: N/A Contraindications: Refer client to physician; follow sanitation requirements.

Human Immunodeficiency Virus (HIV) Infection
Viral infection transmitted by blood and body fluids. Indications: massage is beneficial with physician’s recommendation; follow antiviral precautions for control of virus with 10% bleach solution; avoid body fluid contact; immediately wash area thoroughly with antiviral agent if body fluid contact occur. Contraindications: Refer client to physician for treatment; follow sanitation requirements.

Syphilis
Bacterial infection; in stage one, red sore (chancre) appears; in stage two, flu like symptoms develop; in stage three, the disease attacks the brain and nervous tissue. Indications: N/A. Contraindications: Refer client to physician; contagious; follow sanitation requirements.

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            In the realm of hospitality industry, the determination and passion to serve has always been the main criteria towards success. Without this, such endeavor remains half-hearted and can create an impact towards the clientele. Realizing this, one must have …

Shiatsu is a type of massage therapy; it relives pain and enhances the flow of energy through the body’s energy pathways by applying gentle finger and hand pressure in the specific points of the body. Shiatsu’s practice is now noticeably …

            Passion is a motivating factor for most people, and I am not any different. I believe that aside from being a driven person towards my passion, the healing arts, I am adept and I am willing to learn.             …

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