Pathologies, Massage and Contraindications Part 2 Rheumatoid Arthritis – By Vanessa Ragains

Last week I introduced the topic of contraindications in regards to massage therapy. There have been many times during my 11 years of working in the Massage field where I had a difficult time determining whether I should massage or reschedule depending on what the client was dealing with. Once I decided to make a policy about rescheduling sessions when the client or myself is sick was when I really understood the importance of enforcing this in my practice. Using one of my must-have books for Massage, I am able to make a confident decision and plan out a course of action with whatever Pathology my client is dealing with at the time. A common Pathology we come across with our clients is Rheumatoid Arthritis.

Pathologies, Massage, and Contraindications Part 2 Rheumatoid Arthritis

Rheumatoid Arthritis: The definition of Rheumatoid Arthritis is that it is an autoimmune disease where one’s own immune system attacks synovial membranes, mainly in the hands and feet. As these membranes are inflamed they become hot, are painful, show redness, swelling, and eventually it can result in loss of function. Fluid accumulates in the joint which causes pressure and pain. This makes it challenging to move fluidly.


  • Lack of energy
  • Lack of appetite
  • low-grade fever
  • vague muscle pain
    • Acute Stage
      • red
      • hot
      • stiff

These symptoms appear in cycles and flare up to several times each year. If one is suffering from chronic inflammation, that never fully subsides.

Massage Risks: If Client is in the middle of an episode, then extra gentle strokes are best when dealing with inflammation in the joints that are painful. We need to remember to ask the client for what medications they are taking for this. That way we will know if we will cause more inflammation or pain if massaging the client during a flare.

Massage Benefits: If your client is in remission, bodywork that is more rigorous may be appropriate up to their personal tolerance level. Using the range of motion passively can maintain freedom of movement.

My Opinion: I am very leery of clients with RA. My communication is extra clear mentioning that they let me know if the technique I am using uncomfortable for any reason. In the past, I have worked with RA clients who are on either end of the spectrum. One client in the middle of a flare will want light pressure, but the other (same scenario) wants the deeper pressure. I encourage gentle stretching on a daily basis to provide the joints with movement. Making sure that you exercise joint movement can encourage the RA to reverse itself. Adjustments in diet, exercise, stress reduction, and massage can aid in reversing RA flares.

Is there a Pathology you would be interested in reading about? I would love your suggestions on certain pathologies that you may need to see in the breakdown. Check back next week for our next discussion on Pathologies, Massage, and Contraindications!

Thank you for taking time out of your day to read my blog. I am looking forward to reviewing common and uncommon Pathologies that we may encounter on our journey of being a Massage therapist. For all you awesome clients out there, I hope you learn why massage can actually be contraindicated with certain pathologies and precautions you and your therapist need to take.

I LOVE YOUR QUESTIONS!! Please feel free to ask me a question or comment about what you read today. Looking forward to hearing from radical Folks like yourself!


All this information come from one of my must-have books for the massage career: A Massage Therapist Guide to Pathology. 5th Edition Author: Ruth Werner



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