How to choose a massage therapist without getting burned

Yes, and before rather than after. NCCIH leads its list of 6 things to know with a warning that is easy to skip past: don't use massage therapy to postpone seeing a health care provider about a medical problem. A massage that takes the edge off your back pain for a few days can quietly talk you out of getting something checked that needed checking.

The companion advice points the same direction. If you are unsure whether massage suits you, NCCIH suggests raising it with your health care provider, who may also be able to help you choose a therapist. Mayo Clinic, which treats massage as an integrative therapy, states the rule that comes with that whole category: tell your doctor you are trying massage, and keep up your standard treatment alongside it.

Your doctor also knows things the therapist cannot see: whether you are on a blood thinner, whether that ache in your calf could be a clot, whether your bones can take pressure. One short conversation hands over that context before anyone puts weight on it.

Mayo Clinic names 6 situations: a recent heart attack; a bleeding disorder or blood-thinning medication; a recent blood clot in the leg; newer burns; fractures; or severe osteoporosis. In those cases Mayo says massage may be harmful. It should never be done directly on tumors, and healing wounds or nerve damage mean keeping pressure off the affected areas.

The overall risk still reads low. NCCIH says the risk of harmful effects appears to be low, and that massage therapy appears to have few risks when performed by a trained practitioner. The documented serious harms run to 3 kinds — blood clots, nerve injury and bone fracture — and some of those cases involved vigorous techniques such as deep tissue massage, or patients already at higher risk of injury, such as elderly people.

With cancer patients, NCCIH notes, therapists may need to modify their usual approach, sometimes using less pressure in areas made sensitive by the disease or its treatment. Mayo Clinic makes the same point about cancer care: a therapist working with someone who has cancer has to take special precautions, "so finding a skilled therapist is important."

No. Mayo Clinic is direct: you should not feel significant pain during a massage, though some forms can leave you a bit sore the next day. If the therapist is pushing too hard, the instruction runs one sentence long — ask for lighter pressure — and that is a call to make during the session rather than something to sit through.

The research points the same way. When NCCIH summarized the evidence on massage for fibromyalgia, an area where a 2014 evaluation of 9 studies found the benefit depends on continuing therapy at least 5 weeks, it flagged the review authors' view that the therapist should not cause pain. Some of the clearer benefits show up at the gentle end of the scale: NCCIH notes that a 2010 review found massaging preterm infants with moderate pressure may improve weight gain. Set that beside a safety record in which vigorous deep tissue work turns up in the rare reports of clots and fractures, and more pressure starts to look like more risk without more benefit.

When a therapist asks about pressure, answer honestly in the moment. A good one wants the feedback and adjusts without making you feel like a nuisance.

NCCIH's tips read almost like a script: ask about the therapist's training, experience and credentials, then ask how many treatments your situation might take, what each session costs, and whether your insurance covers any of it. None of that counts as rude — it is the exact set of questions the federal health agency on the subject tells you to ask, and since most people pay out of pocket, the cost question is practical.

One question deserves its own beat: style. Massage therapy covers many techniques, and NCCIH alone names 5. It describes Swedish or classical massage as the most common form in Western countries and the core of most training programs, alongside sports massage, clinical massage aimed at specific goals such as releasing muscle spasms, and the Eastern traditions Shiatsu and Tuina. The right style follows from what you want out of the hour.

Ask us the same questions on the phone before you drive over. We are at 6175 Mission St, Daly City, on the Mission Street corridor near the San Francisco line, open daily from 10 AM to 9 PM, and the number is (415) 916-3282. Every treatment room runs its own Levoit air purifier for dust and pollen, the tables are oversized so your arms rest on the table instead of hanging off it, and linens and towels are fresh for every guest. Most of how to choose a massage therapist comes down to whether the answers arrive plainly. The vetting runs in order:

Uneven things, and knowing that protects you from overpaying for a promise. NCCIH says outright that much of the research on massage is preliminary or conflicting, even though a fair amount of it points toward some benefit for pain and other symptoms. For low-back pain, a 2015 review of 25 studies with 3,096 participants found short-term pain improvement, but the studies were low quality and the reviewers said they had "very little confidence" that massage is an effective treatment. The American College of Physicians, in its 2017 guidelines, listed massage as an option for acute and subacute low-back pain, though not for chronic low-back pain.

The same shape shows up elsewhere. For neck and shoulder pain, NCCIH reports benefits that may last only a short time. For osteoarthritis of the knee, a small body of research suggests short-term pain relief. For headaches the studies are few and their results inconsistent — one trial of 83 people found that adding hand massage had no effect on migraine frequency. For cancer patients, a 2016 evaluation of 19 studies found some signal for pain and anxiety, rated very low quality. And a 2016 Agency for Healthcare Research and Quality evaluation of 20 studies found massage helpful for chronic low-back pain while grading the strength of that evidence as low.

Part of what you are paying for is the setting rather than the technique alone. Mayo Clinic notes that in most studies people report improved overall well-being, and points at ordinary factors behind that: a quiet, pleasant room, the structured manipulation of muscle and tissue, and the effect of caring human touch. Mayo reads more positive on stress and mood, citing several studies that found a decrease in stress chemicals such as cortisol, and noting that massage releases endorphins, the body's natural painkillers.

The recurring words in those summaries are worth reading literally: low quality, short term, small, not consistent. For several conditions massage may help you feel better, often temporarily, and the strongest claim most of the evidence supports stays a modest one. Mayo Clinic draws the boundary in a single line — a massage may help you relax, but it can't cure everything that ails you, and done incorrectly it could hurt you.

That last clause explains why this guide exists. Before your next booking, do 3 concrete things: confirm the credential, send your doctor a one-line note that you are trying massage, and write down 2 or 3 of the questions above to ask on the phone. That is how to choose a massage therapist, and it costs about 10 minutes.