Massage With Varicose Veins and Circulation Problems: What to Avoid

Urgent first: possible blood clot

A blood clot in a deep leg vein (deep vein thrombosis, or DVT) is an emergency in some situations. The NHS (UK health service) describes DVT symptoms as throbbing pain in one leg, usually in the calf or thigh, and swelling in one leg. [1] If those symptoms come with shortness of breath or chest pain, the NHS says to call emergency services at once, because a clot can travel to the lungs. [1] In the US, call 911. Do not drive yourself. [1]

If you have one-sided leg pain or swelling and no breathing trouble, the NHS still advises getting urgent medical advice rather than waiting. [1] Do not book or have a leg massage until a clinician has looked at it.

What varicose veins are, and what they are not

Varicose veins are swollen, twisted veins under the skin, usually on the legs. The NHS says they are common and not usually serious. [2] Symptoms can include aching, heaviness, skin changes and swollen ankles. [2] The NHS lists "have varicose veins" among the factors that make a DVT more likely. [1] It also says to try not to injure your legs, to help prevent bleeding. [2]

What the sources say about massage

It does not treat the veins. A Cleveland Clinic article says massage cannot cure varicose veins but may temporarily reduce swelling and discomfort. [3] We found no trial in the sources we read showing that massage improves the veins themselves. Label: insufficient evidence for any lasting effect.

Why some spas say no. The same article says some spas and massage parlors do not massage varicose veins as a matter of policy, usually from concern about dislodging a clot, causing tears and bleeding, or otherwise damaging the veins. [3] It advises speaking to your provider before getting a massage if you have had phlebitis (superficial vein swelling). [3]

Guidance for the area over the veins. A Canadian chiropractic case report, which cites a massage pathology textbook, says local massage or manual therapy is generally contraindicated over an area of venous disease, and that varicose areas should be avoided if pressure is painful or clot risk factors are present. [4] This is a single case report, not a guideline, and we did not find a vascular-surgery guideline that addresses massage.

Opinions differ. A training site for massage therapists says deep tissue work should not be done when there is a clot risk, but that a past history of clots does not rule out massage. [5] A massage-industry health site says people with a clot history should avoid Swedish massage. [6] Because trade sources disagree, this is a question for your own doctor.

Why leg clots matter so much

Two case reports describe leg massage followed by a life-threatening or fatal lung clot (pulmonary embolism). One was a 25-year-old pregnant woman with an unrecognized DVT who became suddenly breathless shortly after leg and foot massage and went into cardiac arrest. [7] Another was a 23-year-old man with a hairline ankle fracture who died after his mother massaged his leg; the autopsy found a pulmonary thromboembolism from a leg DVT. [8] Case reports cannot show how often this happens, and a 2003 review called serious harm from massage probably very rare. [9] They are the reason leg massage is a sensible place to be careful if you have swelling, pain or any clot risk. Kaiser Permanente's patient encyclopedia lists a blood clot in a vein as a reason not to get a massage. [10]

Circulation problems in general

"Circulation" is a broad word, and different causes call for different cautions. If you have heart failure, diabetes with reduced sensation, a clotting or bleeding problem, leg ulcers, or take blood thinners, tell your therapist and ask your clinician first. Kaiser Permanente also lists bruises or skin abrasions, a bleeding disorder and blood thinners as reasons to think twice. [10] See massage for "better circulation": what is established and massage and diabetes, neuropathy and fragile skin.

Sensible steps

• Tell the therapist about your varicose veins, any clot history, leg ulcers or skin breakdown, and any blood thinners.
• Ask whether they will work around bulging veins and sore spots. If they say they do not work on legs with varicose veins, that is a normal policy. [3]
• Do not press deeply into your own calves or any swollen, painful or warm area. Light, comfortable touch and elevation are as far as this page goes.
• Elevating the legs and regular exercise are what the NHS lists for varicose vein symptoms. [2]

Related pages

Massage and blood clots, claim check: massage moves blood clots, blood thinners and the warning signs checklist.