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What are the contraindications for Thai massage?

There are conditions or situations in which Thai massage is inadvisable because it may harm the recipient, so review the intake form.

There are conditions or situations in which Traditional Thai massage is inadvisable because it may harm the recipient. The recipient’s health history information is essential to evaluate any contraindications and best serve the recipient’s needs.

Contraindications are conditions where Thai massage is inadvisable because it may harm the recipient. The term contra means against or contrary, and indications are symptoms that suggest that a specific medical treatment is necessary. The recipient’s health history information is essential to evaluate any contraindications and best serve the recipient’s needs.

There are more contraindications for Thai massage than you might expect, but Thai massage is safe when performed with adequate knowledge of the recipient’s physical condition. Physical disorders vary from one body system to another, and some Thai massage positions may harm a person with particular health conditions. Therefore, the practitioner must know the recipient’s health condition and problem to perform Nuad Boran safely.


Abdominal Conditions. A hernia is a protrusion of an organ through the muscular wall. Do not perform a Thai massage on this area or attempt to push the organ back inside. Do not massage clients with an umbilical hernia or unknown causes of abdominal pain. If the condition is not severe, proceed cautiously and monitor the client closely.

Injury or Inflammation of Muscles. If an injury is chronic and shows no signs of trauma, you may proceed cautiously. Inflamed conditions include conditions that end in ‘-is,’ such as phlebitis (inflammation of a vein), dermatitis (inflammation of the skin), arthritis (inflammation of the joints) and so on. Thai massage can further irritate inflammation, so do not massage this area, especially if an injury shows trauma, such as bruising or swelling.

Bone Fracture or Joint Dislocation. Only massage this area if the recipient’s physician has given you written consent. Do not apply pressure directly on the mending bones; a light massage beside this area can improve circulation.

Severe Ache and Pain. If the pain is due to the muscles, proceed with caution. If the pain is nerve-related, prevent further harm and do not massage.

Fever. A fever indicates your body is trying to isolate and expel an invader. Do not massage the body, but you may gently massage the recipient’s hands, face and head for relaxation. Thai massage will exacerbate inflammation and might spread infection if bacteria cause the fever. 

Acute Non-Severe Illnesses. Respiratory conditions like colds, influenza or sore throats are contagious to the practitioner and anyone in the clinic. These symptoms may also coincide with other contraindications, such as fever.

Severe Headache. If the cause of the severe headache is unknown, do not massage because underlying conditions may require a physician’s consent.

Migraines. Massage will aggravate the symptoms, so the recipients should rest and take their medications if required.

Osteoporosis. Osteoporosis is when bones become porous, brittle and fragile. Be sure to apply light pressure, as deep pressure can cause be too intense for this condition.

Post Surgery. The practitioner must have written consent from the recipient’s physician before doing Nuad Boran.

High Blood Pressure. This condition means that there is excessive pressure against the blood vessel walls. Recipients with high blood pressure should only receive light pressure, if at all. And regardless of whether they are on medication, a recipient with high blood pressure must have consent from their physician.

Stroke with Chronic Condition. A person who suffers from a stroke will need physiotherapy and massage. Apply light pressure, as deep pressure can cause bruising or dislodge blood clots to the heart or brain.

Vascular Conditions. Do not massage any person with vascular issues without approval from their physician. 

Cancer. Thai massage increases lymphatic circulation, and cancer can spread through the lymphatic system, so massage can potentially spread cancer. Reduce your pressure, and do not apply pressure to the lymph nodes. Only massage with physician approval, and avoid the tumour site and surrounding tissue.

Edema. Edema is the accumulation of fluid in the interstitial tissue space. If you treat someone with edema, the direction of the massage should be towards the heart only. Do not massage if heart, liver or kidney diseases cause the edema, as the movement of the fluid may overload the affected organs.

HIV Infection. HIV is only transferred through the exchange of body fluids (blood, semen, vaginal fluids or mother’s milk), not through massage. However, infections people suffer from in the later stages of AIDS can be contraindications. Stay away from any visible rashes, sores, lesions or swelling. Wear thin surgical gloves if you have any open cuts or scrapes on your hands.

Varicose Veins. Varicose veins are enlarged veins that tend to clot and damage tissue. Apply very light pressure beside the varicose veins toward the heart. Do not massage near the enlarged veins, as massage may dislodge clots in the vein, which, in turn, can obstruct the heart, lungs or brain.

Contagious Skin Diseases. Do not massage the infected area, as massage may spread the disease to other body parts or even infect the practitioner. If you cannot avoid the area, do not massage.

Non-Contagious Skin Problems. Do not massage directly over rashes, wounds, bruises, burn, boils, blisters and other localized skin problems. You may still perform Thai massage away from these conditions.

Pregnant Women. Pregnant women need permission from their physician for a massage, but never massage a pregnant woman who has any complications with her pregnancy.

Women in Menstruation Cycle. You may massage menstruating women but observe the contraindication positions listed in the following section.

Drug or Alcohol Intoxication. Do not massage any person intoxicated by drugs or alcohol, as massage may intensify the effects of the agent. The recipient will also be more unpredictable and uncontrollable when intoxicated.

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