While massage is generally considered safe, a common question arises regarding its potential to cause a stroke. Under very specific and rare circumstances, massage can contribute to a stroke. This exceptionally uncommon occurrence is important to understand, both for individuals seeking massage and practitioners.
The Connection Between Massage and Stroke
A stroke linked to massage typically involves cervical artery dissection. This occurs when an artery in the neck, supplying blood to the brain, tears in its inner lining. These include the vertebral arteries (at the back of the neck, traveling through the spine) and the carotid arteries (at the front sides of the neck). When a tear happens, blood can flow between the layers of the artery wall, causing it to bulge inward or form a clot.
Reduced blood flow or a dislodged clot can then travel to the brain, leading to an ischemic stroke. Forceful or sudden neck manipulations, sometimes associated with deep tissue massage, chiropractic adjustments, or even salon hair washes, have been implicated in these rare instances. While the exact incidence is low, case reports highlight the potential link. This mechanism underscores why the neck area requires particular care during any manual therapy.
Identifying Warning Signs
Recognizing the signs of an artery dissection or stroke is important, especially if they occur during or shortly after a massage session. Symptoms often appear suddenly and can include a severe, unusual headache or neck pain that differs from typical muscle soreness. This headache might be described as a “thunderclap” headache, indicating a sudden and intense onset.
Other neurological symptoms include dizziness, vertigo, or a spinning sensation. Vision changes, such as blurred vision, double vision, or a drooping eyelid, may also occur. Weakness or numbness on one side of the body, difficulty speaking, or problems with balance and coordination are also indicators. If any of these signs appear, immediate medical attention is essential for assessment and prompt treatment.
Reducing Potential Risks
Minimizing potential risks associated with massage involves proactive communication and informed choices. Individuals should always provide a comprehensive medical history to their massage therapist before a session. This includes disclosing any pre-existing conditions such as atherosclerosis, connective tissue disorders, a history of migraines, or recent neck trauma. Openly discussing any discomfort felt during the massage, especially concerning neck pressure or movements.
Selecting a qualified, licensed, and experienced massage therapist is a practical step. Such professionals are trained in contraindications and proper techniques, particularly for sensitive areas like the neck. They understand that deep or forceful neck manipulations carry a higher risk for some individuals and should adjust their approach accordingly. If a therapist does not inquire about medical history or seems unresponsive to concerns, it can be a signal to seek an alternative practitioner.