Why do I feel pain during massage?

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Written By Dr. Marcus Yu Bin Pai

MD, PhD. Physical Medicine & Rehabilitation Physician from São Paulo - Brazil. Pain Fellowship in University of São Paulo.

Feeling pain during a massage can be attributed to several factors:

  1. Type of Massage: Different types of massages apply varying levels of pressure and focus on different areas of the body. For instance, a Swedish massage promotes relaxation with a combination of strokes, while a deep tissue massage applies more pressure to work out problems in the tissues. Trigger point and neuromuscular massages focus on specific hot spots to provide relief from pain[1].
  2. Existing Physical Conditions: If you have sore muscles, damaged ligaments, or tendons, these areas will likely be painful when the massage therapist begins to work on them. Similarly, trigger points, which are hypersensitive spots in the muscle, can cause pain during a massage. Adhesions (scar tissue) can also cause pain when being broken up during a massage. Sprains and strains, which are different types of tissue injuries, can cause discomfort during a massage as well[1].
  3. Individual Sensitivity: Each person has a different pain threshold and tolerance. What may be comfortable pressure for one person could be too intense for another. Additionally, pressure tolerance can vary between different body parts and can even change over time.
  4. Muscle Tension: Your body may naturally tense up in response to pressure. If the therapist applies too much force, it can cause the muscle molecules to cling together, resulting in pain and discomfort. In such cases, the therapist should adjust their technique or prepare the tissues further to alleviate the tension.
  5. Pressure Applied: The most common reason for pain during a massage is the application of incorrect pressure. While the masseuse might think they’re applying the right amount of pressure, it may feel too intense for the client[4].
  6. Health of the Tissue: If the tissue being massaged is not 100% healthy, the massage can cause discomfort. This is because the massage can help improve circulation in the area, which can initially cause aches and pains[7].
  7. Adhesions or Scar Tissue: At times, during a massage, you may experience discomfort or pain when the therapist works on areas with adhesions or scar tissue. These areas can be more sensitive and may require extra attention.
  8. Communication: If you’re experiencing pain during a massage, it could be a sign that you need to communicate more with your massage therapist. Let them know if the pressure is too much or too little[7].

Is it common for people to have different pain thresholds in different parts of their body?

It is common for people to have different pain thresholds in different parts of their body. Pain threshold refers to the minimum intensity at which a person begins to perceive a stimulus as painful, while pain tolerance is the maximum amount of pain a person can tolerate or bear.

Here are some factors that can contribute to different pain thresholds in different parts of the body:

  1. Nerve density: Different areas of the body have varying densities of nerve endings. Areas with a higher concentration of nerve endings, such as the fingertips or lips, tend to have lower pain thresholds.
  2. Skin thickness: The thickness of the skin can also affect pain perception. Thinner skin, like that on the eyelids or inner thighs, may have a lower pain threshold compared to thicker skin, like that on the palms or soles of the feet.
  3. Sensory processing: The way the brain processes sensory information can vary across different body parts. Some areas may be more sensitive to pain due to differences in neural pathways and processing centers.
  4. Previous experiences: Past experiences with pain in specific body parts can influence pain perception. If a particular area has been injured or undergone trauma before, it may have a lower pain threshold due to sensitization.
  5. Psychological factors: Psychological factors, such as anxiety or fear, can also influence pain perception. If someone has a fear or negative association with pain in a specific body part, they may have a lower pain threshold in that area.

Some suggestions

To avoid or deal with pain during a massage, here are a few suggestions:

  1. Communicate with your massage therapist: If you experience real pain during or after a massage, it’s important to communicate with your therapist. They can adjust their technique and pressure to ensure your comfort and relaxation [2].
  2. Be relaxed: Creating a comfortable and pleasant environment can enhance your massage experience. Ensure the room has an ambient temperature, and if you have preferences for scents or background music, communicate them to your therapist [2].

Remember, a skilled and attentive massage therapist should prioritize your comfort and preferences. If you feel that the pressure is too intense or uncomfortable, it’s important to speak up and assert your needs.

While some discomfort can be expected during certain types of massages or when working on certain physical conditions, a massage should not cause extreme or lasting pain. If you’re consistently experiencing pain during your massages, it may be worth discussing this with your therapist to adjust the technique or pressure used. It’s also important to note that massage doesn’t have to be painful to be therapeutic[3].

[1] https://www.somaticservices.com/2015/10/15/why-some-areas-hurt-more-than-others-during-a-massage-treatment/
[2] https://www.healthline.com/health/types-of-massage
[3] https://www.health.harvard.edu/therapeutic-massage-for-pain-relief
[4] https://steppodiatry.co.uk/why-do-massages-hurt/
[5] https://www.arthritis.org/health-wellness/treatment/complementary-therapies/natural-therapies/types-of-massage
[6] https://www.physio.co.uk/treatments/massage/when-can-massage-help/chronic-pain.php
[7] https://www.adicamassage.com/blog/are-massages-supposed-to-hurt
[8] https://chiropractorinoviedo.com/blog/types-of-massage/
[9] https://www.healthline.com/health/sore-after-massage
[10] https://onebodyldn.com/muscle-fitness/why-does-deep-tissue-massage-hurt/
[11] https://www.painscale.com/article/use-these-types-of-massage-for-chronic-pain
[12] https://www.manchesterphysio.co.uk/treatments/massage/when-massage-can-help/chronic-pain.php
[13] https://www.profysionj.com/blog/2021/august/is-it-normal-for-a-massage-to-be-painful-/
[14] https://www.vinmec.com/en/news/health-news/healthy-lifestyle/12-types-of-massage-which-is-right-for-you/
[15] https://pressmodernmassage.com/blogs/going-deep/sore-after-massage
[16] https://www.alphaschoolofmassage.com/blog/2017/10/2/are-massages-supposed-to-hurt
[17] https://www.ogawaworldusa.com/blogs/health-wellness/what-are-types-of-massage
[18] https://www.westlondonphysio.co.uk/news-articles/how-massage-uses-your-own-body-to-reduce-pain-and-heal-injuries/
[19] https://www.vivs-inhouz-spa.co.ke/blog/pain-during-massage/
[20] https://www.naturalhealers.com/massage-therapy/specialties/
[21] https://www.pathways.health/blog/how-can-massage-therapy-treat-your-chronic-pain/
[22] https://melbournenaturaltherapies.com.au/deep-tissue-massage-why-does-it-hurt/
[23] https://tobetterdays.co.uk/blog/massage-types-for-chronic-pain/

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MD, PhD. Physical Medicine & Rehabilitation Physician from São Paulo - Brazil. Pain Fellowship in University of São Paulo.

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