I have PMR (on 5mg currently) and also have pain on walking caused by spinal stenosis/ degeneration of lumbar spine and left hip etc. I also had a steroid injection a while back for bursitis in my right hip. My daughter would like to give me a massage as a Mothers’s Day gift and I’d love to have one but I was wondering if they are advisable, and if OK any guidance on what type is best? Is it best to avoid deep tissue massages for example?
Do I need to consult my rheumatologist/GP/ physio?
Very grateful for your advice and expertise.
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BadDancer
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Are you a regular massage user? I find massage brilliant, preferably the therapeutive or sports massage variety where they attack the knots in muscles or other inflamed attachments of muscles, tendons or ligaments, but many people find it too painful or leaves them feeling as if they are having a PMR flare.
This happens because the knots in muscles are actually regions of inflamed muscle fibres containing accumulations of the same inflammatory cytokines that cause PMR when they are systemic. The massage techniques release the cytokines from these stores and they get into your system - and so you feel flare-y until they have been washed out of your system which is you didn't pre-empt things can take a few days. It isn't a flare as such because they aren't going to be replaced daily as happens with PMR.
I also have similar problems to you - and the rehab rheumy here says it is greater trochanteric pain syndrome in combination with lower spine arthrosis (arthritis is an inflammatory condition involving one or more joints throughout the body that causes pain, swelling and warmth in the affected areas. Arthrosis is a non-inflammatory degenerative condition associated with aging). I have identified a few options available to me here that really help. The only real source of inflammation in the low back for me is the sacroiliac joint - needs the occasional steroid injection to keep it quiet. Then I try to access extracorporeal shockwave therapy for the hip bursitis - though a steroid injection from a good operator helps too. Get a lot of help from the physios too here - but this isn't the NHS and they are pretty good here at PMR and its add-ons.
So it depends on you - and what you are expecting from the massage.
Hmm! Thanks so much for this helpful and detailed explanation. I used to have occasional massages pre PMR and found them beneficial and relaxing ( especially on my back). I suspect that might not now be quite the same experience from what you and others report. Could try and ask for a less deep half hour back massage and see how that goes. But a nice meal might be money better spent! Or perhaps reflexology?
Unfortunately the steroids don’t help the arthrosis pain but trying to strengthen my core, legs etc to enable me to walk further. And doing a very gentle dance class (for older people) which was my passion - I feel fine doing it but pay for it afterwards in aching and fatigue !! But mental wellbeing is important too. Onwards and upwards…
I love learning new stuff! I'd never heard of "arthrosis", so I just researched it.
Apparently, arthrosis an alternative name for osteoarthritis. This is the aging process that happens to our joints as we age. It is caused by 'wear & tear' and the residual effects of healed injuries. The word 'osteoarthritis' is a bit misleading, because 'osteo' means 'bone', and our joints consist of many tissues other than bone (cartilage and membranes, for example).
I don’t recommend. I could not get the massager to be soft enough and sent me in a flare. My rheumatologist said ok if very soft but they don’t understand very soft. Not worth it to me. Use heat or ice and exercises.
Strengthening exercises, other shots or treatments would be more helpful than a massage so you don’t have a flare. A good orthopedic may be helpful. Work slowly on getting your steroid dosage low. I pray you improve. 😘
Because I have severe bruising (often with haematomas) as a result of 3 years of PMR, no one except my physio will give me a massage. I also have bursitis and the physio’s massage helped greatly.
It all depends on your symptoms and how PMR is affecting you. But an occasional fairly painful targeted massage has helped undo tension surrounding muscle in my left thigh not helped by a nail after a fracture. In this way I hope to reduce the chances of bursitis. I keep gentle exercise and stretching too, on alternate days. Good luck! ❤️
Many thanks. Good to know it can help some in …I do a stretch and clinical Pilates class which I think are good for me although no way as much fun as the bad dancing I used to do!
Everything depends on the masseuse and whether he/she can really get a soft touch, which is more difficult than it sounds (speaking as retired physio) The length of time is also important and I'd never consider an hour's treatment at the moment and especially not with deep massage.. If you are not a regular user then I'd think carefully and probably stick with heat and gentle exercise at this particular time in your PMR journey.
For once I'd give different advice to PMRPro about this . Physical therapy , out of all the types of treatment is probably the one that causes the most individual experience, what is a Miracle to one can be absolute Murder to someone else.
If your choosing massage and have various spine and inflammatory pain problems it isn't generally recommended to have a Sports , all deep tissue massages , Hot Stones. Fascia Blasting, Percussion Therapy , Cupping, Trigger Point and even Swedish massage for many unless they stick to Efleurage. The gentler the better , and some trial sessions of a short period with a registered massage therapist whom is used to practising on someone with your medical conditions is vital.
It's better to do local research and find a therapist that is recommended locally by a support group for arthritis , chronic pain or back conditions near to you not just book something at a spa , as no matter how good that spas reputation or the therapist is for generally healthy people they can still cause you rebound pain if they don't know your medical needs well.
Things like Bowen Therapy , Medical Manipulation (usually done by a hospital therapist) , Gentle version Shiatsu, Soft Touch Thai or Beginners Lymphatic Massage, Reflexology , Dry Brushing and Acupressure , Pregnancy Aromatherapy massage and Beginners Reiki are better but can still cause delayed onset muscle soreness DOMS upto 48hours afterwards.
Dizziness and light headedness can happen which is why massage isn't recommended for people if you have low blood pressure or a low heart rate .
People with various Cardiac issues shouldn't have deep tissue massages especially if they are on blood thinners like Warfarin or antiplatelet medications like Aspirin.
People with high blood pressure , uncontrolled pain conditions and some people with Diabetes are also not recommended to have massage without care.
Deep massage around the spine can also trigger arrhythmias or atrial Fibrillation for certain sufferers of these conditions so again they need to begin carefully.
Massage particularly around the head and neck area can trigger Migraines for regular sufferers and toxin release can cause rebound headache or nausea for people prone to these recurrent symptoms as part of their illness.
You can get a flare of various pain and skin conditions because of the effect of toxins leaving the muscles after manipulation which is one reason why, ironically , its only advisable to have massages when you are feeling good rather than unwell , and definitely not soon after an infection or injury or if you are sore.
You might be lying down but a massage is a vigorous workout exercise of your muscles.
Deep Massage can cause bruising if you are on blood thinners , anticoagulants or have fragile skin from long term steroid use.
You do need to check if your GP , Physio or specialist thinks it's ok but I've also found that most have no idea and just say yes.
You also need to prepare yourself well before and afterwards to reduce the chance of side effects . Drinking plenty of water and nutrient rich light meals for a number of days beforehand, warming up your body before you start with a shower and some movement, keeping warm afterwards, waiting for 20 minutes before leaving or driving, drinking well, particularly straight after the session, and resting for the day afterwards.
It's quite a lot of effort , especially at first when you may only be trialling the massage for a 10 minute session.
I'm not against massage , I get Bowen and Medical Manipulation therapies myself with positive effect , and enjoy them ,but it took time to get the right massage level and length for me. I also enjoy Reflexology and Foot and Hand massage .
My daughter and I have also trained to help each other to do Watsu , or water based aqua movement massage which feels fabulous and relaxing especially in a warm or hydrotherapy pool.
Massage is one of those gifts everyone thinks of as therapeutic and wouldn't it be great for someone with health or pain issues but that's because they aren't ill and don't understand it may not be great at all for certain conditions.
It's a well meaning gift but often not really what you want , and as you are already feeling anxious about the thing it's likely you won't fully enjoy it because you'll feel tense about what might happen so for that reason alone I'd say it would be better to say , "What a lovely thought but maybe not at the moment , thank you".
If your daughter was planning to give the massage herself and isn't qualified to massage people with medical conditions , I'd say that's a definite No.
You could go for an alternative like a gentle foot and hand massage ( make sure you have somewhere comfy and supportive to lie ) , and a manicure and pedicure , or a gentle form of head massage ( although you also need to let them know about your back or neck issues so they don't work them these are usually a better option).
You could always choose a massage at some other point in the future with your daughter after you've been able to find out what's right for you and tried some short taster sessions and know you'd find it fun and relaxing.
Hope that helps and let us know what you decide and how things went, take care , Bee
Huge thanks for all your help and advice. I do also have cardiac/ cholesterol issues ( just joined a clinical trial for high risk patients!) and am on blood thinners so all round I think a massage may need to wait until I’m over all this. Your point about now feeling tense is also a good one - in the past I used to so look forward to a treat of a massage. My lovely daughter was just trying to find something that she knows used to give me great pleasure. Perhaps a gentle head massage might be a good alternative as you mention. Very grateful. If I go ahead with something I’ll post an update.
As ever, we're all different. I’ve had regular massages throughout my whole time with PMR and find them massively helpful. I always feel much better afterwards. That said I have been having them for decades and have a well qualified massage therapist who is trained in remedial massage therapy. I think it’s important that you only go if you really want one and research carefully what sort to have and which therapist to use rather than going because you don’t want to upset your daughter.
Another crucial point is whether you have had massage in the past and what you expect of it. I am like Highlandtiger - I have lived in central Europe for a third of my life and massage techniques are commonly used here and much of the massage I have had has been done by physiotherapists and through the healthcare service. I am on blood thinners, have atrial fibrillation and a pacemaker - never been suggested that is a problem though once or twice I did develop a bruise where a physio was a bit enthusiastic with some myofascial release!
It is certainly true that the physios here don't need any explanations about the restrictions PMR put on what works and what doesn't!!! I've had a couple of brilliant back physios in the UK - but in general it was pretty much as disaster area! I suspect that part of it is that here they are almost all heavily involved in sport and VERY aware of rehab physio.
I agree with Blearyeyed. For me Bowen therapy was good, any massage made me feel tense rather than relaxed because of sensitivity, and I’ve had lots in the past. All of the light touch therapies I imagine would be a treat.
Hello I cannot have massages. It leaves me with a feeling as having a severe PMR flare. Pain but also feeling like the flu and very tired. I tryed again resently as I am on both pred. and MTX, and doung OK. Only neck and back and VERY soft. But I did not get anything positive out of it. So all you can do is try - good luck
Thanks for sharing your experience- don’t think it’s worth her spending a lot of money on something which might have an adverse effect on me. That would upset her too.
I’ve started having fortnightly deep tissue massages which hurt like hell and have me nearly jumping off the massage table but I can feel the knots being broken up. I feel bruised for a day or two afterwards but then feel so much better that for me it is worth the initial pain. Definitely not for the faint hearted though!!
You are very brave! I have put up with that in the past from a physio but not sure I fancy it on top of all the other stuff going on! Thanks for your help.
Hi, I have bilateral hip and shoulder bursitis and just diagnosed with oestoarthritis in knees and hips plus possible pmr or fibromyalgia. I don't recommend massage as it's sore (but nice) at the time, but I find the next day, I'm massively sore plus actually quite draining.
I used to love having massages, pre-PMR, just for pleasure as much as anything else! But something has changed. The last one I had - and it was gentle - I just didn't enjoy it so much. It didn't feel pleasant having my skin touched. I know my skin has thinned as a result of pred so I am guessing it is sensitive to touch now, and not in a good way. I am considering hot stones as I think that would feel nice but without all the movement over the skin. I would also agree with whoever said that a hand and foot massage would be a nice treat without the intensity of back and joint massage. I think the important thing is that you enjoy it, as it is not going to cure your PMR! A nice meal with your daughter might be equally therapeutic!
Enjoyment is key I agree. Sadly I suspect a hand massage with osteoarthritis might not be too pleasurable either! Narrowing it down to possible reflexology, Bowen or scalp massage thanks to all these useful responses…..
I had a (gifted) massage last year and it was a disaster. I was so nauseous by the time they were finished, I barely made it the short drive home before vomiting multiple times and having a terrible headache. In addition I was sore for two days afterwards.
All of this despite advising the RMT of my ongoing PMR for 5 years (she said she did some preliminary research on my condition), requesting a gentler touch, and drinking plenty of water. I was sad with this outcome as I used to enjoy and benefit from massage. Bowen Therapy on the other hand proved very helpful for my PMR, specifically my neck and shoulders, in the early days after diagnosis.
As others have said, you may not know how your body will respond until you try. Good luck!
I think it depends who is doing the massage and whether they have any knowledge of PMR.
I found the type of massage that you get from a beautician quite enjoyable and did relax the muscles a bit. But I also had a lot of physio before I had any diagnosis for my debilitating stiffness and pain, and that included deep massage. It made it worse and I found it excruciatingly painful. It did remove most of the stiffness temporarily and I could move more freely afterwards until next morning, which I know now to be after the cytokines having their 4.00 am party. So not only did the stiffness ping back like an elastic band next day, but I found that I was so bruised that I could barely sit down for a week.
Since then, I have found an osteopath who has a lot of knowledge and experience of PMR. He is very good at gently freeing up the stiffness without causing all the deep bruising. He reckons that his other patients benefit from twice weekly massages. Alas, I am no longer working and my pockets do not extend to that kind f expenditure.
ha ha I thought you might home in on that. 😆 The same thought crossed my mind too. Though he does seem to know what he is doing. I'm not sure that my bank account could endure the pain though. 🤣
I would be surprised if PMR is part of their normal portfolio, but this guy impressed me with how much he knew about PMR. I would rate him well above the physio I saw in expertise. I suppose that there must be other osteos who know about PMR, but the challenge maybe in finding one. I went to him to free up the joints in the upper thoracic area, a long standing issue and I had just been diagnosed with PMR, which prompted the discussion. And he worked on some of the areas that had been giving me trouble.
My experience was horrible with a massage therapist. She did not have a clue what PMR was. I ended up with a mass of painful bruises all over my back, took two weeks to heal. I suggest you check into something called "lymphatic massage", very gentle movements to help lymph fluid to be removed from your body. I have lymphedema from previous cancer surgery. Your tender body could be easily damaged from regular massage.
Lymphatic massage is wonderful at helping your body remove toxins. Massage therapy should never hurt. It can be difficult to find a therapist who is trained in lymphatic massage. If you have never had lymphatic massage, be prepared. It is an absolutely europhia experience.
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I cannot have massages. It leaves me with a feeling as having a severe PMR flare. Pain but also feeling like the flu and very tired. I tryed again resently as I am on both pred. and MTX, and doung OK. Only neck and back and VERY soft. But I did not get anything positive out of it. So all you can do is try - good luck
Is difficulty with walking a symptom of a PMR flair
Ok pmr officially sucks. 
“Old” hip hurting with PMR more than “new” hip? 
Recently diagnosed with PMR
