Massaging the outcome: an unusual presentation of pulmonary embolism
Two articles on PainSci cite Lim 2009: 1. Massage Therapy Side Effects 2. Does Massage Increase Circulation?
PainSci commentary on Lim 2009: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.
This is a case study of a man who’d had deep vein thrombosis presumably caused by a long-haul flight (flex your ankles regularly on flights!). He was treated with anticoagulants for months, but the clot remained… until it was dislodged in a massage two years later. The massage was a “full-body” massage and included the legs, but no other details were noted. “The onset of dyspnoea soon after leg massage suggests that this was the likely cause of thrombus embolisation.” It does seem likely.
His only symptom was shortness of breath, which is impressive considering how serious the embolus was. It was a “worm-shaped right atrial embolus, most probably a femoral cast.” Meaning the embolus was basically the shape of the vessel where it had lived until it was dislodged, and wormed its way into a lung. Shudder.
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
A 56-year-old man with a previous deep vein thrombosis presented with dyspnoea after a leg massage. A transthoracic echocardiogram demonstrated a "worm-shaped" right atrial embolus, most probably a femoral cast. A pulmonary artery angiogram confirmed a large wedge-shaped perfusion defect caused by a pulmonary embolus. There are previous case reports about leg massage causing pulmonary emboli but this is the first reported event where the thrombus has been visualised directly. Also, it demonstrates the important role that echocardiography plays in pulmonary embolus.
related content
- “Pulmonary embolus originating below knee,” Warren, Lancet, 1978.
- “Renal artery embolization after back massage in a patient with aortic occlusion,” Mikhail et al, Nephrol Dial Transplant, 1997.
- “Massive pulmonary emboli after legs massage,” Jabr, Am J Phys Med Rehabil, 2007.
- “Leg massage by mother resulting in fatal pulmonary thromboembolism,” Behera et al, Med Leg J, 2018.
- “Leg massage during pregnancy with unrecognized deep vein thrombosis could be life threatening: a case report,” Sutham et al, BMC Pregnancy Childbirth, 2020.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
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- Prediction of an extruded fragment in lumbar disc patients from clinical presentations. Pople 1994 Spine (Phila Pa 1976).
- Characteristics of patients with low back and leg pain seeking treatment in primary care: baseline results from the ATLAS cohort study. Konstantinou 2015 BMC Musculoskelet Disord.
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