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Large Buttocks Hematoma Caused by Deep Tissue Massage Therapy

PainSci » bibliography » Sun et al 2015
updated
Tags: harms, massage, case, pain problems, manual therapy, treatment

Two articles on PainSci cite Sun 2015: 1. Massage Therapy for Low Back Pain (So Low That It’s Not In the Back)2. Massage Therapy Side Effects

PainSci commentary on Sun 2015: ?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.

Sun et al. report a case of a “large buttocks hematoma” in an older patient directly caused by “aggressive” gluteal massage, intended to relieve back pain, leading to a hospital stay and surgery to resolve substantial swelling and leg numbness.

Some readers may be inclined to dismiss this as irrelevant to massage therapy because the "real problem" was a patient's unusual vulnerability. But the problem here was aggressively massaging someone with that vulnerability — a vulnerability that is quite common in aging patients. Blood vessels do get more fragile with age, and strong massage can break them — sometimes even the big ones — and this is a risk that massage therapists absolutely need to be aware of and adjust for. While we cannot know if this specific case of "aggressive" massage also involved incompetent/negligent ignorance mismanagement of the risk, it is obviously likely.

~ Paul Ingraham

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.

Our patient was a 59-year-old male who received a 30 minutes deep tissue massage therapy during which the therapist used his hand, wrist and elbow to aggressive press the patient's lower back and buttocks to alleviate CLBP. Within 2 hours of the deep tissue massage, he began to feel pain in the central of left buttock. Visual analogue scale (VAS) of the pain is 6 (the boundary of scale is 0–10, rating them from “no pain at all” to “the worst pain imaginable”). Four hours later, the pain had gradually increased that the VAS reached nine meanwhile there was an obvious swelling appeared in the central of left buttock. The patient was sent to hospital by ambulance and examination findings on admission were as follows: blood pressure: 160/100 mm Hg, conscious with stable vital signs, protruding and obviously swollen of the central of left buttock, and the numbness of the back of the thigh, down through the leg and foot. Ultrasound examination identified a hematoma within the muscle fibers of left gluteal maximus.

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