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Medical Policy

Find out about under what circumstances we are unable to perform treatments.

Your Visit

Contraindication Policy

Please note that all treatments and packages are subject to medical status and some medical conditions require a doctor’s note. If you have a medical condition please ensure you read the below and contact us if you are unsure or have any questions, our team will be able to advise you on the best course of action.


Contraindication – Means you are not able to receive massage or the massage may be limited to certain areas of your body. Contraindications are there for your health and safety along with that of your therapist.

Total Contraindication – A situation where massage is avoided completely. This is usually for reasons presented by the customer and therapist safety and protection.

Relative Contraindication – a situation in which a massage Practitioner may proceed with the treatment with a doctor’s note, but will need to modify techniques related to the client’s condition e.g., using lighter pressure.

Local Contraindication – a situation in which a local area of the client’s body should not be massaged under any circumstances. This may be for the client’s own comfort, to avoid spreading infection or to avoid further injury

Massages are not permitted if you have had surgery within the last 6 months.

Suitability of treatments will be confirmed on arrival at the Spa with a consultation with your therapist. If treatments are unsuitable we will endeavour to offer alternatives, where possible.

Portland Hall Spa reserves the right to refuse treatment where it is deemed to be a risk to the health and safety of the client or therapist.


Disorders of the Nervous System

Stroke – There is a high risk of a second stroke occurring within six months.
Undiagnosed Severe headaches – that come on suddenly, with no previous history of similar headaches, and dizziness or numbness or sleepiness.


Disorders of the Heart and Blood

Heart attack – Because there is a very high risk of a reoccurrence in the two to three months after the attack, massage is contra-indicated. After this time is permitted with a doctor’s note.
Haemophilia – severe haemophilia is a total contraindication to massage. (Mild forms consult a doctor)
Severe Anemia – Massage is fine for mild anemia, but contraindicated for severe anemia.


Disorders of the Immune System

Cancer – if undergoing treatment.

If the client is currently undergoing any form of treatment for cancer then a doctor’s note must be produced prior to treatment. If the doctor is happy for the client to receive treatment then his note should be attached to the therapist consultation form and then the relevant treatment can be carried out.

If the client has cancer but is not currently undergoing any treatment for the disease then we would carry out the treatment, making any relevant notes on the consultation form. If the client is having a massage then the following adjustments should be made by the therapist: the massage should be very light and gentle, no aromatherapy oils should be used and the site of cancer if relevant should be avoided.


Disorders of the Abdominal Organs

Hepatitis is contra-indicated in acute stages for client/therapist protection
Cirrhosis of the liver – is contraindicated for advanced cirrhosis.


Disorders of the Urinary System

Acute urinary tract infections
Acute or chronic renal failure
Acute stages of gout
Kidney stone attack


Conditions of the Reproductive System

Pregnancy – Massage should be avoided during the first and last trimester of pregnancy. Specialist pre-natal massage can be performed during the last trimester.

Spa Pools/Saunas/Steam rooms where heat is prevalent needs to be avoided during pregnancy.


Infectious Skin Conditions (viral, fungal, parasites and bacterial)

Head Lice


Non Infectious Skin Disorders

Areas of skin that are bleeding, broken or weeping fluid.
Open wounds


Undiagnosed Conditions

Inflammation or Odema
Undiagnosed Severe headaches – that come on suddenly, with no previous history of similar headaches, and dizziness or numbness or sleepiness.


Disorders of the Heart & Blood

Blood thinning tablets i.e Warfarin
Seek medical permission prior to massage – if permitted, massage should be light and gentle with no firm pressures or deep tissue movements due to increased risk of bruising to client.

Proceed with caution (treatment can go ahead with a doctor’s note or require separate Risk Assessment)


Skeletal System Diseases



Disorders of the Nervous System

Stroke – after 6 monthsTransient Ischaemic Attack – (TIA- a mini-stroke from which the person recovers with little or no damage.
Meningitis, Brain haemorrhage and Brain tumors
Epilepsy – active epilepsy only (previous 18 months). Do not use essential oils.


Disorders of the Motor Nerve System

Parkinson’s disease – Massage: is indicated under medical supervision, to maintain flexibility and reduce anxiety
Multiple sclerosis (MS) – Massage: is indicated in sub acute stages, when the client is in remission.
Neuralgia – Massage: Light massage to relieve muscle tension can be beneficial. Deep massage on the site is contra-indicated.


Disorders of the Endocrine System

Diabetes – doctors note only needed if not under medical control (diet or insulin)


Infectious Respiratory Disorders

Tuberculosis (TB) – until the client has been on medication for 1 month

Inflammatory Respiratory Disorders



Disorders of the Heart and Blood

Unstable angina – should only with permission from the person’s doctor.
Heart failure – Get medical permission, and then give only gentle massage to avoid stressing a weak heart.
High blood pressure – Deep abdominal massage is contra-indicated, high blood pressure that is not controlled by medication requires a doctor’s note. Low Blood pressure is not contraindicated but extra care is needed.
Thickening of the arteries – Seek medical permission, and then give gentle massage only.
Deep vein thrombosis (DVT) – Totally contra-indicated for 3–6 months after diagnosis, for client/therapist protection. After that period, seek medical permission, and give gentle massage only.

Leukaemia (‘cancer of the blood’) – Seek medical permission and then use gentle massage.


Disorders of the Immune System

HIV/Acquired Immune Deficiency Syndrome – see guidelines and separate risk assessment which assist with this condition.

Local Contraindications – avoid the affected area (therapists).


Skeletal System Injuries

Partial fractures
Simple fractures
Compound fractures


Joint Problems

Osteoarthritis and Rheumatoid arthritis – in acute stages
Ankylosing spondylitis – in acute stages


Disorders that affect motor nerve supply



Non-infectious Skin Conditions

Skin cancer
Eczema – only when open and weeping
Psoriasis – only when skin is broken
Recent Surgery and open wounds


Infectious Skin Conditions (bacterial, fungal and viral)

Acne (vulgaris) – depending on severity and degree of inflammation
Boils and carbuncles
Warts and Verrucas
Herpes – coldsore
Athlete’s foot


The Cardiovascular System

Varicose veins – Massage is contra-indicated in the area directly over, or immediately below the veins
Phlebitis – Massage of the affected area is contra-indicated.


Disorders of the Abdominal Organs

Abdominal hernia

Urinary System Disorders

Joints/limbs affected with gout or on
The abdomen in non acute stages of urinary tract infection.

Abdominal Contraindications – massage needs to be adapted.

Cysts / Fibroids if localised pain


If you require any further information, please do not hesitate to contact us on 01704 537733 or contact us on [email protected].

Need help? Contact our friendly staff today.