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The Use of Heat During Massage (Thermotherapy)

By Jacqueline / May 26th, 2017

The use of heat during massage is a choice LMTs can choose to incorporate into their routine or not. For me personally, I prefer to use some amount of heat during massage sessions, with the exception of those with medical condition(s) or contraindication(s). In such cases, the use of heat will not be appropriate. However, for many, the application of heat also known as  thermotherapy, when used properly, can be extremely beneficial.

According to author Mark F. Beck, thermotherapy is effective for relieving pain caused by muscle tension/ stiffness or spasm, and to promote relaxation to the blood vessels, nerves, and muscles, as well as encourage the metabolic activity of body cells. Before administrating the massage, I apply a moist hot towel usually on the back of the client or area(s) of tension. I usually notice an automatic deep relaxing breathe most take, or the comment, “that feels good” as the heat seeps into their skin. I have experienced this myself and it feels AMAzing! A stressed or nervous client usually feels more at ease after the application of heat.

Moist heat sources, like hot towels, when administered before a massage, increases circulation and help relieve muscle soreness aiding in the overall effectiveness and therapeutic benefits of the massage.

4 Ways Heat is Transferred to the Body

1. Conduction- the direct exchange of heat when the surface of the body is in direct contact with the thermal agent. Ex: heat pack, immersion bath, hot towel.

2. Convection- the conversion of heat through the movement of the air. Ex: steam bath, sauna.

3. Radiation- the transfer of heat by way of rays contacting the body . Ex: the sun, infrared radiation.

4. Conversion- the converting of an energy source into heat as it passes through the body’s tissue. Ex: diathermy, ultrasonography.

The average skin temperature is 92 degrees. According to massage therapist, Leslie DeMatteo,  hot stone temperatures should never be higher than 120 degrees and will usually be hot enough for most clients at about 105-110 degrees. When it comes to pregnant women, small amount of low heat on tensed areas is okay. According to a study conducted by Shahrekord University of Medical Sciences, “thermotherapy decreased the intensity of pain in the first and second trimesters of pregnancy in various measures. Continuous application of thermotherapy in a low level was effective on treating acute low back pain and nonspecific low back pain.” Again the key word is “low level” of thermotherapy. Some consequences of using high amounts of heat on a pregnant woman during her massage is discussed under “contraindications.”

“Heat quiets and relaxes the entire body, is efficient, nontoxic and promotes sleep” – DeMatteo.

Applying heat to the extremities is contraindicated of clients with impaired arterial supply such as diabetes, because local heating may increase the metabolic demand of the tissues beyond what the circulatory system can supply, which can result in tissue damage.

Also, for those suffering from diabetic neuropathies, where there’s decrease or loss of skin sensitivity, should not have heat applied on their skin during the session since they may be unaware that the heat is too much for them. Very hot stones especially should be avoided due to possible burns.

Edema, cardiovascular conditions, and high blood pressure, can all be aggravated more by hot stone massage or thermotherapy in general. Full-body hot stone massage is contraindicated for pregnant women due to the fact the pregnancy naturally raises body temperature and the high amount of heat associated with this type of massage will be too intense resulting in  high core body temperature of the soon to be mother. This can result in increased risk for birth defects, particularly during the first trimester.

Overall, thermotherapy is an excellent way to enhance the effectiveness of a therapeutic massage to assist in healing the body naturally.



Andrade, Carla-Krystin. “Outcome-Based Massage: Putting Evidence Into Practice.” Google Books. Lippincott Williams & Wilkins, 15 Feb. 2013. Web.

Battaglia, Gina. “How to Use Hot Moist Towels in Massage Therapy.” LIVESTRONG.COM. Leaf Group, 12 Oct. 2015. Web.

Beck, Mark F. Theory & Practice of Therapeutic Massage. Fifth ed. Clifton Park: Cengage Learning (Milady), 2011. Print.

Bucher, Jordan. “Heat Side Effects During Pregnancy.” LIVESTRONG.COM. Leaf Group, 24 June 2015. Web.

Dehghan, Morteza, and Farinaz Farahbod. “The Efficacy of Thermotherapy and Cryotherapy on Pain Relief in Patients with Acute Low Back Pain, A Clinical Trial Study.” Journal of Clinical and Diagnostic Research : JCDR. JCDR Research and Publications (P) Limited, Sept. 2014. Web.

DeMatteo, Leslie. “Hot Rocks! Is Hot Stone Massage Safe?” Massage Professionals Update. N.p., 18 Apr. 2014. Web.

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