By Lori Beyard
I would like to talk about an issue that has been coming across my desk a lot lately. That issue is: People refusing to give out their medical history or list their medications. People often will write a huge “NO” across the areas reserved for medication or medical problems. I realize that we, as a society, need to protect our personal medical information. But clients don’t realize why we, who are not considered medical personnel, are asking for this information. Therapists are just as guilty of not understanding why they need this information. Therapists will glance at the intake form and not pay attention to what that client has written down.
Let’s say a client comes in and they list some form of blood thinners on their list of medications. We need to know this since it will affect how we proceed with their session. Even someone on baby aspirins everyday can have a tendency to bruise easily since blood thinners do what? Exactly! They help to thin the blood. This makes it very easy for you to bruise the client when doing deep work. It can also turn a thrombus, which 
is a stationary blood clot, into an embolus which is then free to head towards the lungs or heart. That can be pretty scary right? I had a client not too long ago that came in and showed me some bruises she had acquired after her deep tissue massage. When I asked if she was on any medications, she reluctantly admitted to being on an aspirin regimen. She didn’t put that on her form because she felt we shouldn’t be privy to that kind of information. Had the therapist known, he or she would not have done a deep tissue massage since that is not recommended for those on blood thinners.
How about pain medications and muscle relaxers? Think about it for a minute. One will inhibit pain signals to the brain and the other will chemically induce the muscle to relax. How does this affect your massage? Well in the case of the first one, you will not be able to accurately let the therapist know if they are going too deep or are hurting you since your brain is telling you “it’s all good!” As for the muscle relaxers, if the therapist determines that you need stretches added into your session, your joints and muscles will not be able to accurately tell when they are stretched too far which may cause another issue you don’t want to have with muscle fibers, tendons or ligaments. A session can also leave you feeling more drained than usual after a massage since these kinds of medications can make you tired and loopy to begin with. When taking medications like these, you really should take them after the session and not before, or if you must, take them a couple of hours ahead of your appointment time so they have had time to work through your system and not be as strong.
Massage also will increase blood flow. This can make any medication the client is taking work their way through the system more quickly. A diabetic specifically injects insulin into subcutaneous tissue. They inject it into that type of tissue because it will release the medication slowly over time. If they injected it into muscle the medications would disperse much more quickly. The therapist should check in with their client and let them know that they need to check their blood sugar levels sooner than they normally do and to make sure that they have something handy in case they have an issue with their blood sugar levels. Therapists also need to avoid any injection sites for medication, period, no matter the medicine injected. It is a superb idea to educate ourselves on what the top ten most popularly prescribed medicines are and how what they do, may or may, not alter a session.
Various medications and conditions will let us know what can and cannot or what should and should not be done during that session. It is very important that we know our client’s private medical information. So the next time a client refuses to fill out an intake form, it is our duty to explain the necessity of having that
information. The client does have the right to know, legally, how that information will be used after they give it to us. Educate the clients as best you can. Sometimes we don’t realize how much we can affect the body as a whole with what we do. Think about it!
I get the reason why people say NO on the forms. I do that a lot, but for the fact it is my first time in the office of treatment and I do not know them well enough to have that trust factor as the client. I may not want to use them again in the future after my initial visit and also want to hear what they have to say about a treatment plan before I devulge all my personnal info. On the flip side, as the therapist, I understand why we need the clients info. Especially those who have blood pressure issues or allergic reactions to smells or different types of oil, creams, etc. I usually make it a habit to verbally ask my client if they have any sort of medical issue or are taking any over the counter/ prescribed medication at the time of massage, EVEN if their form says NO…Just always best to ask. they may tell you in person, but not on paper. That is where the SOAP notes come in handy. List anything they tell you on there.
This blog post was full of great information! I had never thought about how meditation would affect the outcome of the massage. But now I see how important it is to know what your client is taking…It really benefits the client.
Thank you!
I explain to my clients that I need this information so that I don’t hurt them unintentionally,which makes me very happy! I haven’t come across any that kept medications from me. I let them know it will not leave my desk drawer and that I will not under no circumstances give out thier information. I worked in a hospital and we had classes on patient confidentiality, so I am well versed in client/therapist confidentiality. I don’t want to blow my cover and the trust of my clients. I love helping them.
Thank you Lori for this article
so far when I have been at Clary sage the clients don’t seem to mind so much about filling out the forms. then again they understand that its a professional spa. so far I haven’t had any clients on pain medications or anything other then vitamins, so i would say I have been lucky. In the future tho once I leave clary I plan on double checking with the client and explaining as to why I would need to know that information.
This was a very thoughtful and eye opening blog as to what how much the little things can affect our patient care.Studying and learning about the multiple most commonly used medications could help us and the client to avoid dangerous situations for future massages, and educating them about the importance of medical intake form. Which will be beneficial for them in the long run. Very good info that I will share with my future client if they do not fill out their sheet. I will make sure they understand the gravity of what medications effects can have during a massage session.
I used to go to a chiropractor and he would tell me that before my appointment, he would rather i didn’t take any pain medication so when i told him my pain level on a scale of 1-10 it would be more accurate and a more honest reading when it came to doing my adjustments.
I personally am very thorough when it comes to filling out intake forms of any kind. Whether it be for a medical facility or simply a job application, I like people to know what I have gone through in case anything further were to happen.
I find it scary to think some people withhold information when it is only for their benefit for us to know. I can slightly understand why people may think the prescriptions they take may not affect a massage, but it is better to be safe than sorry in any case. I would advise every therapist to get an intake form every time and every client to not leave anything absent when filling out an intake form.
I can see the reason that we need medical information, definitely! But a lot of patients do not see us a a medical-type profession, but more of a voodoo-hoodoo hippy sort of profession. I experienced this way of thinking this weekend. I was certainly put off considering I’ve learned so much about how much massage can affect a person’s health and well-being! The problem is going to be much the same as many other professions, and that is getting the world to take massage seriously as a profession. We have to start locally and that is going to be hard, but just to do my part I am going to post this blog on my Facebook so that my friends and family members might recognize what I am learning as a serious profession and not just some mumbo-jumbo. I think we should continue to insist of medical histories as well as even require it. I think it provides protection for us as well as for our client’s health.
Personally, I see no reason why anyone would have the desire to withhold any medical information from a therapist whether that is a Doctor or a Massage Therapist. No one can accurately treat an individual without knowing their medical history or status. The body is a factory, each part is interlaced into the others, so we should not assume that medication is not going to affect the massage because everything you do to your body affects other parts of it. I realize some people do not want personal information out there but that is not a valid reason to impose on their own treatment.
This article actually teaches me about how important it is to be honest and what medication(s) that our client takes on a daily basis. I feel that it is really important where the client is hurting the most or what part of their body is hurting them and needs to be looked at.
Be sure to protect yourself. Make an intake form before the massage and why not after. There’s a lot people out there trying to make a quick buck. Protect yourself.
Wow that is an great point in WHY we need to know the meds the client is taking. to protect not only the client but ourselves as well.
This was a great article. Having worked in the medical field I have come across lots of people who didn’t want to fill out certain areas on their forms or even refuse to sign the HIPPA agreement. I think it’s great advice to educate your clients. We will find out what is going on with them one way or another, so they might as well be honest and upfront.
I agree 100{dd4fd4792e0eb33cfcd896730531ad5ee27f408bd2ce28da7f8125f8188131a8}, I feel as if people do not understand yet that massage therapists not only relax the body but we can help improve your lifestyle and other times heal body parts that have been injured, but we must work with the client. For us massage therapists we need all the information we can get to work with our clients to stamp out this issue and get them on a one stop road to pain free life.
Why wouldn’t someone want to fill out an intake form?? It for medical reasons like lori said so we know what we can and can not do or what needs to be done to that client.
Wow, I didn’t realize how much medication can affect a massage! I will definitely be more careful when asking someone their medical history.
I do understand why some client’s even the elder one’s would not want to have their information out there for everyone to see, they might not understand that the information isn’t seen by everyone that works there. My grandmother is that way about a lot of her information. Us as therapist do need to make it as clear as possibly the reasoning why it is important to have this information so that during an massage we (the therapist) do not cause an condition a client might have to become worse.
You should always be honest with medical personnel. Regardless, cause you get those meds mixed with the wrong thing it could be deadly for you!
Wow I never really thought about that very informational. this article really teaches me a lot
This is a very helpful blog Lori! I knew that knowing the client’s medications was important, but I didn’t know just how much massage could affect those medications our client’s take. It makes sense though since massage increases blood flow. I’ll make sure my client’s know how important it is to let me know what medications they’re taking… thanks for the great blog!
I could understand a client not disclosing everything but I mean really I don’t understand why someone would write NO. I don’t see how someone is going to steal your identity or something by putting I take blood thinners on a form. But that’s just me. I like this blog though especially for people I know like this it is good for them to understand why we need this information.
I don’t really understand why anyone would refuse at the very least medication information when it comes to someone that is going to be working with your body. Maybe, just maybe because they think the medication they’re on isn’t relevant, but that’s the only thing I can think of. I think client’s should be explained upon being given the form why we need that information. Don’t wait for them to ask questions, set their minds at ease before they have to.
This article was full of great information that will help me as a therapist & as a client. I’m a private person, so there are time where i don’t want people to know whats going on in my personal life. I now understand the importance of sharing specific information to someone such as a doc, or therapist. Allergic reactions do happen, and people don’t always know all the things that they are allergic to.
I dont understand why people would with hold important info like this. If people only knew the trouble we could get in as massage therapist say someone were to sue because they thought the bruses were intentional from the therapist. The massage therapist doesnt ask these questions for no reason. Not only could we get in legal trouble but also we dont want to cause any pain or discomfort to the client as well as further their medical issue. And on the other hand if theyre having a problem and let us know we might have some simple solutions instead of the medication they are using.
I am guilty for not putting all my medical information on some forms as well! This blog has kind of opened my eyes on how important it is to let a therapist know what medication a person is taking, or medical problems they have. Thanks!
This is a super helpful blog! I knew the importance of medical history but had not really considered a client’s intentional refusal to provide information. It’s important to consider ways to approach reluctance / refusal with clients to ensure you are able to provide the best care possible for your clients! Thanks!!
Okay, totally need to be more honest when filling out medical forms. That blog was very matter of factly. I prefer the truth and the blood thinners information that was very intense. Not just about the bruising but also about the clots. Really makes you think about the adverse affect you can have on someone without the proper information, Great blog
Wow…this blog was full of information that we need as massage therapists! I definitely agree that we should inform ourselves about the most common medications taken and be familiar with their ramifications regards our massage.
I never anticipated a client being hesitant to fill out a questionnaire, but will be ready now with good reasons that they should do so, now that I have read this article.
I never with hold any kind of medical information because there are a lot of risks in which I could be hurt so I don’t understand why others would!
I believe that it is extremely crucial to let your massage therapist know about any medical conditions and/or medications. I don’t understand why people would want to hide it. It is nothing to be ashamed of. It is their job to know not be grossed out or creeped out by anything you have to tell them
Very informative blog and going to be very helpful to me when I start externship and my massage career. I understand why clients what to keep some things private but it is great for us as massage therapists to stay informed and inform our clients about how medication can affect the massage experience.
I didn’t know asprins would affect a massage that much, so I learned something!
I can see why clients wouldn’t want us to know every little thing about them, but most of the time, we do need to know. We are touching your body! We need to know if our touch is hurting you. We absolutely do not want to hurt you in any way and the only way we can know is by the client being 100{dd4fd4792e0eb33cfcd896730531ad5ee27f408bd2ce28da7f8125f8188131a8} truthful with us. If I eventually have a client that is leary to tell me about their medical history, I will just inform them that I am bound by law to protect their information and I will do everything in my power to do so.
Very good information. A lot of times clients think we are just prying into their personal business and they don’t realize that we ask this information to help them and we really aren’t just trying to be noisy.
Regardless of whether or not the client is honest, they are still our hands and we still feel bad. If the client does not find it important to be honest on an intake form, they may not understand why “you bruised them.” It’s a catch-22 situation. The most important thing I have found to help combat this is to go over the client’s intake form with them in regards to medications and medical disorders, and always maintain a profession demeanor.
I believe that not wanting to tell medical history is crazy it’s not your social security number we can’t steal anything from you and I sure won’t work on someone who refuses to tell me the things I need to know to give them the proper massage! It’s for the clients safety as well as the therapists. I believe that if they say no all you can do is explain why you need it and that everything is kept secure then maybe they will change their minds but if not the massage will not happen.