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Posted by: Kathryn Kemp, 8 Jan 2012 7:02PM
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How long after cortisone injection can deep tissue massage be given

Hi, can anyone advise how long after a cortisone injection to the shoulder a client can be massaged (deep tissue) - I'm getting conflicting information. Many thanks. Kind regards Kathy


Nicki Lee
17 Jan 2012 6:49PM

Hi, I'm afraid the formal answer should be, as it's a medical treatment, you need to ask (or have the client ask) the doctor who performed it. With any luck, this will be a doctor who specialises in muscular-skeletal problems and will know what massage does and the correct answer! I'm very interested to see what other answers you've found, as I agree this can be a murky area. This is a bit long, but extracted from fabulous book by Ruth Werner: A Massage Therapists Guide to Pathology "Steroidal anti-inflammatories are powerful but have several serious side effects. In addition to altering tissue response (which requires extra caution with massage) they supress immune system activity. Long term use is associated with weakened connective tissue, fat deposition, muscle wasting, reduced bone density, fluid retention, hypertension, and easy bruising. Topical application can result in thinning skin. All of these features influence bodywork choices. Deep tissue massage should not be used when these drugs are used in the long term and myofascial techniques should be used with great caution." So even this doesn't really give an entirely clear answer to a first and possibly single injection. I have tended in the past (after doctor check) to massage around the area but not directly on the injection site 2 - 4 weeks afterwards, but gently. In a way, they have selected this treatment over massage, and while massage works in conjuction very nicely with many other treatments, I'm always aware that the steriods are in some ways inhibiting the natural healing response that massage appears to stimulate and encourage. One other place I can point to advice would be on Linked In (anyone can join up) and there is a group called Medical Massage, where people post questions such as this - I'm sure you'd get a good response (although I can't promise they would all agree with each other!) If you need help finding or joining linked in, send me a message or email and I'll send you an invitation through my membership. Very best of luck, Nicki
Kathryn Kemp
17 Jan 2012 7:31PM

Thanks Nikki, much appreciated. I've postponed anyway as the client seems to have reacted rather badly to the cortisone I had advised against. I do trigger point therapy and was very hopeful I could provide relief to the problem. The clients GP having injected her with cortisone and pumped her full of painkillers has now referred her to physio and told her to stay away from anyone else. I feel quite frustrated. I'd really appreciate the offer of a link to LinkedIn. Kind regards Kathryn
Nicki Lee
17 Jan 2012 10:47PM

I've been there, and it is frustrating! Although I don't deny there is a place for injections (possibly, anyway) for me it would be very much a last resort. But I've seen people who simply want a quick fix which they expect it to be, not understanding pain relief and healing aren't the same thing. But it is their choice, and it may be that once they've done that, massage possibly isn't the right thing in the early stages after injection - I just don't really know. I'll send you a linked in invitation, and once you join and accept you can look at the groups I'm on and if you go to the Medical Massage Group (can't remember exact name) I think you'll find it interesting and helpful. All the best, Nicki
Jane Hopwood
19 Jan 2012 9:18AM

Hi read with interest. Can you also send me a link please. Thanks Jane
Nicki Lee
19 Jan 2012 9:21AM

Sure, Jane, I'll do it now. The group is called Medical Massage Therapists - there is a lot of American content but there are also a good number of UK participants.
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