So if the client is coming in for pain reduction or simple pleasure, the session will probably be advantageous to the purchaser.

A situation where the massage could be harmful is called a contraindication.

For many years, cancer was a contraindication for massage. Now, however, with additional training for the therapist, it is thought that massage can be a valuable part of the program of treatment in conjunction with written authorization from the physician. The old fear that massage would cause the cancer to spread is now regarded as unlikely, though the mechanism for cancer growth is not completely understood. There is even a book on the subject--Gayle MacDonald's Medicine Hands: Massage Therapy for People with Cancer.

Other conditions which may indicate massage is not appropriate include sinus trouble, phlebitis, nausea, headache, blood clot, spinal injury, epilepsy, heart trouble, stiff neck, drug pump implant, fainting spell, arthritis, skin problem, pacemaker, recent surgery, low or high blood pressure, infectious disease, back or neck injury, dislocation, recent accident, diabetes; fever, under the influence of drugs or alcohol, neuritis, thrombosis, hypertension, oedema, osteoporosis, nervous or psychotic condition, Bell's palsy, trapped or pinched nerves or gynecological infections. It may be convenient for the therapist to ascertain that a client has any of these by requesting the completion of a preprinted health questionnaire. The therapist can then determine whether massage will still be advantageous for the client with special care or precautions or whether the client should be advised massage is not appropriate at this time. The therapist may find it better to recommend other health care professionals to the client if massage is not timely.

There may be conditions which are contraindicated to the particular area but do not void the therapy. Thus the therapist can massage if the effected area is avoided. These could include varicose veins, undiagnosed lumps or bumps, pregnancy (though additional training may be required), bruising, cuts, abrasions, sunburn, undiagnosed pain, and inflammation.

If the client has any condition which is being treated by a medical professional, the therapist should defer to the other practitioner. The therapist can of course proceed with written authorization from the medical practitioner.

Therapists are not doctors and not trained to diagnose. The discovery of contraindicating conditions will most likely come from disclosure by the client. But it is the ethical responsibility of the therapist to ask for the information and then to use it to evaluate whether the therapy will be advantageous for the client. A negative determination may lead the therapist to the ethical obligation to recommend a health care provider in another discipline.