there is the possibility that a person

only use very gentle massage techniques on Kathleen Drugs are prescribed to alter the physiology of the body when something has gone wrong. Since massage can also alter the physiology of the body, there is the possibility that a person on prescribed drugs may respond in an unpredictable way. For example, a client who is using ibuprofen, a common analgesic for muscular pain, on a sore calf muscle may experience pain and bruising after some deep work on the muscle, because ibuprofen reduces the clotting ability of the blood. Another factor to consider is that the side effects of some medication mimic common ailments. Some anti-depressants cause aching in the muscles and joints. If your client on anti-depressants isn't getting any physical benefit from

, this may be the reason. So it's important to take not just a full medical history, but also to ask a new client for names of prescribed drugs. And if she doesn't remember, ask her to check the labels on the medication and write it down for you. It's also important to know how a drug is administered. If medication is taken orally, or as drops into the eyes or ears, a massage won't interfere, but if it's a cream or ointment applied onto the skin, that area should be considered a local contraindication as should sites of injected drugs. The best site for reliable information about medication belongs to the British National Formulary. This information is complied by the British Medical Association and the Royal Pharmaceutical Society. All prescribed drugs are listed, the conditions for which they are recommended, how they work and possible side effects. Much of the information, being aimed at medical professionals, is too detailed to be of use, but at least you can find out what a named drug has been prescribed for, and whether there are any things to watch out for, as a massage practitioner. For example, Alice had rheumatoid arthritis and told me she was taking sulfasalazine and methotrexate. Checking with the BNF informed me that both these affect the immune response and suppress the disease process. From the long list of possible side effects, I note that rashes, bruising and anaemia,ewrertie and peripheral neuropathy are possible so I know to look out for these and watch the pressure I use. Here's another example where knowing about drug side effects was useful. Kathleen has enjoyed a massage every two weeks or so for the last twenty years, and claims that's what's kept her going so well. Her health has been pretty good most of her life. In the last few years she's had a couple of small TIA's (transient ischaemic attacks) and as a result, she now takes warfarin, an anti-clotting medication, which 'thins the blood'. Kathleen now bruises very easily; even carrying heavy shopping can result in bruised fingers. So I only use very gentle massage techniques on Kathleen.