Why would full body massage cause these symptoms?
January 17, 2021 10:51 AM Subscribe
My husband gets a full body massage every five weeks. He is a pianist, so there’s some emphasis on his back and shoulders, where he tends to “hunch.”
Upon returning from the massage, he always takes a long nap. That evening and through the night, he’ll be beset with chills such that the whole bed shakes. The chills taper off by late the next morning, but he’s still pretty wiped out the next day.
What might be causing this? I searched the internet; “massage chills”...nothing. Also not touched on, Metafilter-wise. Is this about water-drinking? His first massage therapist stressed drinking LOTS of water upon returning home; this current one doesn’t really mention it.
What might be causing this? I searched the internet; “massage chills”...nothing. Also not touched on, Metafilter-wise. Is this about water-drinking? His first massage therapist stressed drinking LOTS of water upon returning home; this current one doesn’t really mention it.
From a quick google myself it sounds like it could be a variety of things, from the immune system reacting to sore muscles to an excess of myoglobin, to a blood sugar crash from the pain of the deep tissue work.
If he's concerned, I would suggest he talks to his doctor about it and gets his levels tested, in case it's related to poor kidney function which needs to be addressed. In the meantime I would definitely follow the advice to make sure he's really well hydrated after massage, as well as avoiding caffeine/alcohol for at least 24 hours after.
posted by fight or flight at 11:01 AM on January 17, 2021 [7 favorites]
If he's concerned, I would suggest he talks to his doctor about it and gets his levels tested, in case it's related to poor kidney function which needs to be addressed. In the meantime I would definitely follow the advice to make sure he's really well hydrated after massage, as well as avoiding caffeine/alcohol for at least 24 hours after.
posted by fight or flight at 11:01 AM on January 17, 2021 [7 favorites]
Response by poster: HotToddy, I don’t remember him mentioning it back then.
posted by BostonTerrier at 11:06 AM on January 17, 2021
posted by BostonTerrier at 11:06 AM on January 17, 2021
If you can, I'd check his blood pressure and take his actual temperature the next time he's experiencing this.
posted by snuffleupagus at 11:19 AM on January 17, 2021 [2 favorites]
posted by snuffleupagus at 11:19 AM on January 17, 2021 [2 favorites]
This is just from searching, not any medical knowledge, but I found a comment referencing "full-body kinetic tremors that feel like I’m constantly shivering" from someone under a short piece linking deep tissue massage and nerve damage.
The comment is from 'Chris' on November 7, 2018, 12:21 am.
posted by knapah at 11:34 AM on January 17, 2021
The comment is from 'Chris' on November 7, 2018, 12:21 am.
posted by knapah at 11:34 AM on January 17, 2021
This happens to me after about 50% of the massages I get, and my therapists have always told me it is 'toxins getting flushed out of the body.'
FWIW I've always felt like it was good not bad. Like, during the massage I would feel 'good pain,' as trigger points released and muscles stretched and lengthened and tense areas started to relax. And the flu-like symptoms afterwards felt like a second stage of that healthy process. Basically good pain not bad pain.
So IDK. By all means your husband should probably drink water, avoid alcohol, check with his doctor, etc. But I don't think what he's experiencing is necessarily an indicator of anything being wrong. Or rather, I'm saying it could be an indicator that something was wrong, and is in the process of getting fixed.
posted by Susan PG at 11:39 AM on January 17, 2021 [6 favorites]
FWIW I've always felt like it was good not bad. Like, during the massage I would feel 'good pain,' as trigger points released and muscles stretched and lengthened and tense areas started to relax. And the flu-like symptoms afterwards felt like a second stage of that healthy process. Basically good pain not bad pain.
So IDK. By all means your husband should probably drink water, avoid alcohol, check with his doctor, etc. But I don't think what he's experiencing is necessarily an indicator of anything being wrong. Or rather, I'm saying it could be an indicator that something was wrong, and is in the process of getting fixed.
posted by Susan PG at 11:39 AM on January 17, 2021 [6 favorites]
I experienced this once and according to research I did at the time it was a side effect of too many toxins being released at once in the lymphatic system. What I read made it sound like this isn't actually a good thing because we are not likely to be able to flush them entirely with fluids, and it usually means the massage is too intense.
posted by crunchy potato at 12:41 PM on January 17, 2021 [3 favorites]
posted by crunchy potato at 12:41 PM on January 17, 2021 [3 favorites]
I have no ability to evaluate the science here, but fwiw this potentially alarmist post ties it to rhabdomyolysis and says it's because the massage itself is causing damage to muscle tissue.
I also get a post-massage flu-like feeling sometimes, but never with the kind of dramatic chills you describe. It sounds worth asking a doctor or two about, and looking for alternative ways to treat his hunch.
posted by trig at 1:28 PM on January 17, 2021 [2 favorites]
I also get a post-massage flu-like feeling sometimes, but never with the kind of dramatic chills you describe. It sounds worth asking a doctor or two about, and looking for alternative ways to treat his hunch.
posted by trig at 1:28 PM on January 17, 2021 [2 favorites]
Best answer: I'm not sure that toxins can be flushed from lymph nodes that way that various people claim. The lymph fluids in general are processed in a much more slow manner than the blood, for instance, and they can't be "flushed" or rushed through the body's drainage systems due to the anatomical structure of lymph nodes as well as the body's need to maintain homeostasis with interstitial fluids between cells, blood stream, and lymph system. Anything that claims to "flush toxins" is probably BS.
We don't know enough about your husband's medical history or body to make any kind of legitimate, valuable claim about whatever he is experiencing, however, so he really needs to see a doctor because this sounds abnormal, and if he is experiencing enough self-reported discomfort about this then it seems worthwhile to ask an actual professional about, not a bunch of internet randos.
posted by erattacorrige at 2:05 PM on January 17, 2021 [26 favorites]
We don't know enough about your husband's medical history or body to make any kind of legitimate, valuable claim about whatever he is experiencing, however, so he really needs to see a doctor because this sounds abnormal, and if he is experiencing enough self-reported discomfort about this then it seems worthwhile to ask an actual professional about, not a bunch of internet randos.
posted by erattacorrige at 2:05 PM on January 17, 2021 [26 favorites]
I have had migraine auras and occasionally migraines after massage/sauna. I always assumed it was dehydration. But it might be worth checking out with a doctor, as chills are one form of migraine aura.
posted by Morpeth at 2:14 PM on January 17, 2021 [1 favorite]
posted by Morpeth at 2:14 PM on January 17, 2021 [1 favorite]
I haven't had this happen with massage, but recently had an instance of random muscle tremors and spasms like this after a muscle-relaxant event from a different cause (edibles), and spoke with someone (my friend who uses medical marijuana) about that. They said that dehydration indeed could be partly to blame for that, plus a slightly more intense dose of what I was using than I was used to, making my muscles super-relaxed. So I think there's something to the dehydration theory. Also, while I didn't have this same kind of after-effect, I've also had some super-intense massage in the past, and the therapist told me to make sure I drank a lot of water when I got home; maybe it was to stave this kind of thing off. But this also seems to suggest dehydration has something to do with this.
Still worth checking with a doctor about, but I think there's certainly some evidence for slight dehydration at least contributing to things. And if not - water's good for you anyway, so drinking an extra glass can't hurt regardless.
posted by EmpressCallipygos at 3:31 PM on January 17, 2021
Still worth checking with a doctor about, but I think there's certainly some evidence for slight dehydration at least contributing to things. And if not - water's good for you anyway, so drinking an extra glass can't hurt regardless.
posted by EmpressCallipygos at 3:31 PM on January 17, 2021
Sounds like inflammation, which can cause flu-like symptoms and could temporarily increase after a massage. Has he ever tried Advil or another NSAID?
posted by en forme de poire at 3:45 PM on January 17, 2021 [1 favorite]
posted by en forme de poire at 3:45 PM on January 17, 2021 [1 favorite]
Best answer: He should definitely speak with a doctor. Also if he’s doing anything extreme — drinking a huge amount of water or whatever — he should chill on that.
But it is not “toxins” being “released” from the body which is basically California speak for medieval humors. He may be having weird chemical reactions to having his muscles and fascia mashed for sure.
Also: if he’s doing serious massage and then flooding is body with water, he might be having weird potassium or magnesium or sodium shortfalls. Try a banana or a kiwi and keep some magnesium citrate around the house (warning: will poop) and even maybe try a pinch of salt.
posted by RJ Reynolds at 5:35 PM on January 17, 2021 [13 favorites]
But it is not “toxins” being “released” from the body which is basically California speak for medieval humors. He may be having weird chemical reactions to having his muscles and fascia mashed for sure.
Also: if he’s doing serious massage and then flooding is body with water, he might be having weird potassium or magnesium or sodium shortfalls. Try a banana or a kiwi and keep some magnesium citrate around the house (warning: will poop) and even maybe try a pinch of salt.
posted by RJ Reynolds at 5:35 PM on January 17, 2021 [13 favorites]
What en forme de poire said. This is almost certainly something cytokiney going on, responding the way it would to tissue injury or intense, prolonged exercise.
posted by Kid Charlemagne at 5:40 PM on January 17, 2021 [1 favorite]
posted by Kid Charlemagne at 5:40 PM on January 17, 2021 [1 favorite]
I've felt shivery and shaky after intense massages, but after having some water or gatorade and a snack, it passes. Having such intense chills seems concerning. I would check in with a doctor just to make sure the massages aren't making anything worse.
posted by yasaman at 6:12 PM on January 17, 2021 [1 favorite]
posted by yasaman at 6:12 PM on January 17, 2021 [1 favorite]
When you say “chills”... is he describing a sensation of being cold, does he seem cold to the touch, or is he just “shivering” ?
posted by pt68 at 11:26 PM on January 17, 2021
posted by pt68 at 11:26 PM on January 17, 2021
Yeah, echoing above commenter - maybe he is experiencing feelings in his body?
posted by acridrabbit at 12:09 AM on January 18, 2021
posted by acridrabbit at 12:09 AM on January 18, 2021
Best answer: Former massage therapist here.
What did the therapist say when you reported this reaction? If you haven't let them know yet, you should.
Your husband having such bad chills is an extreme reaction that warrants at the very least a temporary pause in getting massages, while he checks in with a doc. More likely, a change of massage therapist is indicated. There is an, ahem, toxic subset of therapists who are not skilled enough to do good deep tissue or trigger point work, and excuse the damage they do with hand-waving and woo about the body "releasing toxins".
If you ask the therapist exactly what toxin or toxins the body is releasing, they will usually have no answer. The only specific answer I've ever heard was "lactic acid" and that is simply untrue. Studies have shown that massage very slightly slows lactic acid removal. And lactic acid isn't a "toxin" anyway, it's a normal bodily chemical.
My suspicion is that the therapist is using too much pressure, and/or incorrect technique, and/or isn't in tune with their clients' reaction to the work. They may be doing more harm than good. I've heard the theory of rhabdomyolsis causing reactions like this before, but the damage has to be really severe for it to be that. That's the type of reaction typically caused by car accidents! The massage would almost certainly be very painful if this is what was happening.
Deep tissue work should nearly never cause "bad pain". If the therapist wants to do something challenging, they should warn the client first, they should be able to explain what they are trying to accomplish with that specific work, they should keep it brief and book-end it with less challenging work, and they should check in with the client during and after to gauge their reaction. But again, nearly never should massage cause bad pain. Bad pain causes muscle guarding and is almost always counterproductive to the goals of a massage. Skilled trigger point work elicits the feeling of "good pain" and a sense of relief. Is he getting relief from these massages?
Another thing that stuck out in the question, although it's less important, is that a good therapist would be doing quite a bit of work on his anterior as well. Only working on the back and shoulders of a client who hunches is very amateur and unhelpful. If the therapist isn't working on the pecs and the neck, as well as giving him stretches and postural advice, that alone is reason to consider a new therapist.
posted by Flock of Cynthiabirds at 4:15 AM on January 18, 2021 [13 favorites]
What did the therapist say when you reported this reaction? If you haven't let them know yet, you should.
Your husband having such bad chills is an extreme reaction that warrants at the very least a temporary pause in getting massages, while he checks in with a doc. More likely, a change of massage therapist is indicated. There is an, ahem, toxic subset of therapists who are not skilled enough to do good deep tissue or trigger point work, and excuse the damage they do with hand-waving and woo about the body "releasing toxins".
If you ask the therapist exactly what toxin or toxins the body is releasing, they will usually have no answer. The only specific answer I've ever heard was "lactic acid" and that is simply untrue. Studies have shown that massage very slightly slows lactic acid removal. And lactic acid isn't a "toxin" anyway, it's a normal bodily chemical.
My suspicion is that the therapist is using too much pressure, and/or incorrect technique, and/or isn't in tune with their clients' reaction to the work. They may be doing more harm than good. I've heard the theory of rhabdomyolsis causing reactions like this before, but the damage has to be really severe for it to be that. That's the type of reaction typically caused by car accidents! The massage would almost certainly be very painful if this is what was happening.
Deep tissue work should nearly never cause "bad pain". If the therapist wants to do something challenging, they should warn the client first, they should be able to explain what they are trying to accomplish with that specific work, they should keep it brief and book-end it with less challenging work, and they should check in with the client during and after to gauge their reaction. But again, nearly never should massage cause bad pain. Bad pain causes muscle guarding and is almost always counterproductive to the goals of a massage. Skilled trigger point work elicits the feeling of "good pain" and a sense of relief. Is he getting relief from these massages?
Another thing that stuck out in the question, although it's less important, is that a good therapist would be doing quite a bit of work on his anterior as well. Only working on the back and shoulders of a client who hunches is very amateur and unhelpful. If the therapist isn't working on the pecs and the neck, as well as giving him stretches and postural advice, that alone is reason to consider a new therapist.
posted by Flock of Cynthiabirds at 4:15 AM on January 18, 2021 [13 favorites]
Response by poster: A few points of clarification:
The therapist doesn’t only work on his back and shoulders. It is a full body
massage, including anterior.
The therapist has never once uttered the word “toxins.” Mr. Terrier was on the red-alert for woo-speak when he was interviewing therapists. This guy has been in the business many years and is highly regarded by friends of ours.
Mr. Terrier has never experienced pain, just the expected sensation of muscle wiped-out ness. He’s had his bloodwork done, due to a very recent yearly wellness checkup. It revealed nothing out of the ordinary.
He will indeed check with his doctor, and tell his massage therapist about this on the next visit. In the meantime, Mr. Terrier will halt caffeine intake before and after his massages, and increase his water intake, which he admits is not enough, even on ordinary days.
Thanks to all responders for your care and concern!
posted by BostonTerrier at 7:30 AM on January 18, 2021 [2 favorites]
The therapist doesn’t only work on his back and shoulders. It is a full body
massage, including anterior.
The therapist has never once uttered the word “toxins.” Mr. Terrier was on the red-alert for woo-speak when he was interviewing therapists. This guy has been in the business many years and is highly regarded by friends of ours.
Mr. Terrier has never experienced pain, just the expected sensation of muscle wiped-out ness. He’s had his bloodwork done, due to a very recent yearly wellness checkup. It revealed nothing out of the ordinary.
He will indeed check with his doctor, and tell his massage therapist about this on the next visit. In the meantime, Mr. Terrier will halt caffeine intake before and after his massages, and increase his water intake, which he admits is not enough, even on ordinary days.
Thanks to all responders for your care and concern!
posted by BostonTerrier at 7:30 AM on January 18, 2021 [2 favorites]
Thanks for the update, BostonTerrier.
My own point of clarification: many therapists don't work on certain areas unless they are specifically requested to, even in a session referred to as a full body massage. Partially this is due to time constraints and partially it is due to poor training or in some cases squeamishness about certain areas of the body. Pecs and anterior neck are left out of most massages in the US (especially but not limited to relaxation massages) and glutes are left out surprisingly often, even when client has back pain and dysfunction.
posted by Flock of Cynthiabirds at 8:20 AM on January 18, 2021
My own point of clarification: many therapists don't work on certain areas unless they are specifically requested to, even in a session referred to as a full body massage. Partially this is due to time constraints and partially it is due to poor training or in some cases squeamishness about certain areas of the body. Pecs and anterior neck are left out of most massages in the US (especially but not limited to relaxation massages) and glutes are left out surprisingly often, even when client has back pain and dysfunction.
posted by Flock of Cynthiabirds at 8:20 AM on January 18, 2021
as soon as the massage is over, drink like three tall glasses of water. stay hydrated that whole night.
should help with symptoms.
posted by evilmonk at 12:49 PM on January 18, 2021
should help with symptoms.
posted by evilmonk at 12:49 PM on January 18, 2021
Another former LMT here, we were instructed at massage school to tell clients to drink water after a session, but if I were still working I would recommend an electrolyte drink and staying warm. The client should always be kept extra warm during a session and should make sure to keep an extra blanket at bedtime or take a warm shower.
I’ve also had post-massage aches and pains and weird general malaise and it always resolved on normal activity. Worst reaction was after getting deep work in my anterior neck and pectorals; the next day I was on a normal bike ride and an hour from home I felt like my tank had just hit E—what’s referred to as “bonking” in the cycling world. I got home, rested, ate, hydrated, and was fine the following day.
So what your husband seems to be experiencing is within the range of normal, but he should definitely ask his therapist to keep him warm during the session and possibly back off on pressure and intensity the next time.
posted by computech_apolloniajames at 1:51 PM on January 18, 2021 [3 favorites]
I’ve also had post-massage aches and pains and weird general malaise and it always resolved on normal activity. Worst reaction was after getting deep work in my anterior neck and pectorals; the next day I was on a normal bike ride and an hour from home I felt like my tank had just hit E—what’s referred to as “bonking” in the cycling world. I got home, rested, ate, hydrated, and was fine the following day.
So what your husband seems to be experiencing is within the range of normal, but he should definitely ask his therapist to keep him warm during the session and possibly back off on pressure and intensity the next time.
posted by computech_apolloniajames at 1:51 PM on January 18, 2021 [3 favorites]
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posted by HotToddy at 10:57 AM on January 17, 2021