Adverse Events of Massage Therapy in Pain-Related Conditions: A Systematic Review

Table 1

Cases of AEs associated with massage therapy.

Author (year)	Country	Language	Age, sex	Details of manual therapy	Clinician type	Adverse event (nature and location)	Follow-up
Jay et al. (2003) [17]	USA	English	26, F	Chiropractic manipulations	Chiropractor	Bilateral dissection of vertebral arteries followed by bilateral occipital-parietal hemorrhagic infarction and visual impairment	Complete resolution (20 d.)
Beck et al. (2003) [18]	Germany	English	40, F	Axial tension and rotation	Chiropractor	Intracranial hypotension	Complete resolution confirmed by MRI
Nadgir et al. (2003) [19]	USA	English	34, M	Neck manipulation	Chiropractor	Neck cramping (bilateral internal carotid and vertebral artery dissection)	Minimal residual hemianesthesia and dysesthesia
Oehler et al. (2003) [20]	Germany	German	31, F	Chiropractic neck manipulation	Unknown	Bilateral dissections of vertebral arteries	Resolution
Yokota et al. (2003) [21]	Japan	Japanese	38, M	Chiropractic neck manipulation	Unregistered practitioner	Dissection of left vertebral artery followed by Dejerine syndrome	Unknown
Licht et al. (2003) [22]	Denmark	English	39, M	Cervical manipulation	General practitioner	Large infarction in the left cerebellar hemisphere (presumably due to arterial dissection)	Complete recovery (3 mo.)
Xiong (2003) [23]	China	Chinese	39, M	Reduction manipulation	Not mentioned	Cerebral infarction	Irritating cough and limb numbness (2 y.)
Ma and Xu (2003) [24]	China	Chinese	50, F	Rotation	Not mentioned	Peripheral nerve entrapment syndrome	Recovered
Yu et al. (2003) [25]	China	Chinese	42, M	Manipulative reduction	Not mentioned	Spinal cord injury	Recovered (6 mo.)
Yu et al. (2003) [25]	China	Chinese	22, M	Manipulative reduction	Not mentioned	Spinal cord injury	Symptom remission (15 d.)
Zhang et al. (2003) [26]	China	Chinese	35, M	Rotation	Not mentioned	Extrusion of lumbar intervertebral discs (lower limb pain, incontinence, and saddle sensation disorders)	Pain relief after surgery, but residual saddle area numbness
Zhang et al. (2003) [26]	China	Chinese	48, M	Rotation	Not mentioned	Extrusion of lumbar intervertebral discs (lower limb pain, walking and sexual dysfunction)	Muscle recovery after surgery, but still sexual dysfunction (1 y.)
Izquierdo-Casas et al. (2004) [27]	Spain	Spanish	37, F	Chiropractic	Not mentioned	Dissection of vertebral artery followed by tetraparesis	Locked-in syndrome
Morandi et al. (2004) [28]	France	English	49, F	Lumbar vertebral manipulation	Physician	Caudal spinal cord ischemia	Permanent neuroloss
Saxler and Barden (2004) [29]	Germany	German	27, F	Cervical chiropractic manipulation (C5/6), facet joint infiltration	Not mentioned	Epidural hematoma extending from cervical to sacral spine	Complete resolution
Tomé et al. (2004) [30]	Spain	Spanish	Not noted	Chiropractic manipulation	Not mentioned	Multiple cervical disc herniation	Not mentioned
Hansis et al. (2004) [31]	Germany	German	45, M	Chiropractic manipulation	Unknown	L4 fracture osteoporosis	Surgery
Hansis et al. (2004) [31]	Germany	German	38, M	Unknown	Unknown	Disk protrusion	Surgery
Wang et al. (2004) [32]	Australia	English	82, F	Lumbosacral manipulation	Unknown	Extradural hemorrhagic synovial cyst, leg pain	Complete recovery after L3–L5 laminectomy and cyst removal
Wang et al. (2004) [32]	Australia	English	76, F	Lumbosacral manipulation	Unknown	Hemorrhagic synovial cyst with resultant lumbar canal stenosis and exacerbation of severe pain in buttock and left leg pain	L4-L5 laminectomy and cyst removal with excellent outcome
L. Zhang and G. H. Zhang (2004) [33]	China	Chinese	15, F	Rotation	Not mentioned	Atlantoaxial dislocation	Recovered after surgery (2 wk.)
Chen et al. (2005) [34]	Taiwan	English	72, M	Chiropractic and massage therapy	Not mentioned	Neck pain, relieved by chiropractor, hematoma of ligamentum flavum at the level of C3-C4 with hemiparesis	Complete recovery after laminectomy (1 y.)
Suh et al. (2005) [35]	Korea	English	37, F	Axial tension and rotation	Chiropractor	Intracranial hypotension	Complete resolution after epidural blood patch
Schmitz et al. (2005) [36]	Germany	English	37, F	Cervical manipulation	General medical practitioner	Displaced odontoid fracture in the presence of an aneurismal bone cyst	Complete recovery after surgery
Chen et al. (2005) [37]	China	Chinese	48, F	Rotation	Self-treatment by her husband	Cervical myelopathy (neck pain, dizziness, and numbness of limbs)	Recovered (28 d.)
Jing and Yang (2006) [38]	China	Chinese	41, M	Rotation	Not mentioned	Fracture and bulge of intervertebral discs	Nearly full recovery after surgery
Solheim et al. (2007) [39]	Norway	English	77, M	Lumbar manipulation therapy	Chiropractor	Partial cauda equina syndrome due to spinal epidural hematoma in the L3 region	Surgical evacuation of hematoma via L3 and L4 laminectomies, improvement with motor deficits, but the bladder dysfunction remained
Guo et al. (2007) [40]	China	Chinese	78, F	Lumbar manipulation therapy	Not mentioned	Rib fracture (the seventh rib)	Not mentioned
Guo et al. (2007) [40]	China	Chinese	60, M	Cervical manipulation	Not mentioned	Lacerations of soft tissues	Recovered (1 mo.)
Guo et al. (2007) [40]	China	Chinese	48, M	Lumbar manipulation therapy	Not mentioned	Fracture (L3 transverse process fractures)	Not mentioned
Guo et al. (2007) [40]	China	Chinese	67, F	Lumbar manipulation therapy	Not mentioned	Fracture (L2 transverse process fractures)	Not mentioned
Guo et al. (2007) [40]	China	Chinese	49, F	Cervical manipulation	Not mentioned	Syncope	Not mentioned
Guo et al. (2007) [40]	China	Chinese	53, M	Rotation	Not mentioned	Fracture (proximal humeral fracture)	Not mentioned
Yi et al. (2008) [41]	China	Chinese	45, F	Cervical manipulation	Not mentioned	Hypochondriacal neurosis	Not mentioned
Yi et al. (2008) [41]	China	Chinese	54, F	Cervical spine manipulative reduction	Not mentioned	Hypochondriacal neurosis	Recovered
Jiang (2008) [42]	China	Chinese	28, M	Rotation	Massage therapist (private clinics)	Brown-Sequard syndrome due to spinal epidural hematoma	Near full recovery after surgery (3 wk.)
Huang et al. (2010) [43]	Taiwan	English	51, M	Manipulation directed at the lumbopelvic-thigh region and massage	Physiotherapist	Rupture of soft tissue tumor at anterior proximal thigh	Surgical tumor resection, and neither recurrence nor metastasis was observed 48 months after surgery
Zhu (2010) [44]	China	Chinese	35, F	Joint mobilization	Not mentioned	Hemarthrosis of knee joint	Improved the joint activity (4 mo.)
Jin et al. (2010) [45]	China	Chinese	46, not noted	Rotation	Massage therapist	Dead	Dead
Tamburrelli et al. (2011) [46]	Italy	English	42, M	Spinal manipulation	Doctor of chiropractic	Cauda equina syndrome, L5-S1 extrusion	L5 laminotomy and L5-S1 discectomy,; improved, but with persistent bowel dysfunction, impotence, lower extremity; pain, paresthesias, and mild sensory deficit
Bi (2011) [47]	China	Chinese	59, M	Cervical manipulation	Not mentioned	Dorsolateral medullary syndrome	Improved (14 d.)
Zhang et al. (2011) [48]	China	Chinese	29, F	Rotation	Massage doctor	Atlantoaxial dislocation	Near full recovery after surgery (3 mo.)
Li et al. (2012) [49]	China	Chinese	37, F	Neck massage	Not mentioned	Vertebral arterial dissecting aneurysm	Horner syndrome disappeared and without dysphagia (3 mo.)