Bodywork & Massage Therapy Precaution/Contraindication: Diabetic Neuropathy

Having high blood glucose for many years can damage blood vessels that bring oxygen to some nerve endings. Damaged nerves may stop, slow, or send messages at the wrong times, especially during a massage appointment. Numbness, pain, and weakness in the hands, arms, feet, and legs may develop over time with diabetic neuropathy. Problems may also occur in various organs too. Diabetic neuropathy is the medical term for damage to the nervous system from diabetes. The most common type is peripheral neuropathy, which affects the arms and legs or upper/lower extremities.

Sometimes nerve damage can deform or misshape feet, causing pressure that can turn into blisters, sores, or ulcers. Poor circulation can make these injuries slow to heal. Sometimes this can lead to amputation of a toe, foot, or leg or any area that cannot heal, usually from a cut of the dermis which can lead to infection. This is one of the reasons why it is so important for massage therapists to maintain good fingernail hygiene.

 It is ill-advised to work on any bodily surface area that the client cannot feel.  Diabetic clients can experience numbness, especially in the distal extremities, due to the common nerve damage that can occur with this life-long disease. Furthermore, a diabetic’s capacity to heal from skin nicks or cuts is poor.  The smallest unhealed cut on a diabetic could result in infection, necrosis (tissue death), amputation, sepsis and/or death.  It is important to use special caution when working with diabetics, and as always, seek approval and/or direction for services from a medical physician regarding medical conditions.

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