1) Keyword List
Raised Body Temperature
Massage Therapy
Manual Therapy
Adverse Event
Adverse Reaction
Harmful Reactions
Patient Safety
Risk of Harm

2) Prevalence of Condition

Fever (also known as pyrexia, from the Greek pyretos meaning fire, or a febrile response, from the Latin word febris, meaning fever, and archaically known as ague) is a frequent medical symptom that describes an increase in internal body temperature to levels above normal. Fever is most accurately characterized as a temporary elevation in the body's thermoregulatory set-point, usually by about 1–2 °C.
Fever differs from hyperthermia. Hyperthermia is an increase in body temperature over the body's thermoregulatory set-point, due to excessive heat production or insufficient thermoregulation, or both. Carl Wunderlich discovered that fever is not a disease but a symptom of disease.
The elevation in thermoregulatory set-point means that the previous "normal body temperature" is considered hypothermic, and effector mechanisms kick in. The person who is developing the fever has a cold sensation, and an increase in heart rate, muscle tone and shivering attempt to counteract the perceived hypothermia, thereby reaching the new thermoregulatory set-point. A fever is one of the body's mechanisms to try to neutralize the perceived threat inside the body, be it bacteria or a virus.¹

According to one common rule of thumb, fever is generally classified for convenience as:
Fever classification||~ Grade ||~ °C ||~ °F ||
low grade
>107.6 ¹
Fever is a common symptom of many medical conditions:

3) Relevant Literature

¹Wikipedia http://en.wikipedia.org/wiki/Fever

4) When & Why is it dangerous to work on patient with that condition

Potential danger to the therapist could be the historical and logical reason behind fever being listed as a contraindication. If the symptom of fever is present it indicates the possibility of the presence of infectious or communicable disease.

A second reason for the listing of fever as a CI is possibly due to the fact that it would be very unpleasant to receive massage therapy while having a fever.

Awarenesss of the variation in symptoms and possible causes of fever is important to the safety of the patient. Because of the serious nature of some causes of fever there is a need to know when to refer a patient to their physician for diagnosis. While there isn't much information available on the reason for fever being a contraindication, it can be a symptom or complication of disease or infection that should not be treated.

5) Alarming Signs and Symptoms to Watch For - Red Flags

Hyperpyrexia - Is classified as a fever greater than 43 ° C or 107.6 ° F and "...is a med ical emergency because it approaches the upper limit compatible with human life." ¹

6) References to research that supports the reason why this condition is a Contraindication

I have not located any research supporting why Fever should be a Contraindication for Massage Therapy.

7)Optional - Benefits of Massage for this Conditions

I was able to locate one study supporting massage therapy's role in reducing fever. Because there is so little information about his subject I thought it was relevant to post this information here for our future consideration of whether this should be listed as an absolute CI.

"50 patients with high temperature were given back massotherapy. After 30 of the patients with 39.5 to approximately 40 degrees C of the body temperature were given a single back massotherapy about 30 minutes, the temperature fell to normal. 10 patients with 39.0 to approximately 39.5 degrees C twice (20 min/time), the temperature fell one degree for the first time, and it returned to normal for the second time. 6 patients with 38.5 to approximately 39.0 degrees C three times (15 min/time), the temperature to normal. 4 patients with 37.5 degrees 38.5 degrees C, 4 times (10 min/time) to normal. This method is simple and safe."²

²Yi, Z. Effects of back massotherapy on patients with high temperature [Chinese].
County People's Hospital, Si County, Anhui Shanxi Journal of Nursing (SHANXI50 J NURS), 1995 Apr; 9(2): 81