Hot Stone Massage Case Study

Published on 27 July, 2015 | Holistic Therapy

 Hot stone massage case study


In preparation for this treatment of Hot Stone Massage I made sure I had a clean uniform, nails are short, jewellery removed and my hair is tied. As a Reiki Master I also use my protection symbols on myself and around the room to protect myself from the possibility of receiver’s mood, negativity or feelings of stress.

I previously sanitized the stones in water heated between 130-145 degrees Fahrenheit to kill bacteria after a previous client.  I then took the extra step of individually spraying the stones with the disinfectant PureGreen24 as recommended within the student Library material. I understand that this is used for cancer patients who have low immune systems; however, this extra step I feel will benefit all clients as it’s a natural product that kills almost all germs so each client will be assured the stones are sterilised to the highest standards. I then place them into the heater for 30minutes along with a thermometer to ensure the heat is consistent at 120-135 degrees Fahrenheit, ensuring heat of 125 degrees for client’s skin only due to risk of burning. If the client states she has sensitive skin or taking age into consideration for thickness of their skin I will lower the temperature to accommodate this. To aid relaxation I will add essential oils to the water after I have spoken to the client to make sure she has no allergies. Next I prepare the towels, massage oil, sarong, washing up bowl, cleansing agents for hands and large plastic spoon on a high table next to the heater within easy access before I begin the massage. I ensure the therapy room is warm, softly lit and low relaxing music is playing in the background.



Beginning the initial consultation I sat with Client who told me she was 29 and a stay at home mother who for the last week had been re decorating her house. The redecorating had left her feeling stiff and sore in her back and arm muscles so she had decided to have a hot stone massage to pamper herself after all her hard work. I began filling out the treatment card communicating the questions clearly and precisely making sure that each question was understood. I asked Client if she had any medical conditions or if she was taking medication at the present time and she stated she has no medical issues, takes no medication and is not seeing her doctor at this time for any physical or emotional issues. She is not pregnant nor is she trying to become pregnant and does not suffer epilepsy.

We further discussed if she had any known allergies to any essential oils or if she had any special skin conditions and again she replied no. I further asked if she considered her levels of stress to be high or low on a ratio of 1-4 and she estimated it at 1. I then explained my duty of care in full detail and repeated the questions as good practice is paramount throughout the consultation process.  I then asked Client to sign the declaration form that states she has answered all the questions correctly and has not withheld any information from me that is relevant to her treatment.


I explained to Client I had decided to use a blend of Sweet Almond Oil (10ml), Marjoram 1 drop and Grapefruit Oil 1 drop for her massage. I used Marjoram as it is beneficial for muscular/rheumatic pains, sprains and stiffness and is particularly good when used in massage application. I am aware though that marjoram oil has a more masculine odour and why I chose the charming smell of grapefruit oil to blend with it. Grapefruit oil is beneficial for reducing aches and stiffness and stimulates the Lymphatic system that works with the circulatory system to deliver nutrients, oxygen and hormones from the blood to the cells that make up the tissues of the body (course material, Part 1).  Client smelt the oils and indicated she liked the smell. I further explained that sometimes people with sensitive areas of the skin may feel irritation from Grapefruit oil however she was happy to proceed with the chosen oils.

I went on to explain the movements I would be using during the massage to ease the soreness and stiffness in her erector spinae muscle, trapezius, deltoid and Latissimus Dorsi as a few examples so she felt at ease beforehand and was comfortable with beginning the therapy session. I asked Client to undress but leave on her underwear and lie face down on her face over the face hole and used a larger towel to cover her below the waist. I asked if she felt comfortable and warm which she stated she did and then proceeded to wash my hands before I began the treatment. I checked the temperature of the stones which were at 120 degrees Fahrenheit.

Back Massage

I applied the blended oil using the effleurage movements x3 from the base of the back to the top of the back. I placed the large flat sacrum stone wrapped in a towel on the lower back area to maintain a gentle relaxing heat to this area. I continued the back sequence using two larger stones that I held in my hand a moment before placing them on a towel at the side of client out of reach of risk of burning and again did the effleurage movement x3 this time letting Client feel the warmth on my hands before using the stone on her back area.

I then started working with the stones in each hand at the top of the back  as the lower area is more sensitive ( library material) and continued using  good firm pressure effleurage movements x 6, gliding up and down all over the back area to locate knotty tense areas, flipping the stones as they lost heat and ensuring continued movement. Moving to the base of her back in a slow rhythm using circular stretching and Palmer kneading movements, thus enabling the heat to penetrate the superficial tissues and absorb into the muscle, again asking her if the pressure is adequate. Using firm effleurage movements with the trigger stones for deep tissue I worked up either side of the spine, careful not to touch the spine itself and not to be too invasive letting the stones do the work,  I moved over the scapula and returned to the bottom of the back. Moving on I used the edge of the stones in slow circular movements to remove any tightness working up to the neck and shoulders in a sliding movement. Working the edge of the sacrum I then proceed to knead and stretch the muscles above the Gluteus. I then place the trigger stones at the bottom of the spine to facilitate deep heat penetration relaxing the muscles and bringing out tightness and discomfort.

Again leaving the new stones either side of the client making sure of safety I use the warmth of my hands to introduce heat and effleurage the scapula area x3. Continuing with the stones I work them in firm circular motions using the edge, moving back and forth to remove tightness in rhomboids, trapezium and scapula areas maintaining an even pressure and movement throughout the process and again asking Client if the pressure was acceptable. I then raise her arm and using a sliding back and forth motion around the scapula to ease any tension and knots. Proceeding to the other side of the scapula I repeat the process. Keeping to the side of the stone I then massaged using firm circular movements down the neck area across the trapezium muscle ironing out any tension then back up to the occipital ridge x3 before finishing the back massage with gliding up and down, stroking and stretching effleurage movements to all the back area.

Starting with even pressure effleurage movements x3 introducing heat across the chest area I worked across to the arms concentrating on the deltoid, triceps and back up to the trapezium finishing at the occipital ridge, repeated opposite side. Using smaller neck stones to release tension from the neck and shoulder area. I use soft Petrissage movements x3 with sides of the stones repeating the process on opposite side. I asked Client to move her head to the side and used small circular movements maintaining firm pressure to work the trapezius from the base of the neck and finishing at the shoulder before repeating on the other side. For an added experience for Client I massaged the heat of the stones over the tops of her arms working in circular movements down to her elbows then back up to shoulders before placing stones on her shoulder blades to aid more relaxation. I then covered her with a warm towel and moving on to the backs of her legs. I asked at this point if she felt comfortable and warm enough to ensure she was having a pleasant experience as I intended.

Back of legs

Working on the left side first I did effleurage x3 with the essential oil blend to introduce residual heat to the leg. Using stones I glided up and down the top of her leg as an extension to my hands with deep circular movements. Moving softly down the leg crossing my hands over just below the knee I glide down to the ankle area then begin gentle Petrissage movements, flipping the stones for an even temperature and repeat this process x 3. Deep and slow wringing effleurage movements were used down her leg draining the back of the knee whilst moving on to hamstring area. Wringing movements were used here to work deeply into the muscles easing the stiffness. Using one hand firstly I then use slow deep circular motions using the sides of the stones, moving back and forth over the calf muscles releasing tightness and stiffness. Returning to effleurage movements I massage the whole leg and cover with a warm towel before starting the opposite leg.

After both legs were complete I  asked her to turn over but remain sitting up whilst I placed the thinner equal sized stones in a spinal layout pattern before covering with a pillowcase and asking Client to gently lie back down. I asked Client if she felt comfortable and was happy to proceed to the fronts of her legs and she stated she felt lovely and comfortable.  Placing the sacral stone wrapped in a towel on the bottom of the stomach to penetrate the heat into stomach muscles which I am aware is good for IBS or stomach cramps I then cover her top half with a warm towel before starting the front of the legs. √


I uncover her leg and effleurage using quick firm pressure x3 with blended oils to the whole leg transferring heat from my hands so Client gets used to the sensation and warmth before beginning with larger stones. Using the larger stones on the whole leg transferring heat and pressure equally I cross hands at the ankle area and glide up each side of the leg before uncrossing hands just above the knee area and continue to glide to the tops of the legs then softly moving back down the leg re crossing hands across the patella and returning to ankle position gliding down firmly either side of the fibula and tibia x3. Gliding up to the thigh area I used deep kneading movements and alternate wringing movements either side of the thigh applying firm pressure to work the muscles deeply, flipping the stones to keep even temperature throughout.

Effleurage x2 to whole leg again to increase blood flow and circulation before using smaller stones for the lower leg in deep circular movements working up to draining pressure points of the patella, I began using even pressure Petrissage movements using the side of the stones either side of the patella before leaving a placement stone behind the patella to continue deep heat penetration whilst I covered the leg and repeated process on opposite leg.  For additional pleasure I warm the foot with soft effleurage hand movements, working up and down the metacarpals with edges of the stones. Continuing with gentle circular movements to sole of the foot before stroking and gliding the stone from the heel to place the toes stones x4 between the toes for ten minutes. √


Uncovering the arm I begin applying the blended oils using soft stroking effleurage x3 taking residual heat to full arm. Using smaller stones which are adequate for the smaller muscles of the lower arm I work between the radius and ulna in gentle circular movements gliding up whilst gently kneading the front and back x3. Supporting the hand and elbow I begin gentle kneading with side of the stone to the upper arm to boost circulation and encourage lymphatic drainage before lowering the arm. Using larger stones to manipulate in an even sliding up and down pressure around the shoulders I ease any tension and nodules in this area. Leaving a cooler stone in the palm of the hand after gently effleuraging the hand to transfer  heat I place small stones in between her fingers to penetrate heat. I cover her hand and proceed to repeat on opposite arm.

Ending the session

After completing the opposite arm I lightly placed my hand on her shoulder indicating the massage was complete. I gave Client time to rest and asked her to remain lying down in case of dizziness whilst I went to get her a glass of water. As I returned I removed all the stones and assisted Client to sit up to take the glass of water before she began to dress.


We discussed aftercare and I explained the importance of drinking plenty of water to aid elimination of toxins via urine. I discussed the intake of caffeine and asked her to avoid for 24hours and to also avoid strenuous exercise again for 24hours. I continued the aftercare process by explaining the essential oils would still be working even though the massage is complete and to refrain from bathing or showering if possible until the next morning, however if irritation occurs especially with using Grapefruit oil it is advisable she showers or bathes immediately removing the oils from her skin to decrease irritation. I explain the possibility of a healing crisis and what it means and tell her that she can contact me on my mobile number if she has any concerns. I also hand her a copy of the aftercare procedure to remind her of the necessary steps to take after treatment.


Client stated after aftercare that she felt so relaxed and her stiffness and tightness had reduced massively. She continued to say she can feel more free movement around her back and arm area. She will fill out a feedback card for me whilst at home and return it as she passes in the next few days. As she left she said she would be arranging another therapy session as she has never felt so relaxed and enjoyed the treatment fully.



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