Soreness for a day or two, tiredness and a light head on standing are normal after a massage; a bruise means the pressure was too much, and pain past three days is not normal. What four massage books say, with page numbers, and how to ask for pressure that doesn't leave you sore.
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Most questions guests ask us come before a massage. This page is about the ones that come the morning after: why am I sore, why do I have a headache, is this bruise normal, why did I feel faint when I stood up? The answers come from four books on our shelf, led by Ruth Werner's A Massage Therapist's Guide to Pathology (5th edition) and Clair and Amber Davies's The Trigger Point Therapy Workbook (3rd edition), with page numbers. We are Nghê Prana, a riverside hotel and spa on the Thu Bồn in Hội An. The short version: a little soreness is common and should be gone within two or three days, and most of it is avoidable if you say "less" when the pressure is too much.
| After a massage you feel… | Normal? | What the books say | Source |
|---|---|---|---|
| Sore muscles for a day or two | Common after firm work | Overtreatment "could leave them sore"; overdoing it makes pain "worse for a day or two" | Werner p. 125; Davies p. 35 |
| Sore for more than three days, or worse each day | No | The worst expected is "up to two to three days" | Davies p. 48 |
| A bruise | A sign the pressure was too much | "Bruising is a sign that you're trying too hard" | Davies p. 48 |
| Tired and sleepy | Yes | You "may feel really tired"; rest for about an hour | Mumford p. 386 |
| Light-headed when you stand | Common, more so on blood-pressure tablets or aspirin | Get up slowly | Mumford p. 386; Werner pp. 258, 502 |
| A headache | Usually from neck work, heat or too little water; should ease within a day | Irritated points settle in two to three days; heat brings headache | Davies pp. 48, 66; Werner p. 288 |
| Queasy or woozy | Occasionally, after long deep work or on an empty stomach | "Woozy or nauseated"; massage lowers blood sugar | Davies p. 35; Werner p. 404 |
| Dizzy or faint during neck work | Stop at once | Pressure on the front of the neck can drop blood pressure | Davies p. 65 |
Werner's page numbers are the printed pages of the 5th edition (Lippincott Williams & Wilkins); Davies's are the 3rd edition (New Harbinger). The other two books are Susan Mumford's The Massage Bible (Sterling) and Ryan Hoyme's The Complete Guide to Modern Massage (Althea Press), which has no printed page numbers, so we cite its chapter and section.
The explanation you will hear most often is that massage releases lactic acid, which makes you sore, and water flushes it out. Werner does not support it: the role of lactic acid in muscle soreness "is no longer generally accepted", the research on massage and soreness "has so far borne inconsistent results", and the mechanisms by which massage helps recovery "have not been identified" (p. 59). What she does name is simpler. For people with knotted, painful muscles, "the only risk massage has" is that "overtreatment could leave them sore" (p. 125). In other words: too much pressure, for too long, in one place.
Davies puts the same thing in a self-treatment manual's plain words. Good pressure is "therapeutically delicious" — "a level of discomfort you can still relax into"; try too hard, and "your body will react against it and make your pain worse for a day or two" (p. 35). Hoyme adds the part guests control: "the more a person tenses up during a deeper massage, the more likely they will be sore the next few days" (ch. 4, "Deep Tissue"). If you are holding your breath or clenching your jaw, the pressure is past the point where it helps.
Davies's advice for a flare after firm work is ice on the area "for ten to fifteen minutes several times throughout the day", or very gentle massage, "almost as if you were massaging a baby"; without anything, "the worst that will happen is that the activated trigger points will stay irritated for up to two to three days" (p. 48). So a day or two of tenderness is ordinary. Pain that is still getting worse on the third day is not, and neither is swelling, numbness or weakness: those are for a doctor, not for another massage.
If you take ibuprofen or aspirin so that firm pressure is easier to bear, you remove the warning that stops it going too far. Werner writes that anti-inflammatories "may hide the results of overtreatment" (p. 15), that clients who took them beforehand "may be less sensitive to pressure and consequently vulnerable to overtreatment" (p. 16), and that with painkillers in general "overtreatment is a significant risk" (p. 502); Davies says the same (p. 48). She is equally clear that it is not for a therapist to tell you to skip medicine you need (p. 502), so do not change anything your doctor prescribed. Tell the therapist what you took. And if the only reason for the tablet is to get through the pressure, ask for less pressure instead.
A bruise after a massage is not a badge. "Bruising is a sign that you're trying too hard", Davies writes, and some things make it far more likely: blood thinners including "aspirin, ibuprofen, Plavix, and Coumadin", corticosteroids such as prednisone, and supplements including "fish oil, ginkgo, ginger, dong quai, and garlic" (p. 48). If any of those is you, say so before the massage, not after; our page on what to tell your therapist covers blood thinners in detail.
Mumford's advice at the end of a massage is to roll over and get up slowly: the recipient "may feel really tired", and "the best option is to rest quietly for about an hour afterwards" (p. 386). A light head on standing is common for a reason Werner gives in her drug appendix: people who take blood-pressure tablets "may feel dizzy or lethargic" after massage (p. 258), and aspirin's effect on blood vessels "raises the risk for hypotension (dizziness and lethargy) and chilling during and after a massage" (p. 502). If you feel cold afterwards, that is the same mechanism. Sit on the edge of the table for a minute before you stand, and do not plan to drive a motorbike straight after.
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None of our books has a chapter on this, so here is what they say in pieces, and our reading of it. Neck muscles are a common source of headaches, and working them can go either way. Davies writes that massaging the sternocleidomastoid, the long muscle at the side of the neck, "often makes a headache better almost immediately" (p. 66), but also that points irritated by overly firm work "will stay irritated for up to two to three days" (p. 48): a headache the evening after hard neck work is usually that. Heat is the second cause. Werner lists headache among the signs of heat exhaustion, alongside heavy sweating and dehydration (p. 288), and in Hội An's climate a hot stone massage, the herbal steam or the jacuzzi on top of a hot day can add up to the same thing: drink water. Our page on when to wait covers the heat treatments in more detail.
Davies also keeps the line every page about headaches should: "there are serious medical causes of headaches" (p. 69). A sudden, severe headache, or one with confusion, weakness, a stiff neck and fever, or trouble speaking, is not a massage after-effect. In Vietnam the ambulance number is 115.
Davies notes that after long work on many tender points "you can come out of it feeling woozy or nauseated" (p. 35). Werner adds that "massage has been seen to drop blood sugar" (p. 404), which matters most with diabetes but is a reason for anyone not to come on an empty stomach: eat something light an hour or two before. The one symptom that means stop immediately is dizziness or faintness during work at the front of the neck. Pressure on the carotid sinus there "can cause a sudden uncontrollable drop in blood pressure leading to dizziness, fainting, and falling", and Davies's instruction is to stop at once (p. 65). Say so the moment you feel it.
The whole of this page comes down to one habit: say "less" as soon as you want less. Hoyme calls open communication "essential and ethical" in firm work and tells the therapist to "ease up if it's ever too much pressure" (ch. 4, "Deep Tissue"). The consultation form you fill in before the visit asks what to focus on and what to avoid, and nobody minds being told during the treatment. On our menu, the oil massage (450,000₫ for 60 minutes) is medium pressure; the back, neck and shoulder treatment (490,000₫) and the bamboo massage, "firmer than hands" (570,000₫), are the firm end. Firmer is not better value, and our page on referred pain explains why the sore spot is not always where the work should go. At the couple spa, each of you can ask for a different pressure.
We are a hotel spa, not a clinic, and our therapists do not diagnose. Werner's book is a textbook for massage therapists, Davies's a self-treatment manual, and Mumford's and Hoyme's guides to massage at home; we quote them because they answer, with page numbers, the questions guests ask us the day after. Where we connect their points ourselves, as on headaches, we say so. None of it replaces a doctor.
Nghê Prana Riverside Hotel & Spa, Hẻm 384 Nguyễn Tri Phương, Cẩm Nam, Hội An, Đà Nẵng 51312 — on the Thu Bồn, a few minutes from the Old Town. Phone or WhatsApp +84 896 687 961, or email sales.nghehotel@gmail.com. An hour's notice is enough; walk-ins are welcome when a therapist is free. You do not need to be staying with us.
Sources: Ruth Werner, A Massage Therapist's Guide to Pathology, 5th ed. (Lippincott Williams & Wilkins), pp. 15–16, 59, 125, 258, 288, 404 and 502; Clair Davies and Amber Davies, The Trigger Point Therapy Workbook, 3rd ed. (New Harbinger), pp. 35, 48, 65, 66 and 69; Susan Mumford, The Massage Bible (Sterling, 2009), p. 386; Ryan Jay Hoyme, The Complete Guide to Modern Massage (Althea Press, 2018), chapter 4, "Deep Tissue". Page numbers checked against the printed pages on 28 September 2026. Prices read from our live spa menu on 28 September 2026. We are a hotel spa, not a clinic; nothing here is a diagnosis.
23 rooms on the quiet south bank of the Thu Bồn River, ten minutes by bicycle from the Ancient Town and a world from its noise.
Book your stayA day or two of soreness after firm work is common. Werner's A Massage Therapist's Guide to Pathology (5th ed.) says overtreatment "could leave them sore" (p. 125), and Davies's Trigger Point Therapy Workbook says overdoing it makes pain worse for a day or two, with irritated points settling within two to three days (pp. 35, 48). It is not lactic acid, whose role in soreness Werner says is no longer generally accepted (p. 59). Pain still worsening on the third day, or with swelling, numbness or weakness, is a doctor's question.
Usually from neck work or heat. Davies notes that neck massage often relieves a headache, but points worked too firmly can stay irritated for two to three days (pp. 48, 66); Werner lists headache among the signs of heat exhaustion (p. 288), so hot stones, steam or a jacuzzi on a hot day plus too little water can cause one. Davies also notes there are serious medical causes of headaches (p. 69): a sudden severe headache, or one with confusion, weakness or a stiff neck and fever, needs medical help; in Vietnam call 115.
Tiredness is normal: Mumford's The Massage Bible advises getting up slowly and resting for about an hour (p. 386). Light-headedness on standing is more likely if you take blood-pressure medication or aspirin (Werner pp. 258, 502), and massage can lower blood sugar (p. 404), so eat something light beforehand. Dizziness during work on the front of the neck means stop immediately (Davies p. 65).
No. Davies writes that "bruising is a sign that you're trying too hard" (p. 48), and it is more likely with aspirin, ibuprofen, Plavix, Coumadin, corticosteroids and supplements such as fish oil, ginkgo, ginger and garlic. Tell the therapist about those before the massage, and ask for less pressure; firmer is not better value.
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