The burgeoning spa industry has been progressively establishing itself in most of the world’s top vacation destinations. Whether due to exhilarating activities or the breathtaking views, one of the most desirable locations for a getaway is in the mountains. While many massage therapists find themselves employed in a mountainous setting, not all are as aware of the dangers of altitude sickness as they should be.

About Altitude Sickness

Also known as Acute Mountain Sickness (AMS), altitude sickness occurs when a person gets insufficient amounts of oxygen from the air at high altitudes. At sea level, there is an abundant amount of oxygen in the air because of the compression from the weight of all the air above it. However, increases in altitude reduce the air pressure and air density, resulting in lower oxygen levels in the air. If an individual reaches 18,000 feet, the molecules are so spread out that they are inhaling 50 percent less oxygen compared to sea level.

Causing problems for those accustomed to functioning with plenty of oxygen, the air at altitudes over 8,000 feet contains a marked decrease in oxygen levels. Although, altitude sickness has been known to strike some engaging in physical activity (where the demand for oxygen is greater) at altitudes as low as 5,000 feet. There are three basic kinds of high-altitude illness:

  1. Acute mountain sickness (AMS)
  2. High-altitude pulmonary edema (HAPE), which affects the lungs
  3. High-altitude cerebral edema (HACE), which affects the brain

An estimated 20 percent of people visiting the Western mountains in the United States are affected by a mild case of AMS. Experts are unable to predict who might succumb to altitude sickness – with age, gender and fitness level seemingly irrelevant.

Signs of Altitude Sickness

Symptoms of altitude sickness can range from mild to severe and they may not begin until a day or two after arriving at a high altitude. Many people say altitude sickness feels like having a hangover. Since there is no definitive way to forecast altitude sickness, health professionals who may interact with people in mountainous settings must be familiar with the first signs of AMS, as well it’s more dangerous progression to HAPE or HACE.

When struggling with lower oxygen levels, the beginning signs of AMS, include:

  • Headache – usually throbbing
  • Light-headedness or dizziness
  • Weakness or fatigue
  • Difficulty sleeping
  • Upset stomach – including having no appetite and vomiting

If AMS progresses to HAPE or HACE, the person’s condition is critical and, if not treated immediately, can be fatal within just a few hours. When this lack of oxygen causes fluid retention in the lungs or brain, immediate help must be sought to prevent death. Clues of HAPE or HACE, include:

  • Difficulty breathing – including raspy breath sounds
  • Coughing – especially with bloody sputum
  • Confusion or inability to walk a straight line
  • Feeling faint
  • Having blue or gray lips or fingernails
  • Seizures, nerve palsy or hemiplegic can occur, but are less common

Altitude Sickness Solutions

Since the first thing a person who is not feeling well on his or her vacation might do is book a massage at the resort’s spa, massage therapists need to be able to recognize AMS, suggest solutions for it or demand the client see a physician right away.

While there are various stages of AMS and a handful of possible treatments, the best solution is descent. Going closer to sea level is the only surefire way to recover from altitude sickness. However, those with mild symptoms may be able to adapt and get used to the thinner air. For those with mild forms of AMS who want some help to stay at the elevated altitude, the following suggestions may be helpful:

  • Rest – Taking it easy is imperative. This includes limiting walking and other exercises – as well as indulging in daytime naps.
  • Hydrate – Experts advise drinking lots of water. They also warn victims of AMS to avoid dehydrating beverages such as alcohol and coffee.
  • Don’t Go Higher – Although it may take several days, do not proceed to higher elevations until all symptoms dissipate.
  • Eat Carbs – Eating carbohydrates seems to help ease mild cases of AMS.
  • Oxygenate – Some high altitude vacation destinations accustomed to travelers with AMS have responded accordingly. To help reduce mild symptoms, oxygen delivery systems via oxygen bars and personalized oxygen tanks are becoming increasingly popular in these areas.
  • Medicate – Over-the-counter medications such as acetaminophen, ibuprofen or naproxen can be used to ease AMS-related headaches. In addition, there are several medications a physician can prescribe to help prevent or treat altitude sickness.

Specifically for Massage Therapists

While a handful of resorts around the world offer spa services claiming to ease altitude sickness, there is no proof that this is true. It makes perfect sense that massage techniques to increase blood circulation will deliver more oxygen to the tissues. Though, this should never be attempted if the person’s symptoms are severe, have worsened, have persisted for more than two days or have advanced to include any signs of HACE or HAPE.

Since AMS may take a while to manifest, cranial-sacral therapy may prevent oxygen deprivation if applied before symptoms appear. This osteopathic method can be especially valuable to visitors just beginning their holiday, because cranial-sacral techniques help facilitate circulation around the head and spinal cord. However, clients should be advised to take it easy, drink lots of water, avoid alcohol and watch for signs of AMS. If employed within a resort at a considerable altitude, massage therapists should always be clear on altitude sickness protocol with their employer.

Many visitors to the mountains mistakenly assume they have a hangover or are coming down with the flu. Bodyworkers aware of this misconception can help those affected identify and take appropriate action for AMS or call for help if HACE or PACE are suspected. Once therapists have a firm understanding of how to recognize and address altitude sickness, they are better prepared to care for their clients high above sea level.

Editor’s Note: Even though massage therapy has been shown to increase circulation, any massage other than energy work or very light touch massage should be avoided if AMS is suspected to be causing symptoms in a client. At least one study has shown AMS may result in the coagulation of platelets, which may, in turn, increase the possibility of stroke.

Recommended Study:

Advanced Anatomy and Pathology
Cranial-Sacral Fundamentals

References:, High-Altitude Illness: How to Avoid It and How to Treat It, Retrieved August 6, 2008, American Academy of Family Physicians, 2008.

http://jap/, Platelet count and function at high altitude and in high-altitude pulmonary edema, T. Lehman, H. Mairbäurl, et al. Retrieved December 2, 2010, Journal of Applied Physiology, October 2005., Altitude Sickness: An Integrated Perspective, Ronda Wimmer, PhD, MS, LAc, ATC, CSCS, CSMS, SPS, Retrieved August 6, 2008, Acupuncture Today, July 2003., Therapy a breath of fresh air for altitude sickness, Phaedra Haywood, Retrieved August 6, 2008, The Sante Fe New Mexican, July 2008., Altitude Sickness, Retrieved August 6, 2008, WebMD, LLC, 2008.