hot stone massage

Hot stone massage is a popular modality offered by thousands of massage therapists. It’s also a way to add a new dimension to your existing sessions—and as a modality that involves tools, it can give your hands a break from their normal stressful routine. (For more about how this modality developed, check out “The History of Hot Stone Massage.”)

MASSAGE Magazine reached out to some hot stone experts to give you the information every practicing therapist should know when it comes to offering clients hot stone massage—from who should get one and who shouldn’t, to how to best clean your stones.

Who Hot Stone Massage Is Good For

Pat Mayrhofer, L.M.T., president of Nature’s Stones Inc. ( has more than 20 years in the field, and knows adding stones to massage has benefits for both client and practitioner. The heat provides the client a rich, soothing, pain-relieving massage experience, while the therapist enjoys the added benefit of letting the stones do some of the work.  

“If I didn’t have my stones, I wouldn’t be able to do as much work,” Mayrhofer says, noting how much they’ve helped her as a therapist.

Client conditions she has found hot stones helpful with include chronic illnesses such as fibromyalgia. For instance, she had a student in Kentucky who suffered with fibromyalgia; after the student had a hot stone massage during training, she reported that she had never slept so well. As a result, this person now specializes in offering this type of massage to fibromyalgic clients. Mayrhofer has also found hot stone massages have been beneficial for people presenting with plantar fasciitis, neck problems, low-back problems and trigger points.

While few research studies have been conducted on the therapeutic use of hot stone massage as a modality, several studies, such as those referenced in a 2004 narrative review in the journal Pain Physician, support the use of heat therapies for musculoskeletal pain.


Who Hot Stone Massage Is Not Good For

Just as it is important to know what type of conditions hot stone massage can help treat, it is equally imperative that you realize who should not receive this type of massage.

Dale Montelione Grust, L.M.T., owner of massage-stone company CoreStones (, says hot stone massage could hurt clients who present with any of several health conditions, including:

  • Conditions involving loss of sensation (neuropathy, diabetes, nerve damage)
  • Ingestion of medication that creates side effects when combined with heat
  • Receipt of chemotherapy or radiation
  • Weakened immune systems (as in cases of Epstein-Barr, mononucleosis, AIDS)
  • Pregnancy
  • Cardiac problems
  • Skin conditions

Grust also cautions therapists about using hot stone massage on older clients. For them, she indicated that you want to “keep the heat around 115 degrees—any higher may be too hot.” Also, she added, older clients’ skin is delicate, so be careful when conducting this or any other massage on geriatric clients.


Washing Your Stones

Mayrhofer spoke very passionately about the importance of washing massage stones. She shared her story of staying in a top-rated, very expensive hotel and deciding to meet the spa director. Upon doing so, the director asked her how to clean massage stones. Mayrhofer was alarmed that this person was the one responsible for the almost-$300 service to clients, yet she had no idea how to care for the stones in a way that made them safe for therapists and guests to use.

It is important to care for your stones by washing them in hot water and antibacterial dish detergent. (Note: Use warm, not hot water, for marble stones, to prevent damage.) After washing, rinse in hot water, dry with a clean towel, then spray with alcohol or another environmentally safe disinfectant.

Mayrhofer also stresses that you must change the water you wash stones in after each client. Although some practitioners fear the stones won’t be hot by the time the next client is ready, Mayrhofer stated that as long as you use hot water to wash them, they will be ready in just a few minutes. She also suggested practitioners use water-soluble massage oil because it is lighter and easier to rinse from stones than oils that are not water-soluble.


Other Must-Know Hot Stone Massage Tips

What else should you know as a hot stone massage therapist? Some other tips provided by Mayrhofer and Grust include:

  • Never place hot stones directly on a client—always place a sheet, pillowcase or towel between hot stones and skin.
  • Keep your water between 110 and 125 degrees Fahrenheit, and invest in an infrared thermometer so you can accurately test the stones’ temperature. If your stones are too hot, put them in cool water or spray them with alcohol before using.
  • Always ask your clients to say something if the stones are too hot. “This is imperative,” Grust stresses. You don’t want to burn your clients, so their input is extremely necessary.
  • Don’t keep the stones in your hand during the entire session. Not only is this potentially harmful to you, but “clients like the feel of your hands as well as the stones,” adds Grust.

Becoming trained in hot stone massage is a way to add a sought-after modality to your menu of services, either as a stand-alone session or as an add-on to other types of massage. Whether a client seeks relief from pain and stiffness or simply a relaxing, stress-melting escape, incorporating hot stones into your treatments can enhance client satisfaction and help you build your practice.