Sometimes there is nothing better than a deep massage - unless, of course, it puts you in hospital.

A 39-year-old woman was ill for six months after a massage therapist apparently rubbed too hard and damaged her liver.

This led to a painful accumulation of blood called a haematoma.

Dr James Trotter, of the University of Colorado Health Sciences Centre, treated the patient.

He said that even after the damage was discovered, the woman experienced nausea and low-grade fevers.

As a result, she lost 23 pounds in weight. She subsequently recovered fully.

Dr Trotter said: "Therapeutic body massage has become a popular treatment for a variety of disorders.

"Doctors whose patients undergo massage therapy should be aware of these potential complications."

Dr Trotter said that the rate and severity of side effects "is probably quite low".

Patients have differing needs

Denise Brown, a trained osteopath and expert in massage who runs the Beaumont College of Natural Medicine in Bournemouth, said she had not heard of similar cases in the UK.

"We teach our students to be receptive to patients' needs as every patient requires a different pressure."

Ms Brown said masseurs had to be particularly careful with diabetics who tended to bruise more easily, with people on steroids, whose skin is thinner than normal and with elderly people.

She said: "When pressing on an area where there is a build up of tension and the muscle tends to be quite knotted, you would work very gradually into the knotted area, releasing the pressure slowly.

"If an area continues to be painful then we tell our students that they should always send the patient to get a doctor's diagnosis."

The case was reported in the New England Journal of Medicine.