I recently walked a street with a day spa on one side and a holistic wellness clinic on the other side. They both had a sign in the window: Massage Therapy Available.
Now, that sounds like a good idea. You want to relax and work out some knots in your shoulders. Besides, massage is supposed to be good for your health.
But do you want a relaxation massage or a medical massage?
I’ve seen so many people make the wrong choice and not only do they pay for a bad experience but, sadly, they may give up on massage altogether.
Take Amy, for example. She’s in serious pain and wants massage for Sciatica. She joins her mom at her favorite spa. When Amy walks out an hour later with her hip still hurting, she thinks massage doesn’t work.
Or consider Tom, who had a terrible week at work and just wants to destress. He knows he can get massage with his insurance and his co-pay is small, so he goes to the neighborhood clinic. He’s surprised by the stale atmosphere, bright lights, and constant conversation, and leaves frustrated that he didn’t get a full body massage when the therapist had a whole hour.
The intention behind the massage creates a very different experience. When you know the 6 key differences between medical massage and relaxation massage, you can avoid disappointment and make the right choice for you.
1. Before the Session
All massage therapists will collect some basic information from you, such as your name, date of birth, and health history. This fulfills state requirements and allows the therapist to avoid contraindicated techniques.
A relaxation massage follows a predetermined routine, so once they know it’s safe for you to receive their techniques, you can go ahead and get started.
If you’re receiving a medical massage, the intake forms will probably be longer and ask for more details about your symptoms and wellness goals. Then you’ll have a consultation with your practitioner, and she’ll ask follow-up questions and perform special tests (such as flexibility tests).
Medical massage is completely customized, so this information is used to identify the source of the problem and design the most effective treatment for you.
The consultation is perhaps the most defining factor of what is a medical massage.
You can expect to spend 5-15 minutes on this consultation process at your first appointment, and 5 minutes at subsequent appointments.
2. The Massage Therapist
The consultation is an investment of time, so to prevent re-doing it every session, you’ll stick with the same massage therapist. You build a relationship and the therapist becomes your wellness partner. They know your history, your preferences, and which techniques are best for your body.
A clinical massage therapist will have advanced training in techniques that get results. Good keywords to look out for are: Sports massage, Lymphatic drainage, Neuromuscular techniques, Orthopedic Massage, Trigger Point therapy, Neurofascial Release, Cupping, Graston technique, and Kinesiology taping.
Additionally, they’ve studied specific conditions and how to treat them, such as massage for Carpal Tunnel Syndrome and headaches.
The relaxation massage therapist focused their training on the art of massage, maximizing techniques that feel good and promote relaxation.
The classic spa massage is a mix of Swedish massage and Lomi Lomi, which are medium-pressure gliding techniques done with oil. The spa practitioner may have advanced training in Hot Stone Massage, Aromatherapy, and other luxurious add-ons for serious destressing.
Because of the sporadic nature of spa visits and birthday massages, you’re less likely to build a relationship with the relaxation massage therapist, and you may see a different therapist every time.
3. The Setting
The spa environment is created for a sense of luxury, relaxation, and self-pampering. You can expect hushed voices, low lighting, and vases of flowers.
Some spas have hydrotherapy add-ons available, such as spa massage with sauna or jacuzzi time, which is a great way to soften muscles. They may also offer packages with esthetician services, such as a spa massage and facial, pedicure, beautifying body wraps, or waxing.
Remedial massage is performed at a clinic, hospital, or private practice (office). You’ll probably hear that same spa music, but there will be anatomical charts on the wall instead of abstract paintings.
Some clinics offer packages of medical massage and acupuncture, chiropractic adjustments, or physical therapy for well-rounded care. If these services aren’t available in-house, they probably have a referral list so they can match you with a qualified practitioner upon request.
So, how much is medical massage VS spa massage? Generally speaking, the more specialized your therapist, the higher the price… whether they’re the expert in pain relief or offer the most pampering spa experience in town.
One major difference is tipping. For relaxation massage, you’ll be expected to tip 20%. This is tip is automatically added to your bill at hotel spas (but not included in the list price).
With medical massage, tipping may or may not be customary. After all, you don’t tip your doctor, so why would you tip your muscle medic?
Another factor is insurance.
To get medical massage covered by insurance, you’ll need a referral (prescription) from a physician that specifies your diagnosis (e.g. lower back pain) and recommends a number of massages. Always verify your benefits with your insurance company first so you’re familiar with your deductible, co-pay, and how many massages they’ll cover each year. You don’t want to be surprised at check-out!
Whether you’re seeking rehabilitation or relaxation, you get what you pay for. You will have a better experience with better outcomes when you’re willing to pay for the talent, training, and experience of your practitioner.
5. The Massage Itself
A relaxation massage consists of Swedish gliding and kneading techniques. It focuses on feel-good areas such as the back, face, scalp, and feet.
It follows a predetermined routine, designed by corporate to ensure everyone has the same experience. This allows for Couples massage (where two people get the same massage at once) and Four Hand Massage (where two massage therapists massage one person at once).
A full body relaxation massage creates a sense of cohesion and connectedness by massaging you from head to toe. Of course, spreading out the massage like that means less time is spent on each body part.
With some quick math, you can expect about 6 minutes of massage on your back, arms (x2), front of leg (x2), back of leg (x2), neck, and scalp/face in a 60min massage.
If you have back pain from years of working at a desk, 6 minutes will not suffice. Consider instead a medical massage that focuses on tight muscles relevant to your symptoms.
The difference between relaxation and medial massage is sometimes boiled down to “relaxation massage VS deep tissue.” However, this isn’t really accurate. Many people find deep pressure relaxing and therefore deep tissue relaxation massage is common.
On the other side, there are plenty of rehabilitation massage techniques that use medium or light pressure. The best example is Lymphatic drainage massage. It’s incredibly beneficial after a surgery or car accident, and it only uses light pressure. (Learn more about the magical benefits of Lymphatic massage.)
6. After the Session
After a spa relaxation massage, you’ll likely find yourself in a quiet meditation lounge sipping tea (or champagne, if you shelled out for a fancy hotel spa). You can take your time to wake up before you must return to the real world after your 60 or 90 minute vacation.
A clinical experience is not over as soon as the massage is done. It began with a consultation and it ends with another check-in with your medical massage therapist. You’ll briefly discuss how the treatment went and make notes for next time. She might point out particularly tight muscles and teach you a relevant stretch to maintain your progress in-between appointments.
(I like to teach Functional Rest: learn how to nap back pain away.)
Before you leave the clinic, you’ll collaborate on a treatment plan that works for your health goals and budget. Massage benefits are cumulative. To improve your quality of life, physicians typically recommend 4-6 sessions of massage, followed by re-evaluation.
After you leave, the medical massage therapist will spend time documenting the session, to satisfy insurance requirements and prepare for your next treatment to be even more effective than the first.
Which one is right for you?
A relaxation massage is about the journey. Forget about reality for an hour and enjoy a lovely, pampering, relaxing experience. If you’re looking to give a one-time gift to a loved one, or yourself, this is the handmade gift that can’t be beat.
The medical massage is about the destination. Improve the condition of your body with evidence informed and results-based techniques. If you’re looking for pain relief, improved function, or increased mobility, medical massage is your best bet.
Personally, I've performed both relaxation massage at the spa, and medical massage at the clinic. In my private practice, I'll work with you to determine your goals and intentions, and design the perfect massage for your body today.
No matter what choice you make, touch is always good for the soul. Just like regular sleep and exercise, you should consider a regular massage program to maintain your health and wellness. Treat yourself and take care of your body!
P.S. Do you have a massage coming up? Learn how to get the most out of it!
Jesse Martel is a Licensed Massage Therapist who practices in Seattle, Washington. She has helped many people overcome neck/shoulder injuries and chronic back pain with Upgraded Myofascial Release massage. Treatment includes Aromatherapy, Myofascial Release, Cupping, Lymphatic Drainage, and Kinesiology Tape at one flat rate. Her website is SageBodyworkSeattle.com.