blog the sixth: How often to get a massage...

“How often should I get a massage?”


This is a surprisingly complex question to answer. It would be nice if there was some kind of standardized treatment schedule that works for everyone, but outside of insurance claims, it's impractical to try to impose a set schedule on every person. There are, however, some broad rules of thumb that I like to use to help my patients decide what is best for them.

Usually when someone first comes to see me, it's for an acute injury (sports injuries, sprains, strains and repetitive motion injuries all fit into this general category, assuming the onset is recent). In these cases, the first massage is primarily assessment and symptom management. I recommend at least one follow up for mild injuries. For repetitive strain disorders and for more severe injuries, I recommend an additional two to three treatments to facilitate the formation of functional scar tissue at the site of injury, and the prevention of postural dysfunctions caused by compensatory changes in gait, posture, and hand/arm use. Additional treatments may be necessary, but I find that if I haven't achieved at least an estimated 70% recovery after the 3rd or 4th treatment, then I need to reassess and possibly refer the patient to their doctor.

For chronic musculoskeletal problems (arthritis, tmj, tension headaches, epichondilitis and carpal tunnel are all examples) a longer treatment schedule is most likely necessary, based on the clients response to treatment, financial considerations, and their activity level (patients that can't or won't exercise tend to need more frequent massage treatments). Depending on the condition, this can potentially continue for as long as the patient chooses to come and see me. When the prognosis is for full recovery, I haven't seen many cases where the ongoing treatment plan of the condition continued for more than 3 months.

For both acute and chronic issues, the treatment plan depends on my ability to measure recovery in an objective manner. This involves observing posture, range of motion, inflammation, muscle strength/weakness, and sensory changes (numbness or tingling primarily).

Sensory change does involve a certain subjective experience on the part of the patient, but I think it's sensible to consider it in this category of observation. Once these issues have been resolved, we move more into the subjective experience of the patient.

Subjective experience can involve pain, changes to activities of daily living, stress and mood.

Once we're dealing primarily with these problems (and if it's what they have come in for in the first place), it's fully up to the patient to define their needs. I recommend weekly treatments until subjective changes are significant, and then gradually extending the distance between treatments until a maintenance schedule has been established. By this I refer to the length of time at which symptoms recur. Settling into a treatment schedule of once every 3-6 weeks seems to be the most common.

For management of both pain and stress specifically, I suggest that weekly treatments are optimal. Patients with chronic pain conditions and those living and working in high stress environments seem to benefit from more frequent treatment. Anxiety and risk of depression seem to be reduced (This is one of the areas where massage therapy is well researched. Check here for a good abstract with additional links.).

These guidelines do tend to differ slightly from therapist to therapist, but a quick investigation on Google shows that I'm not out of sync with other therapists. The "Why Massage Therapy" blog is quite interesting to show the similarities and differences between our perspectives.

One last note:

Beware any therapist who tells you that it will take more than 10 sessions to make significant progress! Excepting certain long term conditions where the goal is relief rather than rehabilitation (see above!), you should begin to feel better fairly early on in the treatment process. Even if the improvements are only small, they suggest we are on the right track and can proceed. Anyone insisting you continue treatment when no change is evident could be leading you on, and is almost certainly wasting your money.

Please feel free to add to this or ask questions! As I said above, everyone has a different perspective on this issue and I'm always interested in people's thoughts and opinions.