Venues offering Medical Massage

Medical massage (clinical massage, therapeutic massage) is a massage approach used not for relaxation but to target a specific complaint. It is not a single technique: depending on the assessment made before the session, deep tissue work, trigger point pressure, myofascial release, stretching and joint mobilisation techniques are used together.

The session, from assessment to treatment

A medical massage session starts with a conversation: you are asked when the complaint started, what makes it worse, which movement is restricted and whether you have a diagnosed condition. The therapist often also looks at your posture and the range of movement of the problem area; they may ask you to make certain movements to see at what angle the restriction begins. The treatment focuses not on the whole body but on the source of the problem and the areas linked to it; with neck pain, it is usual for the shoulder girdle and upper back to be worked on too.

The session is usually given on a table with oil or cream; you lie face down, face up or on your side depending on the area being worked on. Pressure varies from area to area: the surrounding tissues are first prepared with gentler strokes, while brief, firm pressure is applied to trigger points. Recommending stretching or strengthening exercises as a home programme at the end of the session is part of this approach.

Session length and programme

A medical massage session usually lasts 45-60 minutes; the first session may be longer because of the assessment. Usually a programme of several sessions is planned rather than a single one: sessions are closer together at first, and the gaps widen as the complaint eases. The length of the programme depends on how long the complaint has lasted, how severe it is and how far the recommended exercises are kept up.

What it can offer and its limits

Medical massage may help temporarily reduce muscle tension and the pain linked to it, and increase restricted range of movement. It suits people with musculoskeletal complaints that have been diagnosed and for which a doctor considers massage appropriate, such as neck and shoulder pain from desk work, chronic lower back tension or stiffness from repetitive movements. Lasting change, however, mostly depends on keeping up the recommended exercises and on everyday posture habits. At some venues, medical massage is offered under the same roof as movement work such as Pilates; this is a practical arrangement for those who want to continue with regular exercise after massage.

Where it ends and physiotherapy begins

Medical massage is not a diagnostic method and does not replace physiotherapy or a doctor's examination. If the cause of your pain has not been identified, see a doctor first. In Turkey, physical therapy and rehabilitation is a separate health service; the medical massage offered at spa and massage venues is a supportive treatment for conditions that have been diagnosed and that a doctor considers suitable.

Who should not have it

Medical massage is not given with an acute injury, a suspected fracture, a feverish illness, an active infection, deep vein thrombosis, uncontrolled blood pressure or a bleeding disorder. A doctor's approval is mandatory during cancer treatment and with a joint replacement, osteoporosis, use of blood thinners or pregnancy. Signs such as numbness spreading into the leg, weakness, or a change in bladder or bowel control require urgent medical attention. If your complaint started after a fall, accident or blow, a doctor's assessment is needed before massage.

How it differs from deep tissue, sports and Swedish massage

Because of the techniques it uses, medical massage is most often confused with deep tissue and sports massage. The difference lies in the starting point of the session:

Deep tissue work may feature in the session as one of the tools of medical massage; what sets medical massage apart is that the technique is chosen to suit the complaint and the programme begins with an assessment.

Price and choosing a therapist

The price of medical massage varies with session length, whether the first assessment is charged separately, the therapist's training and experience, the type of venue, and whether several sessions are bought as a package. For details, see the guide what determines massage and spa prices. Before booking, ask about:

• The medical massage training of the person giving the session, and their experience with cases similar to your complaint.
• Whether an assessment is made in the first session and whether it is included in the session time.
• How many sessions the recommended programme has and how progress will be tracked.
• Whether the recommended exercises are demonstrated or given in writing.

To judge how reliable a venue is, you can also look at the guide explaining how to tell whether a massage salon is trustworthy.