The Fight to Legitimize Massage Therapy

Massage therapy is a cornerstone of holistic healing. Cultures across the world have used massage for centuries to help people recover from injuries, relieve pain, prevent and recover from illness, and simply relax. Although there’s ample evidence that massage can be an effective treatment method, many Western cultures view massage as a luxury—something wealthy people do on vacation. 

Between the perception of massage as a luxury and the fact that the education requirements vary greatly by state, the field has struggled to gain recognition as a legitimate treatment option from the medical community.  

The interest in massage therapy itself hasn’t waned much over the years. The massage therapy industry has increased 25 percent over the last ten years, and the field is projected to grow another 21 percent over the next ten. As younger professionals look for careers that give them greater flexibility, massage therapy meets that need. And as these younger therapists enter the workforce, they’re working hard to be recognized—and paid—as the medical professionals they are. 

Seeking Recognition in the Medical Community

Andrea Smith, LMT says the industry is working hard to gain the recognition they need to be successful. “We’re still struggling a little bit to find a good balance because some of us do want to do more medical massage. We want more training. We want to be in communication with more doctors,” she says. “Fortunately, more and more insurance companies are starting to recognize us and offer coverage to our clients, which is huge.” 

In recent years, more people have reported receiving a massage for medical reasons. In 2009, 29 percent of people got a massage for medical reasons. And in 2019, that number went up to over 60 percent. As much as “medical reasons” can be a vague term, people have also identified stress reduction, tension headache relief, and injury rehabilitation as reasons for getting massages. The reasons people seek massage increase all the time—and the industry is adapting to keep up with demand. 

Chiropractors, doctors, physical therapists, and physician assistants are some of the most common medical professionals to recommend massage therapy to their patients. As the use of massage therapy continues to grow, it’s opening up new avenues of treatment for people who need it the most. 

Veterans Healthcare Embraces Massage Therapy

Although many medical professionals recognize the benefits of massage therapy, many insurance companies still don’t offer coverage for massage. Medicare doesn’t cover massage at all. While more private insurance companies will reimburse for massage when prescribed by a physician, coverage remains hit or miss. The insurance industry is already complicated to navigate, so changing rules about what is and isn’t covered makes it difficult for people to get the care they need. 

That changed for the veteran community in May of 2017. The US Department of Veterans Affairs (VA) published guidance that classified massage therapy as complementary and integrative health (CIH). This classification allowed massage therapy to be used in treatment plans for veterans—and perhaps more importantly, for it to be included in their benefits coverage. Not only did this simplify the process of getting treatment set up for veterans who needed it, but it also legitimized massage therapists in a way that hadn’t been done before. 

When the VA included massage therapy in their qualified treatment options, they included a job description and a pay scale—as well as the educational requirements necessary for a massage therapist to be hired by the VA. These were key steps toward massage therapy being recognized as a viable treatment option.

And, as a result of this guidance, massage therapists hired by the VA can get paid wages and receive benefits for their services. For a field that was, and still is, made up largely of independent contractors and solo practitioners, this model presented by the VA is much different. And while some people prefer the freedom and independence of being an independent contractor, some may want the stability of a VA position. 

 

The Benefits of Massage Therapy

Smith says there are “a lot more benefits to massage therapy than people realize—and many of them are more mental than you might think.” She goes on to explain that while physical manipulation does have an effect on a person’s stress and relaxation levels, it’s also due to the environment associated with getting a massage. 

“We give people a safe space,” she says. “We give them a quiet place where they can go to focus on just themselves and their bodies—and not the 15,000 other things they might have going on in their lives.” 

It’s this combination of physical and mental relaxation that makes massage therapy a powerful treatment option for a lot of different conditions—from PTSD to chronic pain. 

Treating PTSD

Although massage could be used to treat any individual diagnosed with PTSD, it’s an especially big concern for veterans. Some of the symptoms of PTSD—like increased stress, anxiety, and chronic pain—are all things that massage therapy has been successful in addressing. 

“People don’t realize how much their bodies carry stress and pain. So when people are hurting and are more stressed than normal, it takes your body longer to heal,” Smith says. 

For a lot of clients, Smith explains that the therapeutic benefit of massage comes from the combination of human touch and the space you’re in. “The environment we create when we give a massage does a lot,” she says. “It just tells your brain that you’re actually allowed to relax, which can be really difficult for people to do on their own.” 

Treating Chronic Pain

Chronic pain can encompass a lot of different issues like back pain, osteoarthritis, fibromyalgia, and injury-related pain—all which can be addressed through massage therapy.

Smith focuses mainly on orthopedic and medical massage, and she says she’s seeing more clients with this concern. “What I’m hearing more often is that people are struggling more than ever to get out of pain. They get stuck in the pain cycle longer because of the stress that they’re under,” she says. In a lot of chronic-pain cases, the mental and the physical are so intertwined that a treatment that addresses both, like massage therapy, can provide clients some relief. 

The Importance of Building Relationships

Regardless of what kind of practitioner you are, building trust and respecting boundaries is a critical part of the practitioner-client relationship. Part of building that foundation is making sure that your clients feel safe and respected in their sessions with you. 

This is particularly true with massage therapy. By nature, massage is a pretty intimate treatment method, which not everyone may be comfortable with. Smith says before she begins massages with new clients, they talk about expectations. “It’s really important that I understand what they’re hoping to get out of the massage,” she says. “I always tell them that this is their time, their massage, so they should be comfortable. I always work with their boundaries.” 

Massage therapists should be having this kind of intake conversation with all their clients. The session will be more productive by starting off slow and going through the environment and their expectations together. 

Finding What Resonates

Something about massage therapy makes sense to people. Even when they know very little about it, they’re drawn to it. “I’m always surprised at how many people really have no experience with massage, but they know it’s something they want,” Smith says. “In those cases, we talk about their expectations, but I really do leave the ball in their court. I let them tell me what they’re comfortable with, and we go from there together.”