The way I understand and practice them, medical massage and relaxation massage are two entirely different services.
Medical massage is medical care delivered to a patient under the direction of a prescribing health care provider and typically paid for by a third party.
Relaxation massage is a consumer service delivered to a client who pays for the service themselves.
The table below is my attempt to clarify and elaborate on the differences between these practices (another table illustrates how clinical massage and relaxation massage fit in). This is an early draft of a work in progress. If you have comments, criticisms, or suggestions please leave a comment below.
health care system
personal service industry
reason for treatment
termination of care
maximum medical improvement (usually)
when client’s needs are met or change
primary massage treatment techniques
clinical massage techniques like myofascial treatments, deep tissue massage, cross-fiber friction, neuromuscular “trigger point” technique, and muscle energy technique
relaxation massage techniques like Swedish, deep tissue, circulatory massage, and craniosacral
rates set by UCR and RVU
rates set by the consumer marketplace
yes (discount for payment at time of service)
no (all payments due at time of service)
can take 30-90 days or longer
due at time of service
therapist accountable to
time spent on documentation, coordination, and communication
15-30 minutes or more per session
1-5 minutes or less per session
basic 500-hour massage certification course plus advanced training in
basic 500-hour massage certification course
need clinical and professional experience and/or an internship
can start practicing right after graduating from massage school
receiver’s emotional state/level of proactiveness
didn’t ask to be injured, may be depressed, anxious, or otherwise distressed by both the injury/accident and/or ensuing work, life, and health complications
proactively seeking care, typically healthy and active
physical demands on practitioner
can be heavy – orthodpedic assessments, muscle energy techniques, myofascial treatments, cross-fiber frictioning, and other injury-treatment techniques can be hard on your body
may be lighter – Swedish and some other techniques are less demanding, but deep tissue massage can be hard on your body
emotional demands on practitioner
can be heavy – patients can be disengaged, distraught, or otherwise unengaged or difficult to engage
typically light and/or manageable
may be OK (therapist should ask the prescribing referrer about this), but shouldn’t contradict what the rest of the medical team is saying
OK within scope of practice (“drink plenty of water,” “do that stretch I showed you,” “put an ice pack on it,” etc.)
business-to-business networking with referring providers, health care networks, etc.; many legal and ethical considerations regarding referral relationships, etc.
consumer marketing (much like a tax preparer, hair dresser, real estate agent, etc.); gift certificates, referral discounts, and other consumer marketing practices are OK