Medical Massage is a system of manually applied techniques that can achieve the following:
- Relieve and reduce pain;
- Establish normal tissue tension in sensitive areas;
- Create a positive tissue environment; and,
- Normalize the movement of the musculoskeletal system.
Medical Massage’s purpose is to address the physician’s diagnosis and to improve the patient’s condition While focusing on the physician’s diagnosis, a wide variety of techniques are utilized to assist in the curative outcomes. Techniques are performed by a nationally certified, medically trained massage therapist working within physician guidelines.
A Medical Massage Therapist’s Qualifications
A Nationally Certified Medical Massage Therapist (NCMMT) must perform the prescribed procedures. To become NCMMT, one must complete a minimum of 600 hours of traditional massage curriculum at a state licensed training facility. Becoming a NCMMT involves intensive training and expert supervision in the areas of orthopedic evaluation, curative physical medicine, and proper documentation procedures. Upon completion of this program of study, the qualified, licensed massage therapist must apply to the American Medical Massage Association to take the examination. If accepted, the massage therapist completes a 150-question exam and a board review of his/her credentials. David A. Clinger, owner and senior Licensed Massage Therapist of the Wellness Center for Therapeutic Massage and Bodywork, is the first Nationally Certified Medical Massage Therapist in the State of Ohio and the only one in northwest Ohio. Having completed required coursework and passed rigorous examinations in the field, David now has the distinction of being a Master Medical Massage Therapist.
Following the Doctor’s Orders
To request a Medical Massage, patients/clients must obtain a prescription from their family physician or specialist. To legally treat a patient/client, massage therapists must know what conditions they are treating. Afterall, making diagnoses is beyond the scope of practice for massage therapists who work solely from a physician’s orders. If a physician has questions about the intake process, he/she is encouraged to contact the Wellness Center for explanation on our procedures.
Common Medical Conditions Treated by Medical Massage Therapy
Medical Massage Therapists help relieve the underlying pain and suffering of those medical patients who battle any number of conditions and ailments. NCMMTs treat patients’ pre- and post-operative conditions:
- Work related injuries–Carpel Tunnel Syndrome, Sciatic Nerve Dysfunction, Lower Back Pain
- Personal Injuries–Auto Accidents and Physical Trauma
- Cancer–Incomplete Lymph Systems and Lymphedema
- Joint Replacement
- Frozen Shoulders
We not only insist that your patients keep their appointments with you, but offer services only if they are current with your plan of care. Our professional position is that patients must comply with your directions, which is essential to their recovery.
Working on those areas covered by your prescription, we will not stray from them, regardless of patients’ requests. When you send your patients to the Wellness Center for a Medical Massage, they will receive focused, outcome-based, soft tissue techniques that are designed to increase range of motion and decrease pain to diagnosed areas.
What Patients You Should Send for a Medical Massage?
Typically, prescriptions are written for patients who are recovering from soft tissue injuries. We commonly see patients recovering from automobile accidents, surgeries, and sports injuries, to name just a few. We also see patients with scoliosis, myofascial shortening, carpel tunnel syndrome, surgical joint replacements, back pain, stroke, cancer, etc.
How Do We Meet Your Expectations for Quality Care?
During their first session, your patient’s situation will be assessed. We will evaluate your patient’s condition through a series of range of motion tests, checking for passive, active, and resisted range of motion conditions. We will check for contraindications to medical massage, evaluate the patient’s phase of healing, complete a postural and palpating evaluation, and formulate a plan of care based on your diagnoses paired with the findings from the evaluation. Immediately after the initial session, we will consult with you, if we find contraindications and discuss the appropriate responses. You will also receive updates and, thus, can oversee the entire care plan.
Following the evaluation, if we find no contraindications, the patient will receive treatment. Depending on your patient’s phase of healing and your prescription, this may consist of regular massage (i.e., effleurage, petrissage, and tapotement only); moist heat, cold, or topical pain relief preparations; trigger point therapy; assisted stretching without active resistance; proprioceptive neuromuscular re-education (PNF stretches); muscle-energy techniques (MET); myofascial release; or other manual therapies.
Here is what not to expect: Most massage therapy programs offer instructions in stretches and exercises that clients may do at home. They also advise clients to drink plenty of water following their treatments. This is sound advice in most cases, but the medical massage model is quite different. Although we have been trained in stretches and therapeutic exercises, we will not offer any post-treatment suggestions, unless you specifically instruct us in writing on each individual case. Also, we do not treat any area without a soft tissue diagnosis code provided by you.
Should Medical Massage be Combined with Physical Therapy?
Physicians must answer that question for a patient. Physical Therapy (PT) often focuses on increasing strength. However, a large body of evidence and scientific studies show that it is not necessarily efficient to strengthen before lengthening. For this reason, some physicians find that prescribing PT and Medical Massage together generates the fastest improvement for their patients.
Why Should Physicians Send Patients to the Wellness Center?
Sending patients to the Wellness Center for a Medical Massage will be a good experience for everyone. We intend to have good relationships with partnering physicians by communicating regularly about each patient with the understanding that your time is limited and valuable. Therefore, we know that when you send patients, you trust us to stay within the bounds of your prescription. For example, if you refer a patient for cervical sprain/strain, your patient will be treated for cervical sprain/strain and nothing else.
Wellness Massage is ideal for relaxation, easing aches and pains, soothing tired muscles, improving circulation, and promoting a sense of well-being. It is commonly used with good results by those who are well and want to remain well. Wellness massage, paid for at the time of service, is usually booked for 60- or 90-minute increments.
Medical Massage is used to treat specific health conditions, which are diagnosed by your family physician or specialist. Medical Massage is typically utilized with such medical issues as scoliosis, adaptive myofascial shortening injuries, joint replacement, back pain, stroke, cancer, etc. This treatment emphasizes the three areas of the body: torso, upper extremities, and lower extremities. In all cases, a prescription is required from a physician and only those areas identified by the physician are treated. In some cases, Medical Massage is covered by your personal insurance.
Benefits of a Medical Massage
If recovering from soft tissue injuries or other muscle tissue conditions, a Medical Massage is worth considering and will be beneficial. Medical Massage can aid recovery from accidental whiplash or other sprain/strain injuries of the torso, arms, and legs. Patients recovering from surgeries, sports injuries, carpal tunnel syndrome, thoracic outlet syndrome, scoliosis, and fibromyalgia, to name just a few, can be treated.
Expectations from a Medical Massage
In the first session, your condition will be evaluated. Assessments by palpation as well as a series of range-of-motion tests help determine your passive (we move the muscle groups for you), active (you move the muscles yourself), and resisted (you move the muscles against resistance) range-of-motion. We also check for contraindications (i.e., a symptom or condition that makes a particular treatment or procedure inadvisable). Medical Massage assesses your stage of healing and formulates a treatment plan based on your physician’s diagnoses and orders, as well as the findings of our evaluation. On this visit, you fill out the necessary paperwork and insurance forms. Following the evaluation, you may receive a treatment, depending on your stage of healing and your physician’s prescription. This first session includes one/some of the following: regular massage, hot or cold pack application, trigger point therapy, assisted stretching, muscle-energy techniques, contract-relax-stretch techniques (Proprioceptive Neuromuscular Re-education), or other manual therapies.
Receiving a Medical Massage and Physical Therapy
Although simultaneous therapy is a common medical practice, your physician must approve this plan. Combining therapies generates the most improvement and speeds up recovery. Avoid scheduling Physical Therapy appointments on the same day as your Medical Massage, or your insurance company may choose not to pay for one or the other. Several months of regular treatment may pass before you’re notified that your insurance company won’t pay.
Coverage and reimbursement are determined by your insurance carrier. As a result of Personal Injury Protection, automobile insurance policies are required to pay for what your doctor finds medically necessary. Some other types of policies also pay for medical massage, including Worker’s Compensation. If you request our help, we are happy to call your insurer and find out about your exact coverage.
Code of Ethics
We follow a strict code of ethics from Medical Massage training. The length of treatment is determined by the areas diagnosed. On each date of service, a maximum of two physical, medicinal CPT (Current Procedural Terminology) procedures–15 minutes each per body area can be scheduled. A maximum of four total CPT codes per date of service may be billed to insurance. The three body areas considered industry standard for physical, medicinal billing are the axial skeleton (torso), the upper, and the lower extremities. Four total CPT codes require that a minimum of two or more body areas are diagnosed for treatment. If three body areas are diagnosed for treatment, the maximum CPT usage is still limited to four. If we are given four diagnosis codes, but all of them are in the axial skeleton, the patient is allowed only two CPT codes per date of service. To avoid complications of billing, the patient must not schedule us and the physical therapist on the same day.
Note: If we achieve MMI (Maximum Medical Improvement) for that day of service before the time allowed by the Medical Massage standards, we will bill for the lesser time.