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Different Approaches to Massage Therapy: What Is Best For You?

By Luis Gerardo Galvan Reyes, RMT.
January 24th, 2017.

To state the obvious, I'll start by saying that not all Massage Therapy treatments are the same. And this is because every person has a particular need: either alleviate pain, reduce stress, help with the healing process of a new injury (or an old one), aid sleep, etcetera.

According to Sandy Fritz, depending on the person's needs there are three possible ways to approach their treatment: palliative care, condition management, and therapeutic change.1

Although palliative care is often associated with terminal stages of life threatening conditions, the term is broader by definition: it means to soothe or relieve. Meaning that "Massage can be soothing and can provide comfort, whether the client seeks relaxation to meet pleasure needs, to cope with some type of chronic pain, or to make the transition from life to death".2 This approach is used when a person seeks to reduce the intensity of uncomfortable symptoms but doesn't try to be cured, either because there's no condition (ie. someone looking for a relaxation massage after a long stressful day) or because the condition is not treatable. The term palliative care also applies for modalities like pregnancy massage, massage during labor, spa/vacation massage, sports massage, event massage (ie. prior to a wedding or a significant event that may become stressful), chair massage, corporative massage, etcetera.

Similarly, "condition management is the use of massage methods to support clients who are not able to undergo a therapeutic change process but who want to live their life to the fullest within an existing set of circumstances."3 This approach is useful when a person is dealing with chronic health conditions (including chronic stress), but is also an appropriate approach when they can't commit to a therapeutic process. Physically, massage offers benefits by managing the existing signs and symptoms, and even slowing the progression of certain chronic conditions, or preventing a situation from becoming worse. Emotionally, massage assist in the management of physical stress symptoms, allowing a person to cope better with life stress that cannot be altered (ie. due to a family situation, work, etcetera).

Therapeutic change is defined as "a beneficial alteration in the clients physical, mental, and/or spiritual state that results from a therapeutic massage process."4 Although this is one of the most sought after kinds of care, some people opts to stay in the conditional management level. This is because this approach requires considerable more expenditure of energy and resources that the other two: it is considered active change. Aside from the skills of a Massage Therapist to treat and guide a client through this process, it is often necessary to develop a network of support with other health professionals, and the client must have the motivation and resources (ie. information, time, social support, money, coping mechanisms, etc.) to complete the change process. Given that people's life can be very complex, this kind of commitment is hard to achieve. However, it is important to know that there are many different injuries and conditions that grant a therapeutic change approach, in some cases this is the obvious way to treat (ie. a sprained ankle, muscular imbalance, etc.), in some others there are more factor to consider before deciding for this type of care (ie. treatment of scar tissue, treatment of postual deformities, etc.)

Infographic: Which Massage Therapy approach is best for me? Click here to open as PDF

Considering this facts, it's easy to understand why condition management accounts for the largest client base for therapeutic massage: "many people find themselves in undesirable or unchanging circumstances and search for ways to cope with, but not necessarily change, the existing conditions while remaining productive.5

Luckily, Massage Therapist are prepared to discuss and guide you through an informed decision making process, in order to aid your choice of a Massage Therapy treatment that will work best for you, giving you the best possible outcome. During this process, be very comfortable about asking questions, voicing concerns, and expressing your wishes; in the end, this information will help to determine which approach to treatment is appropriate for you.

One last thing to consider is that a therapeutic process is ever changing in nature, it can be modified and adapted according to outcomes, new challenges, shift of goals, etc. This means that a treatment under the condition management banner can become palliative care, or turn into full on therapeutic change. Either way, your best interest should always be in everybody's mind.

I hope you learned a little bit after reading this piece, and that my writing was clear enough to make it easy to read. If you ended up with more questions than answers, please feel free to ask away, email me to putting "ARTICLE 2017-004: Question" as subject, or "ARTICLE 2017-004: Feedback" if you just want to make a comment or point out errors in the presented information. If you want me to write about a topic in particular please request it with the subject "ARTICLE Topic: Suggestion".

Thank you for reading, see you next week!


(1) FRITZ, Sandy. "Mosby's FUNDAMENTALS of THERAPEUTIC MASSAGE" Indications and Contraindications of Therapeutic Massage: Approaches to care, 5th ed. (USA, Elsevier, 2013): 201.

(2) FRITZ, Sandy. Ibid: 202.

(3) FRITZ, Sandy. Ibid: 201.

(4) FRITZ, Sandy. Item.

(5) FRITZ, Sandy. Item.

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