Medical Massage

Manual Therapy & Treatment

A manual therapy and treatment practice based on the scientific principles of physiology to heal connective tissue and enhance musculoskeletal function. Medical Massage Therapy works best when it is coordinated with additional medical treatments offered by other professionals.

Medical Massage
Medical Massage Therapy is a system of manually applied techniques that can achieve the following:

  • relieving and reducing pain
  • establishing normal tissue tension in sensitive areas
  • creating a positive tissue environment
  • normalizing the movement of the musculoskeletal system


Layman’s Terms

Medical Massage’s purpose is to assist the physician’s diagnosis with progressive treatments that improve the patient’s condition. A nationally certified therapist or trained massage therapist with equivalent qualifications works within physician guidelines, utilizing a variety of techniques for specific curative outcomes.


A Medical Massage Therapist’s Qualifications

The qualifications to be a Medical Massage Therapist primarily include:  1) necessary skill formation with 600 plus hours of traditional massage curriculum at a state licensed training facility and 2) passing a licensing examination to practice, which varies in each state. Choosing to become a Nationally Certified Medical Massage Therapist (NCMMT), however, involves intensive training and expert supervision in the areas of orthopedic evaluation, curative physical medicine, and proper documentation. After completing a rigorous program of study and skill development, the therapist must take the American Medical Massage Association licensing examination. Once the exam is passed, the licensing board then reviews & accepts credentials.


For instance, David A. Clinger—owner and senior Licensed Massage Therapist of the Wellness Center for Therapeutic Massage and Bodywork—was the first Nationally Certified Medical Massage Therapist in Ohio. Having completed required coursework and passed rigorous examinations, David now has the distinction of being a Master Medical Massage Therapist.

Following the Doctor’s Orders

To request a Medical Massage, patients must obtain a prescription from their family physician or specialist. To legally treat a patient, massage therapists must know what medical conditions are being treated. Since making diagnoses is beyond the scope of massage therapy, medical massage therapists work solely from a physician’s orders. If physicians have questions about intake procedures, they are encouraged to contact the Wellness Center for an explanation.


Common Medical Conditions Treated by Medical Massage Therapy

Medical Massage Therapists help relieve the underlying pain and suffering of patients who battle any number of conditions and ailments. Medical Massage treats patients with these pre- and post-operative conditions:

  • work related injuries, such as carpel tunnel syndrome, sciatic nerve dysfunction, lower back pain
  • personal injuries such as auto accidents and physical trauma
  • cancer conditions, such as incomplete lymph systems and lymphedema
  • joint replacement
  • frozen shoulders

Medical Massage


What Physicians Must Know

We can help, when you want quality Orthopedic Medical Massage as well as professional, consistent therapy that gets results for patients recovering from soft tissue injuries.

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 with your prescribed treatment goals, we will not stray from them, regardless of patients’ requests. When you send patients to the Wellness Center for a Medical Massage, they will receive outcome-based, soft tissue techniques designed to increase range of motion and decrease pain in diagnosed areas.

What Patients You Should Send for a Medical Massage?

Typically, prescriptions are written for patients who are or have experienced soft tissue injuries.  Thus, medical massage is a viable treatment for patients recovering from automobile accidents, surgeries, and sports injuries. Medical Massage Therapists also assist patients suffering from scoliosis, myofascial shortening, carpel tunnel syndrome, surgical joint replacements, back pain, stroke, cancer, etc.

How Do We Meet Your Expectations for Quality Care?

Your patient will be assessed in the first session through a series of range of motion tests that confirm passive, active, resisted range of motion conditions. Then we identify 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 our findings. Immediately after the initial session, we consult with you, if we find contraindications to discuss the appropriate responses. You’ll receive updates and, thus can oversee the entire care plan.

Following the initial 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; Myoskeletal Alignment Techniques (MAT), instrument-assisted soft tissue mobilization, or other manual therapies.

What Not to Expect?

Most massage therapists offer instructions in stretches or exercises that clients may do at home or advise clients to drink plenty of water following treatments. This is sound advice in most cases, but the medical massage model is different. Although we have been trained in stretches and therapeutic exercises, we will not offer post-treatment advice, unless you specify such instructions 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 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 positive relationships with partnering physicians by communicating regularly about the status of each patient, understanding that a physician’s time is limited and valuable. Also, Wellness Center therapists will stay within a physician’s prescription guidelines. For example, if patients are referred with cervical sprain/strain, their treatment will be confined to the cervical region, and nothing more.

Code of Ethics

The Wellness Center follows the strict code of ethics for medical massage. The three body areas considered the medical standard for physical, medicinal billing are the axial skeleton (torso), the upper extremities, and the lower extremities. For billing, the length of treatment is determined by the physician diagnosis. On each date of service, a maximum of two physical, medicinal Current Procedural Terminology (CPT) procedures—15 minutes each per body area—may be scheduled. A maximum of four total CPT codes per date of service may be covered by insurance. Four total CPT codes require a minimum of two or more body areas be diagnosed for treatment. If three body areas are diagnosed for treatment, the maximum CPT usage is still limited to four. For example, if three or more diagnostic codes are suggested on the axial skeleton, the patient is allowed only two CPT codes per date of service. Also, to avoid complications of billing, the patient must not schedule medical massage and physical therapy on the same day.

NOTE:  If Maximum Medical Improvement (MMI) is achieved before the time allowed by the Medical Massage standards, billing will cover the lesser time only.


Medical Massage or Wellness Massage—The Difference

Wellness massage is ideal for relaxation, easing aches and pains, soothing tired muscles, improving circulation, and promoting a sense of well-being. Wellness massage—commonly used by those who are well and want to remain well—is paid for at the time of service and usually booked for 60- or 90-minute increments.

Medical massage, however, is used to treat specific health conditions, which are diagnosed by a 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 three areas of the body:  torso, upper extremities, and lower extremities. In all cases, a physician prescription is required and only those areas identified by the physician are treated. Medical massage may be covered by personal and/or auto insurance.

Benefits of Medical Massage

If recovering from soft tissue injuries or other muscle tissue conditions, 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. Also, patients recovering from surgeries, sports injuries, carpal tunnel syndrome, thoracic outlet syndrome, scoliosis, fibromyalgia, to name just a few, can be treated.

Expectations from Medical Massage

During the first visit, a patient’s condition is evaluated. Assessments by palpation as well as a series of range-of-motion tests help determine passive (therapist moves muscle groups), active (patient moves muscles), and resisted (patients moves against resistance) range-of-motion. Also, therapists check for contraindications (i.e., symptoms or conditions that make a particular treatment or procedure inadvisable). Medical Massage assesses the stage of healing and formulates a treatment plan based on a physician’s diagnoses and the initial evaluation. On the first visit, necessary paperwork and insurance forms are filled out. Following the evaluation, a treatment may be given, depending on your stage of healing and physician’s prescription. This first session includes 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 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. Note:  Several months of regular treatment may pass before you’re notified that your insurance company won’t pay.

Insurance Reimbursement

Coverage and reimbursement are determined by insurance carriers. As a result of Personal Injury Protection, automobile insurance policies are required to cover only what a doctor finds medically necessary. Other policies may also pay for medical massage, including Worker’s Compensation. The Wellness Center is able to offer guidance or information on insurance coverage, if requested.

Code of Ethics

The Wellness Center follows the strict code of ethics for medical massage. For instance, the length of treatment is determined by the physician’s diagnosis. (For more explanation of insurance coverage, refer to the Code of Ethics under the Physician’s Information.) Also, to avoid complications of billing, the patient must not schedule medical massage and physical therapy on the same day.

NOTE:  If Maximum Medical Improvement (MMI) is achieved before the time allowed by the Medical Massage standards, billing will cover the lesser time only.