Updated: Dec 3, 2019
What is medical massage?
Medical Massage is a customized Therapeutic Massage prescribed by a medical provider and performed according to the directives of that medical provider. The Medical Massage Therapist specializes in working target areas, using different modalities to treat what is causing the patient pain. The therapist increases blood flow to the area, works on relieving pain in soft tissue, and increases the functionality of the area. Here at Healing Solutions Inc, we document our treatments using SOAP notes and work with medical providers to help clients reach their health goals and live life with less pain.
Auto Accidents and the Need for (Immediate!) Medical Massage
Automobile accidents can be traumatic, even when only minor injuries are sustained. Furthermore, minor injuries can be a long-term danger if left untreated, which is why a doctor or chiropractor may prescribe medical massage as part of a patient’s treatment plan following an accident.
Medical massage can relieve muscular pain, rebuild strength, improve range of motion, and facilitate robust healing – when applied judiciously by a trained healthcare provider.
The physics of car crashes are well researched and documented, but we’re still learning more about how the many variables that occur inside the car affect the outcome. Because our understanding of automobile injury has evolved in recent decades, so too has the medical community’s position on how to treat those injuries.
Common Car Crash Injuries
We know, of course, that automobile accidents often lead to injuries. The most common are:
Brain injuries, known as TBI (traumatic brain injury), which can include mild concussion and severe injury that leads to impairment.
Other head injuries, such as eye injuries, bruising, ear injuries, facial or jaw injuries, and dental trauma.
Neck injuries, this can also cause headaches
Chest and Shoulder injuries, which can include fractured or broken ribs or sternum. Airbags and seat belts have helped to reduce the incidence of these types of injuries, but they still happen.
Diaphragm injuries like torn muscles or ruptures are common after blunt force trauma to the chest – such as the impact of a steering column.
Abdominal injury, particularly to the liver, kidney, and spleen are common in side-impact and head-on collisions.
Hip fractures and pulled or torn muscles in the hips.
Leg, Foot and Knee injuries range from contusions to multiple fractures are common when the body impacts or is crushed by part of the vehicle. Meniscus tears are also notably prevalent in automobile accidents.
Neck and back injuries are by far the most commonly reported aftereffects of a car crash. Even “fender bender” incidents and minor collisions can cause whiplash.
Whiplash, this is further discussed below.
Psychological stress is another factor. Automobile accidents are high-stress events, and multiple studies show that the psychological impact of a collision can be very serious.
How Medical Massage Can Help Patients Recover After an Accident
When medical massage is part of the treatment modality for injury recovery, the practitioner will have several basic goals:
Reduce the patient’s stress
Reduce pain, swelling, and inflammation
Improve the patient’s blood circulation in order to promote faster healing
Improve the patient’s range of motion to discourage any loss of mobility or function
First, let us address stress relief.
Medical massage promotes a sense of wellbeing in the patient by restoring balance to their autonomic nervous system. Thus, the relaxation aspect of massage can have an immediate ameliorating effect on a patient, helping to reverse some of the trauma and shock visited upon them by their accident.
Now, we can spend a moment on pain, swelling, and inflammation.
Medical massage also reduces pain, swelling, and inflammation, when properly applied. This is possible because the medical massage treatment reduces levels of cortisol and cytokines in the body. Cortisol is, of course, popularly referred to as the “stress hormone,” and cytokines contribute to inflammation.
An important – and often overlooked – benefit of medical massage is that medical massage can reduce the need for pain medication. Most pain medication, of course, carries risk factors including addiction and a compromised mental state. Opioids such as Percocet and Vicodin are often prescribed after an injury that might require pain management, but they are not without serious risks. Medical massage will reduce a patient’s reliance on medication to manage their pain.
Regarding circulation, medical massage has been shown to positively affect blood flow and lymph circulation. This helps minimize the edema (swelling and fluid retention at the site of injury) associated with auto accidents.
During the days, weeks, or even months of rehabilitation that can follow a crash, loss in range of motion is possible, particularly if the injuries will form scar tissue or musculoskeletal adhesions.
How Even Fender Benders Can Lead To Long-Term Pain
Often, a person who has been in a particularly minor crash won’t even realize they were injured for days after the accident. When a crash happens, muscles tense up, and it can take some time for soft tissue damage to become apparent. Seat belt rash, contusions, and whiplash are documented in even the simplest fender benders.
Not seeking medical attention could lead to a long-term chronic pain condition. It simply isn’t worth the risk, which is why it is important to add the highest amount of “Med Pay” coverage to your auto insurance policy, in Colorado. “Med Pay” covers you and your passengers if you are at fault for the accident or if the other vehicle owner is at fault and underinsured. “Med Pay” will give you access to medical services without the headache and expense of going through your health insurance or HMO. In other states around the U.S., the personal injury protection (PIP) clause is on almost all automotive insurance policies. However, due to insurance companies changing their coverage, you should review your coverage with your insurance agent to make sure that you have the coverage that you want and need.
Whiplash and Medical Massage
Because whiplash is the most common complaint after an accident, medical massage practitioners have a lot of experience with managing pain and recovery.
What is whiplash?
Whiplash is a neck injury – specifically, it’s a strain of the sternocleidomastoid (SCM) muscles, which are the ones you use to tilt your head and look around. Sudden movement – such as the back and forth motion that happens when your car is struck – can tear or strain those muscles, often quite badly. That type of hyperextension injury or cervical sprain is what we mean when we say whiplash.
Most people with whiplash will recover in a few months, but there are thousands of cases of patients who deal with symptoms ranging from an occasional pins-and-needles feeling in the neck all the way up to severe chronic pain for years following an accident. Swift and comprehensive treatment is the best way to avoid this.
The symptoms of whiplash can take up to 24 hours to manifest, and include:
Tightness, soreness, and stiffness in the neck
Dizziness, pain, or problems with balance
Ringing in the ears
Swelling or tenderness
Difficulty chewing or swallowing
If a patient experiences any of these symptoms, medical massage can help. In fact, studies in recent years show that keeping the neck mobile during recovery is more useful than cervical spine collars, even in serious cases of whiplash.
A few useful ways to apply medical massage to whiplash are:
Trigger Point Therapy or Myofascial release. This is a technique that involves the application of pressure to tender muscle tissue, which relieves pain and dysfunction, tension and stiffness in the muscles and fascia to restore blood and lymph circulation, restore and improve a comfortable range of motion, and relieve the holding patterns and misalignments whiplash often causes.
Deep tissue massage. Once the acute stage has passed and superficial muscle relaxation is achieved, deep tissue work can help underlying fascia stiffness, and reduce adhesions and the formation of scar tissue. While care must be taken to work within the limits of the patient’s pain tolerance, deep tissue massage can do amazing things for range of motion, freeing tissue that may have clustered up around nerves.
Medical Massage Provides Peace of Mind After An Accident
There is no reason a person, following a car crash, shouldn’t at least ask their physician or chiropractor about medical-massage. Even – and perhaps especially – those people who feel that their accident was “too minor” to warrant medical care should ask about massage.
Insurance will cover the cost, and the patient will not be required to wait for care. Medical massage will aid in a speedy recovery and reduce or possibly eliminate the need for medication.
As mentioned above, soft tissue injuries are not always felt immediately. In fact, sometimes it takes days or weeks before something like whiplash or edema is painful enough to be truly noticeable. In extreme cases, it could be six months before symptoms arise. At that point, insurance will deny the claim, and suddenly, the healing process will be disastrously expensive.
That’s why it is good practice – both fiscally and medically – to seek treatment immediately, and to ask about medical-massage.
Choosing a Medical Massage Therapist: Do’s and Don’ts
Once a patient has been recommended for medical massage, it’s time to choose a qualified therapist. Here are a few quick do’s and don’ts for anyone seeking such treatment:
Do communicate directly and openly with any potential therapist. Your needs are of paramount importance, and should be expressed very clearly. Don’t be afraid to be high maintenance.
Don’t go to a massage chain. They lack the training you need, and an inexperienced provider could do far more harm than good, especially when injury recovery is involved.
Do clarify that the massage therapist is trained in “medical massage,” and be particular about that requirement. Massage for relaxation or pleasure is not the same thing.
Do feel free to quiz your therapist about their qualifications before choosing them. Their credentials are their proof that they can aid in your recovery without causing you pain or risking your health in any way.
Don’t allow any therapist without a thorough grounding in soft tissue injury care lay their hands on you. While medical massage can (and should) be an incredibly helpful tool in aiding your recovery, it can have the opposite effect if the therapist lacks the right skill set.
Medical Massage Therapy Through Workers Compensation
Workers Compensation is insurance coverage purchased by the employer/business that provides benefits for job-related employee injuries. Laws require all employers to purchase workers' compensation coverage (with a very few exceptions). Under a workers' compensation policy, employees are compensated for occupationally incurred injuries, regardless of fault.
Workers compensation claims
1. Allow injured workers to get medical care for injuries that happen at work. Back injuries, knee, hand, neck, arm are all covered.
2. Provide wages when you are not able to work
3. It is state regulate
Why medical massage is useful with Workers Comp cases
1. Medical massage helps the body to heal and will help worker’s return to work faster.
2. Helps reduce the need for pain medication
3. Medical massage can help workers regain their mobility and range of motion.
How to check if you are eligible to have Medical Massage covered by Workers Compensation
Workers Comp will cover medical massage sessions. There are requirements that must be met in order for you to receive medical massage as a Workers Comp benefit.
Requirements include the following:
- Your Workers Comp approved Doctor/Practitioner will need to prescribe the medical massage
- Take the prescription for medical massage to a medical massage therapist who accepts
- Workers Comp Insurance Cases
- Your medical massage therapist will call your Workers Comp provider to get approval for the sessions your Doctor prescribed to you.
Working with Healing Solutions Inc. Boulder and Healing Solutions Inc. Broomfield for Workers Compensation cases:
Process of scheduling appointment:
Must have a prescription for medically necessary massage from Workers Comp approved Doctor. Your prescription will need to be emailed or faxed to our massage therapist’s office prior to scheduling an appointment.
Your Medical Massage Therapist’s office will call your Workers Comp adjuster to get approval for your sessions. Once you are approved, then your appointment will be scheduled.
What to expect:
When you come to your first visit, your medical massage prescription must be provided if you haven’t sent it to us ahead of time.
You will fill out paperwork about your injury and how it occurred, and also fill out a HIPPA form to allow your medical massage therapist to talk to your doctor about your injury.
An evaluation of your injury will be completed by your medical massage therapist.
The injured area will be worked on to improve range of motion, reduce your pain levels, and improve movement.
After your session, we will schedule the rest of your sessions according to the details outlined by your prescription, whether that be one massage per week or two massages per week.
On your fourth visit, an assessment will be done to see what improvement medical massage has provided you, and we will determine whether more sessions are needed to continue improvement.
If more sessions are approved, then treatment will continue until you reach maximum medical improvement from massage.
If there is no improvement, then your medical massage therapist will send notes to your doctor that will assist them in finding a better way to gain results from your further treatments.
All claims will be billed to your Workers Comp company. Session notes and evaluations will be sent to your Workers Comp Doctor and to your Workers Comp company for reimbursement.
IT IS CRITICAL that patients come to ALL their appointments. Missed appointments may jeopardize their claim.
Some Need to Knows About MedPay, FSA, and HSA
Medical Payments Insurance or MedPay Insurance is a rider on your auto insurance. This protects you regardless of who caused the accident. Medical Payments coverage, also known as MedPay coverage, pays medical expenses for you and any passengers in your vehicle who are injured during an accident or auto-related injury.
If you are at fault MedPay is the policy that would cover your care. MedPay coverage is an addition to your auto insurance. It is something you are already paying for to protect yourself and to utilize in these types of situations. However, Colorado considers MedPay optional, so you may have rejected this policy. Keep in mind that MedPay can be used regardless of fault and will not increase your rate if you are not at fault. If you are at fault your insurance company has the ability to raise your rates, but not all do. Depending on your policy, MedPay will allot a certain amount of money to cover medical expenses, including Medical Massage. For all cars insured after January 1, 2009, in Colorado, the minimum MedPay coverage offered to the driver is $5,000 (unless you rejected this coverage) to be used towards medical needs. MedPay initially covers any emergency facilities and/or emergency transport companies, then the remainder can be used to compensate any other injury-related medical expenses that are reported to the insurance companies, which includes Medical Massage.
If the other person is at fault you can use your MedPay benefits to get immediate care. Their insurance with then cover your medical bills when all treatment is complete or the insurance will refund your MedPay expenses. You may also consider working with an Attorney Lien to assist you with your claim if funds are exhausted or not enough to cover your medical needs. Healing Solutions Inc. will work with you and your attorney, if a lien is needed, to get Medical Massage as part of your care.
Employer Benefits Programs FSA/HSA
Employer’s offer several benefit packages to their employees. Here at Healing Solutions Inc. we accept both FSA and HSA accounts on a tax deferred basis. Both are health care plans that assist in paying for medically-related expenses. The FSA is similar to personal savings accounts, but for medical expenses, in which an amount is decided upon by the employee to be deposited into that account. The funds can be used by account holders, spouses, and dependents toward qualifying medical expenses. This includes, but is not limited to co-pays, deductibles, qualifying prescriptions, and qualifying medical equipment. For a full list you can view the IRS’ Publication 502, Medical and Dental Expenses.
FSA (Flexible Spending Account)
Must include a Doctor’s prescription/referral from a primary care physician or chiropractor to utilize
No restrictions on what type of health insurance you have. You do not even have to have health insurance.
Up to $500 can be carried over to the next year.
HSA (Health Savings Account)
Allows you to pay for current and future health expenses.
All of the money in the savings account belongs to you.
Employer can contribute to HSA and tax deferred.
Limited to those with qualifying high-deductible health plans.