Massage: A useful adjunct to traditional programming
Massage: A useful adjunct to traditional programming
Technique can improve some injuries’ outcomes
Most people think of massage as a luxury — something you might treat yourself to once in a while — but employee health professionals are discovering that therapeutic massage can be a valid treatment option for many work-related injuries.
Much like chiropractic care, a closely related field, massage therapy has earned more respect in recent years as health care professionals learn it is a serious treatment option that can offer significant benefits when used properly.
Occupational health and wellness is a perfect field for using massage, some proponents say, because many of the injuries that make up the bread and butter of such programs respond well to massage therapy.
Massage becoming more acceptable
Massage has been offered through the occupational health department at Pottstown (PA) Memorial Medical Center for two years, says Robin McMonagle, PT, administrative director of rehabilitation services. She works closely with the occupational health program at the hospital to provide a range of massage services, which she says are becoming more accepted by both health care professionals and the public.
"It still is difficult sometimes to sell the idea of massage because it’s seen as a nontraditional therapy," she says. "It helps that people are becoming more educated about their own health care, so they sometimes bring up the idea with the doctor."
The same skepticism has been seen by Alexis Moraitakis, RN, LPN, director of Body at Ease, a massage therapy program associated with Piedmont Hospital in Atlanta. Moraitakis was a nurse for 13 years at Piedmont Hospital before entering the massage field, and says there has long been a reluctance to see massage as a serious option for treatment. Many health care providers consider massage as a practice that relieves stress and makes the person feel good, but they have not seen any true medical benefits.
That is now changing, she says. "Health care professionals are getting a better understanding of massage, with a lot of them accepting it as a great noninvasive alternative therapy," Moraitakis says. "Ten years ago, I had one doctor referring patients for massage therapy, but now I probably have 15 who see it as a real option and refer patients to us."
Back injuries benefit from massage
Most of the referrals come from occupational therapists and physical therapists, and a significant number of the injuries are work-related, she says. Back injuries, not surprisingly, are some of the best candidates for massage intervention.
No matter how much an occupational health provider is convinced of the value of massage, billing for massage therapy still may be a problem. Many health care insurers have not accepted massage therapy as a valid treatment option. Billing can be a problem sometimes because massage does not fall into the normal course of treatment that insurers expect, and there’s still that nagging image problem of massage as just a feel-good luxury.
Workers’ compensation insurance often will pay for massage therapy as long as the patient is properly referred, Moraitakis says, but she has encountered problems. If you choose to ally with a massage therapist who is not familiar with the intricacies of workers’ comp billing, you should offer a few tips from your own experience.
"I learned the hard way that they want it just the right way, and workers’ comp is not our usual field," she explains. "I once billed for two hours of massage with a client, and the insurer paid me for two 15-minute increments. They said everyone knew they accepted billing only in 15-minute increments and just looked at the two’ on my paperwork." She eventually collected the rest of her fee.
If you wish to incorporate massage into your employee health program, it may be as simple as contacting a local massage therapy program or individual massage therapists to learn more about how and when massage is an appropriate intervention for your patients.
When looking for a massage therapist to work with, be very careful in seeking professionals with the proper training, cautions Dana Hasbrouck, NCMT, NMT, a nationally certified massage therapist in Atlanta who works with Moraitakis’ program. If your state requires massage therapists to be licensed, that is a big help.
"If your state does not require licensure, then anyone can do massage and call themselves a massage therapist," she explains. "Stay away from the Yellow Pages when you’re looking for a massage therapist unless your state requires licensure. Otherwise, you’re going to find a lot of people who offer massage but may not know anything about the ways massage can help people with injuries."
Instead, Hasbrouck recommends contacting massage schools in your area or asking for referrals from other health care professionals. Seek references from physical therapists and occupational therapists in particular, since they are most likely to have some familiarity with massage and may have referred patients already. Make sure the massage therapists you ally with are properly certified — especially if your state does not require licensure. Look for these credentials:
• NCMT — nationally certified massage therapist;
• NMT — neuromuscular therapist.
Employers may pay for stress relief
In addition to massage therapy for the treatment of work-related injuries, massage can be offered to employers as a form of stress relief to improve productivity. Many massage therapy programs, or individual massage therapists, offer work-site massage in which one or more therapists provide "chair massages" for workers. Some employers refer to them as "coffee-break massages," or use similar terms. The worker remains fully clothed and sits in a special chair for a massage that usually lasts about 20 minutes. The service can be provided for a large number of workers at once by using multiple therapists.
"Therapists usually charge about $20 each, or a dollar a minute," Hasbrouck says. "A lot of companies offer that service at break times or at lunch, so that the worker returns to work refreshed for the rest of the day. It’s been proven that a brief massage can boost productivity for the rest of the day."
Some companies pay for the massages, which obviously improves worker participation, and some will only bring in the massage therapists and require workers who choose to participate to pay for their own. If workers have to pay for their own chair massages, that will greatly decrease the benefit of offering the service and promotes the image that massage is a luxury for executives. A better compromise is for the company to subsidize the cost by paying most of the massage therapists’ fees, so the employer pays only a small sum such as $5.
On-site massage popular
McMonagle’s program offers on-site chair massages to employers, and she says about half pay for the massage, while the rest just allow employees to purchase the service. She notes that on-site massage is more popular among office workers, perhaps because the employers tend to better understand the therapeutic nature of massage. Also, she says, manufacturing employees tend not to be as familiar or comfortable with the idea of massage. Industries also may be reluctant to take people off the line for massages.
The occupational health department at Pottstown markets the on-site massage service with a soft sell, just mentioning that the service is available and perhaps suggesting it as a stress reliever when the company is in a particularly busy period. The physical therapist also may suggest the on-site massage when she is on site providing other services.
Hasbrouck notes there is some conflict between promoting the idea of on-site massage for stress relief and countering the misconception that massage is just a luxury rather than a valid medical treatment. There’s no actual conflict, she says, as long as you take the time to educate people about the benefits of the service you’re offering.
"There’s nothing wrong with the idea of promoting that massage feels good, except that sometimes that’s all people think it does," Hasbrouck says. "Sometimes massage hurts. It can be like physical therapy in the way it hurts sometimes. If we’re going to accomplish something for the client, it can’t always feel good."
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