Massage Therapy

Massage, Chiro or Physio – Which one should you choose?

August 24, 2020
massage, chiro or physio branded featured image

Have you ever found yourself injured and not knowing how to proceed? You think, “How will I fix this? Who can help me?” Then you realize that there are many options and not all of them are cheap! You know you can’t afford to stay in pain but you’re not sure where to begin. 

Sound familiar? It’s okay if it does. I understand the frustration. When an injury occurs, aside from going to your family doctor, you will usually require one of the following if the injury is minor. Massage Therapy, Chiropractic or Physiotherapy. The problem for most people is they don’t know which one to choose. This is because most people don’t know the difference between them! 

Today we’re going to talk about that. I’ve had many clients who came in for a Massage when what they needed was chiropractic care or vise versa. Part of my job is to refer out to another practitioner if Massage Therapy can’t help them. Though, I often think, if these clients knew how to recognize when they needed one service over another, they would save themselves some time and money. For that to happen, they need to see the correct practitioner for their problem.


Let’s start with the difference between the services.

Massage Therapy is the manipulation of soft tissue all over the body. Different techniques using fingers, palms, knuckles, and forearms are used with different pressures. The purpose is to manually lengthen muscles to help dissipate trigger points and areas of tight muscle which relieves pain and decreases stress.

Chiropractic Care is the treatment of the body’s mechanical issues within the musculoskeletal system. Manipulations (or adjustments) are used especially on the spinal column and ribs to help alleviate pain from a variety of health conditions. It encourages a  healthy nervous system by alleviating pressure placed on nerves by joints that are pinching them due to them being out of place. 

Physiotherapy is the rehabilitation of acute and chronic injuries. They specialize in mobility and function of muscles and joints. They focus on recovery and prevention of future injuries by improving strength, applying manual therapy and providing the client with home care that consists of strengthening and stretching exercises. 


Now that we understand the difference between the services, let’s take a look at the most common questions asked by the general public for each service. 

Massage Therapy

Massage Therapy photo
What is the importance of Massage Therapy?

Massage Therapy treats painful, acute and chronic conditions caused by muscles. It helps decrease muscle tension and trigger points that can cause debilitating pain that can affect daily activities.

Due to the release of endorphins, having a massage can also help a person gain a higher sense of well being. One may feel more relaxed and happier immediately after a massage.

How do you know when you need a massage?
Signs you need a massage photo
Signs you need a massage – pain when exercising, general muscle pain or tension, carpel tunnel syndrome, tennis/golfers elbow, headaches.

There are many ways to know when you need a massage.  If you know you are suffering from any of these conditions, you should book a massage treatment.

  • Headaches
  • Sharp shooting pain
  • Muscle weakness
  • Negative mood
  • Insomnia
  • Limited range of motion of limbs
  • You have achy or burning pain
  • You feel stressed
  • You feel tight in certain places
  • You just have pain
  • It hurts after you exercise
  • What conditions can massage help with?
  • Headaches
  • Frozen shoulder
  • Carpal tunnel syndrome
  • Muscle Strains
  • Rotator Cuff Syndrome
  • Ligament/Tendon Sprains
  • Tennis elbow
  • Golfers elbow
  • Sciatica
  • Piriformis syndrome
  • Low back pain
  • General tension
  • Trigger point pain
  • Myofascial Pain
How do you know if you’ve waited too long for treatment?
Body Pain photo
Signs you need a massage – back pain, neck pain, headaches

You’ve waited too long to get a massage treatment when you experience the following:

Burning Pain

This happens where there is not enough oxygen getting to your muscles which causes a buildup of lactic acid. Muscle tension and trigger points can prevent oxygen from circulating throughout muscles.

Constant Sharp Pain

Constant tightness of certain muscles can pinch nerves and cause sharp shooting pain. If the pain has become constant then the muscle is constantly pinching the nerve. This can be debilitating.

Achy Pain

Some achy pain is normal after our daily activities of life however, if you have achy pain that is a 7 out of 10 on the pain scale and the pain is constant, you should get a massage.

Restricted Range of Motion

You can’t lift your arm above your head or lift your leg up to walk. You may have muscle tightness or scar tissue formation that is restricting your range of motion and what range of motion you do have is painful.

You Can’t Relax

When your muscles are very tight, in your neck for example, it may be difficult to relax even when you are lying down. You always feel tension or pain in the same areas.

When should you avoid getting a massage?
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When to not have a massage – fractures, IBS, cold/flu, severe joint pain, high blood pressure

There are certain times when even though you may need or want a treatment, you should wait. You shouldn’t have a massage if you have:

  • Certain skin conditions (contagious or otherwise) – warts, boils, rash, burns, open sores
  • Circulatory issues – uncontrolled high blood pressure, varicose veins, blood clots
  • Digestive issues where you can’t lie down for extended periods of time – ex. IBS
  • Claustrophobia issues
  • A cold or flu
  • Inflammation and/or swelling 
  • An acute injury – less than 7 – 10 days old
  • Fractures 
Massage Frequency

This is a question A LOT of people have! I have a very simple answer for you. Most people should have a massage every 4 – 6 weeks for 60 minutes. If your massage therapist puts you on a treatment plan to help a condition you have, follow their recommendations until you get put on a maintenance plan. At that point, my information on massage frequency will apply. It is up to you at that point.

If you aren’t able to manage this due to time or finance issues, my rule of thumb is that the longer you wait between massages, the longer the duration should be. The less time you wait between massages, the shorter your treatments can be. 

For example, if you can only come every 8 – 10 weeks, get a 90 minute massage. Likewise, if you are able to fit a massage into your schedule every 2-3 weeks, have a 45 minute massage. If you can go every single week, go for 30 minutes. You can use this guideline to decide what is right for you.

How much does this service cost?

Massage can be fairly expensive. I work from home and my rates are as follows (not including HST)

30m – $60

45m – $75

60m – $90

75m – $105

90m – $125

However, massage prices can vary from one therapist to another and one business to another, depending on if you’re in a smaller community or a big city. I’ve seen massage prices range from 30 minutes at $45 with no tax to 90 minute treatments that are up to $160 or more. This is just for regular massage therapy treatments. If you get a massage at a Spa and book their signature massage, you could be paying far more than the prices noted above. 

Chiropractic Care

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What is the importance of chiropractic care?

Chiropractic care focuses on spine and nervous system health. It aims to improve the overall function of your musculoskeletal system by way of manual manipulation of joints. Chiropractic care is so important because our joints are constantly moving out of proper alignment due to poor postures or repetitive movements in our day to day lives. 

When joints move out of place, the muscles that are attached to them can either get stretched to their limits or if the joint moves the other way, those same muscles can get squished. On top of this, if joints are not in their proper position, they can put pressure on nerves and cause pain. Ribs that move out of place can mimic muscle pain and cause intense achy pain that doesn’t go away with massage therapy treatments.


One thing I want you to understand is the importance of having both massage therapy and chiropractic treatments simultaneously. Here’s why:

You can massage the muscles all you want, but if the joints or ribs are out of place, your pain will come back quickly (sometimes within a day). This happens because all muscles attach to joints and bone. This means that the joints (if not adjusted) will still either push or pull on the muscles even though the muscles are relaxed which will bring the tension back. 

Alternatively, if your muscles are tight but you get an adjustment and not a massage, the muscles that are attached to the joints and can pull the joint back out of alignment due to the muscle being tight and attached to the joint or bone. Either way, you lose. Which is why you should have both therapies simultaneously. 

How do you know when you need a chiropractic adjustment?
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Signs you need an adjustment – back pain, sternum pain, rib pain

There are a few tell tale signs that you need an adjustment. Once you get to know them, they are easy to recognize. 

Intense Achy Pain

If you have a rib out, you may feel intense achy pain all the time and may have pain when you take a deep breath. 

Sharp Pain in Upper Back

If you have sharp pain in your upper back, that doesn’t lessen after 2 massage treatments, you likely have a spinal joint pinching a nerve.

Feel like it needs to ‘Pop’

If you have hip discomfort where it feels like “it needs to pop”, you may need an adjustment.

Achy Pain Near Sternum

If you have discomfort on one side of your sternum in your chest that feels achy when rotating your upper body, you likely have a rib rotated out of place in your back, but you are feeling it in the front where it attaches. 

What conditions can chiropractic care help with?
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Conditions chiropractic care can treat – whiplash, headaches, joint pain, scoliosis, disc herniation

Chiropractic care can help with a number of acute and chronic conditions including:

  • Headaches
  • Migraines
  • Scoliosis
  • Rib subluxation
  • Rib dislocation
  • General back pain
  • General neck pain
  • Pain for sports injuries
  • Disc herniation
  • Sciatica
  • PSIS pain (Posterior Superior Iliac Spine)
  • Pain from poor posture
  • Limited range of motion
  • Whiplash
How do you know you’ve waited too long for treatment?

Waiting too long for treatment is not a good thing. In fact, you can cause further health issues including re injuring yourself and increasing pain. One important thing to keep in mind is that a lot of chiropractors specialize in car accidents and workplace injuries. In order to get insurance coverage for your injury, your insurance company will require the proper paperwork from your doctor and chiropractor. You need to be able to prove that you are actually injured and are in need of treatment. 

Waiting too long to get treated will show the insurance company that you are not really in pain and can do without coverage and treatment. Do yourself a favor and get treated right away if you’ve had an accident! Below are a few things that you might notice in your body if you’ve waited too long to get chiropractic care.

Pain has become constant

Pain has intensified

You’ve re-injured yourself

Minimal range of motion with pain

When to NOT get an adjustment?

Here are a few instances when chiropractic care may not be appropriate,

  • Bone abnormalities
  • Osteoporosis
  • Spinal Cord compression
  • If you have increased risk of stroke
  • Inflammatory Arthritis
  • Cancer of your spine
  • On blood thinners

If you have a condition you are unsure of, always talk to your doctor and chiropractor to see if you are a candidate for chiropractic care.

Adjustment Frequency

In the beginning, you may need more treatment to deal with your injury before you can move on to the maintenance phase. This means that in the beginning, you might have to see your chiropractor 2 or 3 times each week before moving onto once per week. When you move to maintenance and preventative care, you will begin seeing your chiropractor once every 4 weeks for a quick adjustment.

How much does this service cost?

Chiropractic care can range from $40 up to $65 for a 15 minute adjustment depending on the chiropractor’s experience and expertise. Depending on where you live, there may be tax on top of that as well. 

Physiotherapy

Physiotherapy photo
Physiotherapy
What is the importance of physiotherapy?

If you are having mobility issues of any kind or stability issues when doing certain activities, a physiotherapist can help immensely! They help strengthen your muscles and strengthen your joints so that you can get back to living your life. Without proper mobility, it can be very limiting. 

Signs you need a physiotherapist & What conditions can physiotherapy help with?
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Conditions physiotherapy can help with – mobility issues, sprains, urinary incontinence, recurring pain, car crash injuries

There are certain times when you just know you need help. There are also some tell tale signs if you are unsure. These include,

Mobility issues – If you can’t walk or move around without help 

Balance issues – If you lose balance easily 

Urinary incontinence – caused by a weak pelvic floor

Instability issues – If your knees, hips or ankles feel unstable and shaky when moving

Neurological issues – stroke or accident victims

Surgery is required – physiotherapy can prevent you from needing surgery and help you recover faster after surgery if you have no other option.

Recurring pain issues – If you have pain in your joints that won’t go away after weeks

How do you know you’ve waited too long for treatment?

Here are a few signs that you’ve waited too long for treatment:

  • You can’t walk
  • You can’t move
  • You have constant pain
  • You can’t hold your bladder
  • You feel unstable with basic movements
  • When should you NOT get a treatment?

Physiotherapy is actually the one therapy where you can start immediately after an injury.

If the Physiotherapist prefers you to wait, they will likely recommend that you rest and ice for a few days. Most times, they prefer that you come in as soon as possible so that they can help the injury heal. Doing this allows healing to occur not only faster, but properly.  By doing this, they can ensure minimal scar tissue formation, maximum range of motion returning and pain free movement by the time the injury is fully healed.  

Frequency

This is similar to chiropractic care in the sense that you may have to go multiple times a week in the beginning when dealing with an injury. As your pain lessens and range of motion and stability improves, you can start going once a week and eventually once a month until you are working at full capacity.

Unlike chiropractic care and massage therapy, you won’t need to continue going once a month for preventative care once your body is back up and running. The only thing you may find you need to do for preventive care is continuing with the homecare prescribed by your physiotherapist. Doing your exercises will keep you fully functioning and at your best! 

How Much Does This Service Cost?

Physiotherapy sessions are typically 30 minute sessions depending on the condition and can sometimes be as short as 20 minutes or as long as 45 minutes. The price can range between $50 and $70 dollars depending on their experience and expertise and if you are in a city or in a rural area.


Massage Chiro or Physio Pin for pos

Now that you know the differences between all 3 of these services and what they offer, I hope you feel more confident in being able to recognize which service you should receive, when future injuries occur. 

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