*Guest Article* How Massage Therapy Complements Physiotherapy for Lasting Pain Relief

By Pooja Rishal, RMT  ·  Healastic

When people are dealing with pain or stiffness, they often pick one: physiotherapy or massage. That choice is usually unnecessary. The two treatments do different work on the same problem, and they pair well.
I am an RMT Manotick. I wrote this for Function Physio patients who already have a physiotherapy plan and want a clear picture of what massage adds beside it. Not instead of it.

Different roles, shared goals

Physiotherapy and massage therapy are separate professions. They have different training, different tools, and different scopes of practice.
A physiotherapist assesses why a movement hurts, then uses exercise, manual therapy, and other techniques to restore function. A massage therapist works the soft tissue: muscle, fascia, and the places the body holds tension. The session is longer on those layers, and the aim is to reduce guarding so movement has somewhere to go.

Function Physio has written about this distinction before: physiotherapy is not the same as massage. Massage can be one tool in a physio session. It is not the whole profession.

The goals overlap even when the methods do not:

• less pain
• better mobility
• easier movement in daily life
• support after injury, strain, or a long stretch of stiffness
  
  

How they complement each other

Pain that drops enough to move

Tight muscle and poor circulation make exercise feel like a fight. Massage can lower that background noise. Once the tissue is less guarded, physiotherapy work is easier to do and easier to feel.
A 2011 trial in Annals of Internal Medicine assigned 401 adults with chronic low back pain to massage or usual care. After 10 weeks, more than one in three people who received massage said their pain was much better or gone. In usual care, that was about one in 25. They also used fewer anti-inflammatory drugs.

Tissue that stops blocking the plan

Knots and adhesions limit range. Massage can take pressure off those spots. Physiotherapy then has a better chance of strengthening and coordinating the same area, instead of pushing against a muscle that will not let go.
A 2025 review of ten trials found that adding hands-on soft-tissue work to exercise improved short-term pain or function more than exercise alone in eight of those studies.

Recovery that has two speeds

After a strain, a fall, or surgery that has been cleared to treat, the body often needs both settling and loading. Massage can help with soreness, swelling, and that stuck feeling around a scar. Physiotherapy rebuilds strength and control. Used together, one calms the tissue while the other asks it to work again.
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A 2019 trial in the Journal of General Internal Medicine found that weekly massage improved pain, stiffness, and function in people with knee osteoarthritis at eight weeks. Side effects were rare. Function Physio also has a short piece on ways to reduce osteoarthritis pain, including targeted exercise around the joint.

A nervous system that is not braced all day

Pain is not only a joint problem. People sleep badly. They hold their breath. Their shoulders stay up around their ears. Massage will not treat anxiety. It can drop some of that bracing, which makes the next physiotherapy session more usable.

I practised as a psychotherapist before I trained as an RMT. I do not turn a massage into counselling. I do notice when the holding has a longer story than the muscle. When that drops, home exercises get easier.

What the research says, briefly

The better studies do not force a choice between massage and physiotherapy. They add massage to a plan that already includes exercise or usual care.

An earlier trial by the same research group behind the 2011 back-pain study found that people who received therapeutic massage used less medication afterward than people given acupuncture or a self-care booklet. A 2016 review in Pain Medicine found that massage reduced musculoskeletal pain compared with a sham treatment.

For jaw pain, a 2023 review of randomized trials found that manual therapy can improve pain and mouth opening. A 2023 analysis in The BMJ ranked jaw mobilization and trigger-point work among the better options for chronic TMD pain. That is complementary work: joint and muscle, not one or the other.

Where Function Physio patients often feel the pairing

Neck, desk stiffness, and headaches

Ottawa has a lot of screen work. Stiff mid-back. Head pushed forward. A headache that starts behind the eyes by Thursday. Massage can stay with the neck, jaw, and chest until that pattern lets go, while physiotherapy keeps working on how you move.

Low back pain that keeps bracing

Even with a good movement plan, the lumbar muscles, glutes, and hip rotators often stay on guard. Therapeutic and deep tissue massage through those layers can turn the volume down so the exercises can progress.

Jaw pain and clenching

The joint and the muscles around it both stay involved. Function Physio treats TMJ and jaw discomfort from the movement side. Buccal (intra-oral) facial massage reaches the masseter and pterygoids from inside the cheek. That tissue is hard to get at from the outside. It pairs with work on the temples, neck, and shoulders.

After injury or surgery

Once the tissue has been cleared to treat, soft-tissue work and lymphatic drainage can help with swelling and scar mobility. That is support for the weeks when the exercise is right but the tissue still does not feel like yours. It does not replace post-surgical physiotherapy.

How to use both without wasting a visit

• Tell each practitioner about the other. I change pressure if you had dry needling two days ago. Your physiotherapist should know if your jaw or low back just had a long soft-tissue session.
• Leave a day between the two when you can. Same-morning bookings make it harder to tell what helped.
• Keep the exercises from Function Physio. Massage that is not followed by movement often fades by day three.
• Check your benefits. Most Ottawa plans cover both physiotherapy and Registered Massage Therapy.
• New pain with numbness, unexplained weight loss, fever, or changes in bowel or bladder function needs medical care first.
  
  

If you want to add massage

You do not need to leave Function Physio or change what is working. I work as a Registered Massage Therapist in Manotick. Sessions are 60 minutes with the same therapist each visit. I use hot stones in every treatment so tissue warms and I can work deeper with less force.

If you want to add a session between Function Physio visits, details are at healastic.ca. Bring your physio notes if you have them. I would rather build on that plan than invent a second one.

About the author

Pooja Rishal is a Registered Massage Therapist (CMTO) and the owner of Healastic in Manotick. Patients see the same therapist every visit. She trained at the International Academy of Massage in Ottawa and has been in practice since 2020. Before massage therapy she worked as a psychotherapist. Her work includes therapeutic and deep tissue massage, hot stone, myofascial release, headache and migraine work, prenatal and postnatal care, manual lymphatic drainage, paediatric massage, and buccal facial massage for TMJ.

Clinic details

Healastic
Pooja Rishal, RMT
5511 Manotick Main St #2B
Manotick, ON K4M 1A3
Inside Aesthé Medical Aesthetics
(613) 908-5323
Website: https://healastic.ca/
Monday–Saturday, 8:00am–8:30pm. Closed Sunday. Free parking on site.

Selected research
Cherkin D.C. et al. Annals of Internal Medicine. 2011;155(1):1–9.
Cherkin D.C. et al. Archives of Internal Medicine. 2001;161(8):1081–1088.
Crawford C. et al. Pain Medicine. 2016;17(7):1353–1375.
Narenthiran P. et al. Journal of Bodywork and Movement Therapies. 2025;42:146–152.
Perlman A.I. et al. Journal of General Internal Medicine. 2019;34(3):379–386.
Vieira L.S. et al. Life. 2023;13(2):292.
Yao L. et al. BMJ. 2023;383:e076226.