Physio vs Massage for Back Pain

Updated: Feb 23

Which should I choose, just what is the difference and does it really matter ?





I think for many people there is a common misconception that a Physiotherapist is the same as a Massage Therapist and we regularly get clients phoning us not entirely sure whether they need to book in with the Physio or one of our Massage Therapists for their back or neck pain. There is undoubtedly overlap between the two - indeed the CSP recognise ' manual techniques ' as one of the four pillars of the Physiotherapy profession - but the scope of training varies massively and whilst they both have their place there are reasons why we would advise one therapy over the other when looking at your back pain.

So just what is the difference in the jobs ?

The two biggest differences are in the training involved and regulation of the professions. Physiotherapists all complete a degree level course including musculo-skeletal, neurological and respiratory training enabling them to assess, diagnose and give advice professionally and safely. Physiotherapy is also a protected title so all Physios must be state registered with the Health & Care Professions Council and complete a set amount of training each year to maintain their registration and professional standards. We are randomly audited every two years and our training folder scrutinised.... kind of like having to take your driving test again ! A Sports Massage Therapist is trained solely to deliver Sports Massage and the training can be anything from a two year University course to a series of weekend training courses. They are not qualified to diagnose conditions in the same way as a Graduate Sports Therapist ( GST ) or Physiotherapist is able to and with no mandatory registration there are huge variations in the level of training and ability towards both ends of the spectrum. Our Deep Tissue Massage Therapists are qualified to Level 4 or above standard and have completed additonal post graduate training.


Physiotherapy and Back Pain

A moderate to severe back pain or a new back pain should be seen by a Physiotherapist in order to get a clear diagnosis and exclude any conditions that may require an onward referral to either a medical specialist or for further imaging such as an MRI. They will also give a clear plan in terms of how to treat your issues and will treat as they find with a holistic, hands on approach to improve mobility and rehab you to prevent and manage any recurrence of your back pain.


Massage & Back Pain

For many chronic conditions a Deep Tissue Massage is a great way of keeping on top of your symptoms and keeping back pain at bay. Many people with heavy manual jobs or, increasingly, very static, desk based jobs also find that massage can help to keep those aches and pains and muscular tightness in check, enabling them to continue working and partaking in their sports and hobbies. The psychological benefits of deep tissue massage also should not be underestimated. Many people hold their stress and tension in their muscles and this can lead to backpain, headaches and tension ( Lord knows, we have all had stress enough to last a lifetime in the past two years ! ). Touch is a powerful stress reliever, releasing serotonin and helping with anxiety and stress.


Are there times I MUST see a Physiotherapist ?

There are certain symptoms that we ALWAYS advise should definitely be seen by a Physio rather than a Massage Therapist as they may be a sign of more serious problems which will need careful assessment. They are thankfully very rare but cannot be missed as they need prompt attention :

  • Bladder & bowel changes such as incontinence or not being able to wee.

  • Any changes in the sensation around your groin or between your legs.

  • Pain, pins & needles or pressure in both legs

  • Impaired sexual function e.g loss of sensation during intercourse

  • If you feel generally unwell with your back pain e.g sweats or pain at night, fevers or unexplained weight loss


Can I switch from one to the other ?

Yes ! The beauty of being multi - disciplinary at Natural Elements means we have the ability to ask one of our fellow professionals for their opinion and refer over to them when we feel that our skills are not best suited for treating that particular condition. It's smooth and seamless and the therapists will all have access to the same sets of notes and can easily ask for clarification - no referrals getting lost in transit or sitting in someone's inbox for weeks on end..... we just talk and ask each other !


So in summary ....


Physiotherapist when .....

  • New pain or injury

  • Pins and needles or leg pain associated with your back pain

  • Moderate to severe back pain ( or any kind of pain really ! )

  • Rehabilitation / ongoing exercise programme needed

  • Post surgery.


Massage Therapist when .....

  • Mild to moderate back pain - particularly when chronic ( been there a long time )

  • Ongoing chronic muscular pain & stiffness in back and neck region especially

  • Lack of flexibility

  • Stress, anxiety type symptoms


As ever if you are unsure and want to chat things through with us then please do give us a call - we are happy to chat and give guidance in terms of what might be best for you

















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