All good questions! Massage is rarely a matter of “fixing.” If you come in with back pain that’s been getting progressively worse for 3 months, it’s unlikely that I’ll be able to make it better in a single session. Pain is a complex thing, created by your habits, the work that you do, and your past and present injuries. It’s also strongly influenced by things like stress and mindset. Not an easy thing to change in a single afternoon!
It’s more likely that pain relief will come over the course of weeks or months. As massage becomes a part of your life, your body will come to the slow realisation that it doesn’t need so much habitual tension, and that it can safely turn down the “volume knob” on your pain. This can even be true for structural problems, like knee and hip osteoarthritis. Many recent studies have shown substantial benefit for arthritis sufferers just from plain old feel-good Swedish massage. Less pain, more range of motion, and greater function, just from making massage a part of your routine.
What can you expect after your first massage? You should feel a little better. You might have a few more degrees of motion in your painful shoulder, or fewer spasms in your low back. You should sleep better that night, and the effects can last for several days. As you continue your daily routine, the pain will likely creep back in.
So why get massage at all? Because with each massage, the effects should build. After your 4th massage, the pain will drop considerably, and it won’t return to the same levels that it started at. After the 8th, you might have difficulty remembering what your old pain felt like. There will be ups and downs, but the overall trend should be “down.”
The effects of regular massage are long-lasting. In studies that used a 12-week protocol of weekly massage, the effects stuck around for at least 6 months after the final massage (though the benefits do start slowly dropping off).
How often should you get massage? Most of the studies that show substantial benefits use a weekly protocol, but I’ve seen good results from twice-monthly massage. If you’re in pain, I’d recommend starting with weekly massage for about four weeks, and then tapering off as you recover. I know that massage is expensive, so start with what you can! Just realise that frequency and regularity are big factors in the success of the treatment regime.