In Germany massage is regulated by the government on a federal and national level. Only someone who has completed 3,200 hours of training (theoretical and practical) can use the professional title "Masseur und Medizinischer Bademeister" or Medical Masseur and Spa Therapist. This person can prolong his training depending on the length of professional experience to a Physiotherapist (1 year to 18 months additional training). The Masseur is trained in Classical Massage, Myofascial Massage, Exercise and Movement Therapy. During the training they will study: Anatomy, Physiology, Pathology, Gynecology, Podiatry, Psychiatry, Psychology, Surgery, and probably most importantly Dermiatry and Orthopedics. They are trained in Electrotherapy, and Hydrotherapy. Hydrotherapy includes: Kneipp, Wraps, underwater Massage, therapeutic washing, Sauna and Steambath. A small part of their training will include special forms of massage which are decided by the local college, for example: Foot reflex zone massage, Thai Massage etc. Finally a graduate is allowed to treat patients under the direction of a doctor. He is regulated by the professional body which regulates Physiotherapists. This includes the restriction on advertising and oath of confidentiality to clients.
Swedish massage is now gaining acceptance from the medical community as a complementary treatment. Studies have shown that massage can relax the body, decrease blood pressure and heart rate, and reduce stress and depression. It may also provide symptomatic relief for many chronic diseases. Many doctors now prescribe massage therapy as symptomatic treatment for headache , facial pain, carpal tunnel syndrome, arthritis, other chronic and acute conditions, stress, and athletic injuries. Many insurance companies now reimburse patients for prescribed massage therapy. As of 2000, however, Medicare and Medicaid do not pay for this form of alternative treatment.