Glib Answer: Become a massage therapist! This is one of the main things our schooling is supposed to allow us to suss out.
Actual Answer: Nah but for real though you COULD do worse than to ask a massage therapist (or physiotherapist) "is this pain something that massage would help with?" It's also useful to distinguish between "pain that MASSAGE can help with" and "pain that a MASSAGE THERAPIST can help with", since massage therapists can help with pain in ways other than just rubbing stuff. I think the most useful way I can answer this is by running down a bunch of common types of pain (and some less-common ones, just for fun) and then saying what a massage therapist might do or recommend for them.
- Dull, aching pain that is somewhat relieved with movement or changes in position: usually indicative of muscle fatigue or stiffness from being in a position for too long. Massage is helpful, and massage therapists might recommend behavior modifications like stretching breaks or a more regular exercise routine, as well as specific stretches to target involved muscles.
- Sharp pain at a specific point following recent exertions that is relieved with rest: usually indicates a muscle strain or ligamentous sprain (easy way to remember the difference: remember that T stands for tendon). No massage right at the site of injury, but massage therapist might massage structures above the injury site to relax them, and will recommend methods of symptom relief like heat or ice, as well as giving you an idea of how long healing might take and some rehabilitative exercises.
- Pain that feels like burning, or electrical zapping, or numb, or tingling: usually indicates some kind of nerve involvement. Massage MIGHT help, if the problem is a peripheral nerve being irritated by a nearby muscle that's crowding it. Therapist might also give stretches or demonstrate some nerve-flossing techniques, and recommend certain positional adjustments if they suspect specific things might be contributing to nerve irritation (a common one is long-haul truckers keeping wallets in their back pockets while seated, which can lead to irritation of the sciatic nerve, leading to pain/numbness/tingling down the back of the leg).
- Sickening pain following some kind of impact: usually indicates a bone fracture. Massage can't help, go to the hospital. We'll see you when the cast comes off.
- Headache pain: depends on the kind of headache. If it's a tension headache - that is, a headache being partially or wholly caused by fatigue in head and neck muscles - then yes and people really love us for this one. However, a lot of things cause headaches. Dehydration, sun exposure, malnutrition, those we can't massage away but can usually recommend ways to address. Sinus congestion, too. We see a fair number of post-concussion cases, which always have a number of things to address and you kind of just have to take them as they come. Migraines are a mixed bag too.
- Cramping pain: both types of cramps (cramps to skeletal muscles and menstrual cramping) are unfortunately not especially helped by massage. Skeletal muscle cramps you have to pretty much just ride out, after which light massage MIGHT help (but is honestly better avoided). Menstrual cramping, sadly, we can't do very much for other than helping the patient relax in a general sense.
- Most types of abdominal pain: can't do much. Exquisite right-lower-quadrant pain that's hot to the touch? Probably a burst appendix, go to a hospital. Sharp, burning pain right in the center of your chest after meals? Probably GERD or a hiatal hernia, talk to a doctor. Severe right-sided abdominal pain lasting hours following fatty meals? Probably gallstones, talk to a doctor. Stomachache with long-lasting constipation? Okay actually we CAN help with this one, believe it or not. Slow, circular stroking of the abdomen with a washcloth soaked in warm water for 10-15 minutes can promote large intestine motility and get things moving again.
- Pain in breasts associated with lactation: again, this is a weird one, but massage therapists can actually help with this. It IS actually possible to do very light massage to areas on and around breast tissue that will help unblock clogged milk glands, which can be quite painful. Although massage therapists do all get a brief grounding in breast massage, the ones that make it a regular part of their practice will usually advertise as such (typically they're also ones that will advertise as specializing in pregnancy massage).
- Pain arising from any number of chronic fatigue/autoimmune conditions including CEFS, fibromyalgia, lupus, POTS, and so on: sometimes! Sorta! Your mileage may vary! Honestly with these conditions the patient probably knows better than I do, so I follow their lead - that, or we're working together to figure out what works best.
- Pain arising from multiple sclerosis symptoms: technically yes; multiple sclerosis causes uncontrollable contraction of skeletal muscles leading to extreme pain and fatigue, which IS something massage can help with. It's just not enough.
As with most medical questions, the ultimate answer is: it depends. If you have a specific set of symptoms and would like to run them by me, feel free to do so in the comments, or message me on Discord.