Does massage therapy “work”? What do massage therapists say that they can do for people and their pain, and is there any scientific evidence to support those claims? Massage is a popular treatment for low back pain, neck pain, and tension headaches — can it actually treat them, or does it just pleasantly distract patients and maybe take the edge off? In this article, I examine massage therapy in the light of science — not “objectively,” but fairly.1 I go out of my way to be critical of my former profession — I consider it an ethical duty. Health professionals must be self-critical and critical of each other: that is how we improve.2 And, alas, massage therapists are guilty of an astonishing amount of bullshit.


The University of Maryland Medical Center reports that deep-tissue massage is more effective and affordable for relieving chronic pain than conventional medical remedies. Because deep-tissue massage increases the flow of blood through through the body, it helps reduce the inflammation that causes pain. Deep-tissue massage can also help alleviate muscle tension that is often a side effect of chronic pain by loosening the tight tissue clusters.
People do have clear pressure preferences: they often fire massage therapists who give treatments that are too painful or too fluffy. Pressure that’s fine for you may cause severe pain, emotional distress, “sensory injury” (sensitization) in others, or even physical injury, so pressure should be customized but often isn’t. Brutal massages might be appreciated or even helpful, but most people can’t tell the difference between the kind of pain that might be a necessary part of therapy, and ugly pain that is just abusive and dangerous.
This may come as a surprise, but in fact there is no therapeutic benefit to stretching skin so hard that it feels like it is going to tear! And it is a completely different and uglier sensation than how fascial stretching can feel and should feel (more like a good massage). When I complained about this (politely), the therapists made no distinction between skin-tearing and fascial stretching, and more or less tried to tell me that I was objecting to perfectly good therapy. Needless to say, I never returned to those therapists.
Pre-event. Pre-event sports massage is given within the four hours preceding an event to improve performance and help decrease injuries. It is used as a supplement to an athlete's warm-up to enhance circulation and reduce excess muscle and mental tension prior to competition. It is normally shorter (10-15 minutes) than a regular conditioning massage, and focuses on warming-up the major muscles to be used, and getting the athlete in a good mental state for competition. It also improves tissue pliability, readying the athlete for top performance. Certain massage techniques can help calm a nervous athlete, and others can be stimulating. Pre-event. Pre-event sports massage is given within the four hours preceding an event to improve performance and help decrease injuries. It is used as a supplement to an athlete's warm-up to enhance circulation and reduce excess muscle and mental tension prior to competition. It is normally shorter (10-15 minutes) than a regular conditioning massage, and focuses on warming-up the major muscles to be used, and getting the athlete in a good mental state for competition. It also improves tissue pliability, readying the athlete for top performance. Certain massage techniques can help calm a nervous athlete, and others can be stimulating.
When you think of a massage, you probably think of soothing music, a gentle brush of hands softly kneading the stress from your shoulders, maybe even of a loved one offering to rub your back after a long day at work. While some massages can be soothing, and rely on gentle touches to work out a client’s stress or anxiety, there are other massages that have a little more grit to them. For example, the Deep Tissue massage, which is very similar in style to the Swedish massage, utilizes some of the same techniques as its much gentler cousin; Deep Tissue massages, however, are designed to focus on the deeper layers of muscle tissues and fascia, the protective layer that surrounds muscles and joints. Working out these harder to reach muscles will require more pressure, making the Deep Tissue massage slightly uncomfortable, gritty and highly effective.
Cancer. Used as a complement to traditional, Western medicine, massage can promote relaxation and reduce cancer symptoms or side effects of treatment. It may help reduce pain, swelling, fatigue, nausea, or depression, for example, or improve the function of your immune system. However, there are specific areas that a massage therapist should avoid in a cancer patient, as well as times when massage should be avoided altogether. Talk to your doctor before getting massage therapy if you have cancer.
Yet kicking back is hardly an unproductive activity; experts say that it keeps us healthy and happy. And research shows that regular de-stressing can help ward off heart disease and obesity, act as a buffer against depression, and even boost immunity against colds. Plus, when you're calm, you perform tasks smarter and more efficiently, leaving you with time to—wait for it—relax. Check out these strategies and inspiration for R in R: relaxing in reality.
Proprioceptive studies are much more abundant than massage and proprioception combined, yet researchers are still trying to pinpoint the exact mechanisms and pathways involved to get a fuller understanding.[94] Proprioception may be very helpful in rehabilitation, though this is a fairly unknown characteristic of proprioception, and "current exercises aimed at 'improving proprioception' have not been demonstrated to achieve that goal".[95] Up until this point, very little has been studied looking into the effects of massage on proprioception. Some researchers believe "documenting what happens under the skin, bioelectrically and biochemically, will be enabled by newer, non-invasive technology such as functional magnetic resonance imaging and continuous plasma sampling".[93]
Thich Nhat Hanh says that when we relax, we "become calm water, and we will reflect reality as it is. If we’re not calm, the image we reflect will be distorted. When the image is distorted by our minds, it’s not the reality, and it causes lots of suffering." Relaxation is essential for accessing the tranquility and joy that lead to increased personal well-being. With sections on healing, relief from nonstop thinking, transforming unpleasant sounds, solitude, being peace, and more, How to Relax includes meditations you can do to help you achieve the benefits of relaxation no matter where you are.

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At times, this fight-or-flight response is healthy and necessary—for instance, it helps you kick butt on that work presentation, catch the bus that’s about to pull away, or yank a small child out of harm’s way just in time. However, when anxiety becomes chronic, it may lower your immunity, potentially lead to heart disease, and even cause everyday ailments like headaches, back pain, stomach problems, and poor sleep. Fight back against stress with these five proven tension-tamers.
Athletes tend to know their bodies fairly well, so information presented to the therapist seems to be better. Compared to the general client, the athlete is also in good shape and is concerned about getting back to the field of play as soon as possible. Some athletes have an obsessive compulsive behavior about their sport. This generally makes them very compliant with the therapists’ recommendations. 
In this unique healing system of Thai Yoga Massage, also called Nuad Boran, the practitioner guides the client through a series of yoga postures, while palming and thumbing along the body’s energy (‘Sen’) lines and pressure points. Together these actions result in a comprehensive full body treatment that relieves muscular tension, improves circulation, boosts the immune system and balances the body energetically.
A review of nine studies of dubious quality of “myofascial technique” — rubbing and stretching basically — for joint pain and stiffness. Although all the studies showed improved range of motion and reduced pain, most clearly for the jaw, the authors of this review think that there are “a number of threats that challenge the statistical inferences underpinning these findings.” Translation: they think the studies they reviewed are of poor quality and that their conclusions cannot be trusted (garbage in, garbage out). Obviously the science is incomplete, but there are some reasons for optimism here (and it’s not exactly a huge claim that some rubbing and stretching might help a painful, stiff joint).
When there’s no professional masseuse in sight, try DIYing a hand massage for instant relaxation that calms a pounding heart The effects measurement of hand massage by the autonomic activity and psychological indicators. Kunikata, H., Watanabe, K., Miyoshi, M., et al. Department of Nursing, Faculty of Health Sciences, Kawaga Prefectural University of Health Sciences, Kagawa, Japan. The Journal of Medical Investigation 2012;59(1-2):206-12.. Massages can be especially helpful for people who spend a lot of time typing on a keyboard. Hands in general can carry a lot of tension. Apply some luxurious lotion and start kneading the base of the muscle under the thumb to relieve stress in the shoulders, neck, and scalp.
In this unique healing system of Thai Yoga Massage, also called Nuad Boran, the practitioner guides the client through a series of yoga postures, while palming and thumbing along the body’s energy (‘Sen’) lines and pressure points. Together these actions result in a comprehensive full body treatment that relieves muscular tension, improves circulation, boosts the immune system and balances the body energetically.
It is hard to study what you can’t define … and it is extremely difficult to define massage precisely. Many possible questions arise! What kind of massage therapy? What methods? Could a combination of methods be effective where another combination fails? How well trained is the therapist? Are “advanced” techniques better than relaxation and Swedish techniques? Or maybe the basics are the basics because they really work? How much massage therapy? Could five sessions succeed where two would fail? Is one appointment “massage therapy,” or does it really need more? Could nine sessions actually be better still? Or perhaps counterproductive? Can anything be done with short sessions, or are long ones needed? If massage works, how much of the benefit can be attributed to non-massage elements like bedside manner, relaxation, and reassurance? How much do those factors define massage? What if massage didn’t work at all, or very poorly, without them? Would that mean “massage” works because it’s a great way of delivering a nice experience? Or that nice experiences “work” and the massage is irrelevant? What if massage therapy of a certain type for a specific condition was only effective 20% of the time? 60%? 80%? At what point is it “worth a shot”? (And worth the expense?)
The first thing to examine is if your lifestyle is interfering with your ability to relax. We all get stressed out now and again, but a bad work environment, fights at home, money problems, and even clutter around you can keep you constantly on "high alert." It's hard to relax when something's constantly nagging at you—whether it's at the back of your mind or you're well aware of the stressors.
It’s a fair question. Despite the lack of direct evidence, massage has often gotten a stamp of approval from medical experts. For instance, back pain expert Dr. Richard Deyo: while openly skeptical about most other back pain therapies, but acknowledges that “promising preliminary results of clinical trials suggest that research on massage should be assigned a high priority.”45

“I drew habitually growing up and minored in art in college, but when I graduated, my practice began to slip away. Because I’m rusty now, I get a sort of performance anxiety about the whole thing, so I try to do it in as casual a manner as possible. I typically call a friend who I’ve been neglecting or put music on, get out a pad and doodle. (A really satisfying pen works best. It has to feel like velvety-butter.) I let my pen do all sorts of weird things: make strange shapes, draw people I don’t know who don’t have hands. There are no rules, no expectations of perfection, no product to produce. And when I’m done with it, I’m done with it. It’s very un-precious and so, so relaxing.”
Commit to a regular enjoyable activity, like a monthly racquetball game or cooking class, with your partner or friends. "You're more likely to follow through on a commitment to someone else than to yourself," notes Schulte. "It leaves you no choice but to relax!" One of the rare times when I truly unwind: my bimonthly girls' game night, where we play Scattergories, snack extensively, and laugh our heads off. But thanks to all this inspiration, I no longer have to wait weeks to relax for real.

When we face stressors in life, we can carry physical and psychological tension, and these tensions can feed off of one another. Feeling physically tense can increase your psychological and emotional tension and vice versa. Conversely, relaxing your body physically can help relieve psychological stress, and relaxing your mind can help you to physically relax and release tension in your body. When your stress response is no longer triggered, it becomes far easier to approach challenges in a proactive, peaceful way.

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Does massage therapy “work”? What do massage therapists say that they can do for people and their pain, and is there any scientific evidence to support those claims? Massage is a popular treatment for low back pain, neck pain, and tension headaches — can it actually treat them, or does it just pleasantly distract patients and maybe take the edge off? In this article, I examine massage therapy in the light of science — not “objectively,” but fairly.1 I go out of my way to be critical of my former profession — I consider it an ethical duty. Health professionals must be self-critical and critical of each other: that is how we improve.2 And, alas, massage therapists are guilty of an astonishing amount of bullshit.
Straightforward palpatory pareidolia. Pareidolia is a type of illusion or broken perception in which a vague or obscure stimulus — i.e. subtle textures under your skin — is perceived as if it was clear and distinct. Pareidolia is what makes naive Christians spot Jesus in a T-shirt stain, and why Percival Lowell thought he could see canals on Mars. BACK TO TEXT
Good massage therapists are the ones with more training and a bigger toolkit. They do what they can with the tools they judge to be the most useful, and they candidly discuss risks, benefits, evidence, and controversies. They don’t just pay lip service to humility as a general principle of alternative medicine — they make it a centerpiece, recognizing that they really are not trained enough to know much.
Sports massage was developed to help athletes prepare their bodies for optimal performance, recover after a big event, or function well during training. However, contrary to what the name suggests, you don't have to be an athlete to benefit from sports massage. Sports massage emphasizes prevention and healing of injuries to the muscles and tendons and can be beneficial for people with injuries, chronic pain or restricted range of motion. 

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Perspective cuts both ways here. On the one hand, it’s not as bad as it sounds: these “events” are minor and moderate in severity; only 1 or 2 per thousand visits causes a serious problem; and drugs are actually relatively worse. That is, you are modestly more likely to have an “adverse event” if you are given a pill. This just refers to typical side effects, such as ibuprofen’s tendency to cause indigestion.

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Partners in Healing is a full service holistic healing center. From Acupuncture to Chiropractic Care, Manual Therapies and more, we provide our patients with holistic care personalized for their unique needs. We strive to truly create a partnership between the patient and practitioners, enabling each patient to reach their optimal state of wellness.

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The significant difference in the two approaches is their effect on these layers. A Swedish technique uses lubricant to glide over the layers – whether that be on a superficial layer (light pressure) or a deeper layer (firm pressure). There may also be kneading of the muscles, vibration or percussion to stimulate the muscles, and passive and/or active joint movements. All of these techniques serve to increase circulation of blood and lymph, soften and relax the tissues, reduce cortisol levels in the body (the stress hormone), and provide a generalized sense of relaxation for the client.

Whether you’re just getting started with a Swedish massage or reflexology, enjoying a romantic couple’s massage for two, or healing your body with a sports massage, Spafinder Wellness 365 is your go-to massage headquarters. With endless modalities and customizations, we have thousands of spa and wellness locations for your next massage. Find out what type of massage is right for you in our comprehensive guide.


Sports massage is a good option if you have a repetitive use injury to a muscle, such as what you may get from playing a sport. It’s also a good option if you’re prone to injuries because it can be used to help prevent sports injuries. You may also use sports massage to increase flexibility and performance. Additionally, sports massage can be used to relieve pain, anxiety, and muscle tension.
In a typical massage therapy session, you undress or wear loose-fitting clothing. Undress only to the point that you're comfortable. You generally lie on a table and cover yourself with a sheet. You can also have a massage while sitting in a chair, fully clothed. Your massage therapist should perform an evaluation through touch to locate painful or tense areas and to determine how much pressure to apply.

Before booking an appointment, ask questions about the therapist’s education and experience, like “What is your training?” “How many years have you been practicing?” and “Do you work frequently with runners?”, suggests Gammal. Seek referrals if possible, and ensure s/he is a licensed massage therapist. Rotenberger recommends a massage therapist specifically trained in orthopedic treatment and assessment, as s/he will know when to refer you to another healthcare professional, in the case that you’re experiencing chronic pain and discomfort not fixable via massage. You can find a reputable practitioner via www.orthomassage.net or www.NeuroMuscular-Reprogramming.com.


I am a science writer, former massage therapist, and I was the assistant editor at ScienceBasedMedicine.org for several years. I have had my share of injuries and pain challenges as a runner and ultimate player. My wife and I live in downtown Vancouver, Canada. See my full bio and qualifications, or my blog, Writerly. You might run into me on Facebook or Twitter.

Accredited sports massage therapists must first complete a course in general massage from a school accredited by the American Massage Therapy Association/Commission on Massage Training Accreditation/Approval (AMTA/COMTAA) or their State Board of Education. They must then complete an additional training program approved by the AMTA National Sports Massage Certification Program. Many sports massage practitioners also complete the National Certification Examination for Therapeutic Massage and Bodywork.

How to Relax is part of The Mindfulness Essentials series of how-to titles by Zen Master Thich Nhat Hanh, introducing beginners and reminding seasoned practitioners of the essentials of mindfulness practice. Pocket-sized, with original two color illustrations by Jason DeAntonis, How to Relax shows how critical it is to regularly interrupt the hub-bub and routine of our lives to stop, relax mindfully, and recharge.
I think the true situation in most areas of the world is realistically described by this passage from Laura Allen’s excellent book, Excuse Me, Exactly How Does That Work? Hocus pocus in holistic healthcare She reports a dizzying litany of nonsense attached to “massage therapy.” Note that hardly a stitch of it has the slightest thing to do with actual massage (hell, not even myths about massage). And note that she is describing the sort of things she used to buy into (literally). Laura Allen is a self-described reformed flake.
Another serious general concern about the quality and effectiveness of massage therapy is that there is so much emphasis placed on specific, branded “techniques” and styles. The massage world is fragmented into dozens or even hundreds of these, depending on how you count. It is especially troubling that so many proprietary techniques are hyped as “advanced” and taught in place of genuine continuing (academic) education. This is the serious problem of certification rackets or “modality empires” — selling credibility to therapists in the form of certifications for a treatment method. These techniques are proprietary and profit-motivated, and usually championed and promoted by a single entrepreneur who gets treated like a guru and has legions of dedicated followers (who tolerate criticism rather poorly).
^ Miller BF, Hamilton KL, Majeed ZR, Abshire SM, Confides AL, Hayek AM, Hunt ER, Shipman P, Peelor FF, Butterfield TA, Dupont-Versteegden EE (January 2018). "Enhanced skeletal muscle regrowth and remodelling in massaged and contralateral non-massaged hindlimb". The Journal of Physiology. 596 (1): 83–103. doi:10.1113/JP275089. PMC 5746529. PMID 29090454.
Standing up for a quick stretch can relieve muscle tension and help us relax during a stressful workday Muscle stretching as an alternative relaxation training procedure. Carlson, C.R., Collins, F.R. Jr., Nitz, A.J, et al. University of Kentucky. Journal of behavior therapy and experimental psychiatry 1990;21(1): 29-38.. Why not try a shoulder roll-out or a chest-opening stretch right from the desk chair? 

Why so different? If you pay in United States dollars (USD), your credit card will convert the USD price to your card’s native currency, but the card companies often charge too much for conversion, well above the going exchange rate — it’s a way for them to make a little extra money. So I just offer my customers prices converted at slightly better than the current rate.
Deep tissue massages are usually “cross-grain,” moving against the muscles to relieve aches or pains rather than moving  with them. This can sometimes feel a bit more painful as a result compared to standard “relaxation massages.” However, the pressure involved in deep massages is actually a good thing. It provides many of the benefits that this type of therapeutic massage has to offer. Deep tissue massages also tend to be slower-paced and longer than many other massages, ideally about 1.5 hours long, which gives bodily tissue enough time to warm up and then relax.
On the other hand, hands-on experience is valuable too, and anyone who’s had a good massage is certainly familiar with the seemingly magical way that a therapist can find the perfect spots and “good pain.” An inability to reliably find something does not mean it can’t be done. And the main reason no treatment has ever been proven effective is mostly a lack of good science on the subject — it’s just unknown.
Let go of guilt. Many religious and cultural beliefs instill the value of hard work very deeply. Over time, and increasingly so with the advent of smart technology that keeps us hyper-wired 24/7, many of us have come to believe that being "on-the-go" constantly is the only way to prove our value. Having an unrealistic interpretation of "hard work" will end up wearing you down. Hard work is giving your tasks the attention they deserve at the time they deserve, not letting it bleed into all hours of your day!
The study involved 263 volunteers with an average age of 48.5. Overall muscle spasm/muscle strain was described as either moderate or severe for each patient prior to treatments, which consisted of a massage between 45–60 minutes in duration. Results demonstrated an average systolic pressure reduction of 10.4 mm/Hg, a diastolic pressure reduction of 5.3 mm/Hg, a mean arterial pressure reduction of 7.0 mm/Hg and an average heart rate reduction of 10.8 beats per minute following massage treatment. (6)
I agree with almost every detail of the article and wrote a letter of support to Dr. Barrett, which is published as an addendum to it. That said, the article does neglect some nice things that can be said about massage therapy, and it contains a few minor errors. But I applaud the intent and embrace and welcome most of the criticism. I wish it weren’t mostly true, but I believe that it is.
If exercising feels to much like a chore then how about enjoying some guilt-free time with your friends? In ‘Play it Away’, author Charlie Hoehn explains how spending 30 minutes each day on any outdoor activity with your friends may actually be the key when trying to cure anxiety. He even created a Pinterest board with all sorts of activity ideas you can try out.

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This seems like a fairly straightforward bit of good-news science about stretching. It’s not a surprising idea that movement would have some systemic regulatory effects (motion is lotion, use it or lose it), but it’s nice to see some corroboration of that common sensical notion, and it’s also nice to know that perhaps just stretching did this (to the extent we can learn anything from a single study). If true, it makes for nice evidence to support a general stretching habit, yoga, mobilizations, really any kind of “massaging with movement,” and probably even massage itself.
Good pain. In massage, there is a curious phenomenon widely known as “good pain.” It arises from a sensory contradiction between the sensitivity to pressure and the “instinctive” sense that the pressure is also a source of relief. So pressure can be an intense sensation that just feels right somehow. It’s strong, but it’s welcome. Good pains are usually dull and aching, and are often described as a “sweet” aching. The best good pain may be such a relief that “pain” isn’t even really the right word.
Good pain. In massage, there is a curious phenomenon widely known as “good pain.” It arises from a sensory contradiction between the sensitivity to pressure and the “instinctive” sense that the pressure is also a source of relief. So pressure can be an intense sensation that just feels right somehow. It’s strong, but it’s welcome. Good pains are usually dull and aching, and are often described as a “sweet” aching. The best good pain may be such a relief that “pain” isn’t even really the right word.
Sit back, or lie down. Close your eyes. Imagine a serene beach, a green forest, or a nice breeze. Allow yourself to indulge in seeing a whole picture of peace – whatever that is. Give yourself bonus points for imagining the delightful sounds and scents of your favorite location. You’ll be giving yourself a small escape – a mini-midday vacay. And it can have a wonderful effect on your peace of mind.
In a world where the only thing news sites are non-stop talking about are crime, corruption, economic breakdown, and the end of the world,  you realize that exposing yourself to this on a daily basis is the same as planting seeds of fear and anxiousness. Try and limit the time that you spend watching the news or browsing on social media, and focus your time and energy on things that will help you get forward and appreciate who you really are without you having to worry about the future.
An Indian physician named Shivago Kumar Bhucca, a contemporary of the Buddha, is often credited with developing Thai massage. The impetus was to give monks and nuns the flexibility to sit for long hours in meditation. Whatever its genesis, massage was considered such a crucial aspect of medical treatment in Thailand that until the early 20th century, the Thai Department of Health included an official massage division. Thai massage is based on releasing blockages along ten lines of energy called sen, which are similar to the meridians of traditional Chinese medicine. The technique incorporates stroking and kneading of muscles, manipulation of joints, and pressure applied to specific points in order to balance the body’s four elements—earth, water, fire, and air. But there’s also rocking, breathing, and lots of stretching—Thai massage is often referred to as “lazy yoga.”
This study is the source of a new massage myth that massage reduces inflammation. Inspired by the doubtful notion that “massage may relieve pain in injured muscle” after intense exercise, researchers looked for changes in the proteins that cells constantly make (“gene expression”). They compared muscle tissue samples with and without massage and concluded that “massage therapy appears to be clinically beneficial by reducing inflammation and promoting mitochondrial biogenesis.” Massaged muscle was found to be producing different amounts of five protein related to inflammation and promoting the growth of mitochondria (cell power plants). It was an interesting, technically demanding, and worthwhile experiment, and it’s nifty that there was any difference in gene expression in massaged muscle.

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