Massage helps relieve pain associated with occupational and muscular stresses, chronic pain conditions, as well as muscular overuse. Massage therapy is used to treat acute and chronic health conditions and is able to work for a wide variety of injury rehabilitation, illness, and disability. Massage is beneficial for the nervous, musculoskeletal, lymphatic, and other organ systems in the body.

Massage is an effective pain management technique. The ‘gate control theory’ explains that pain signals do not reach the brain instantaneously from injured or strained muscles. They encounter certain neurological ‘gates’ before they reach the brain. Massage helps ‘close’ the gates to pain signals, which is the reason why we feel a sensation of relief when we rub or stroke an injured tissue.

Massage is responsible for introducing physiological changes in the body through two main types of responses: The relaxation response and the mechanical response.

The two responses work together to produce physical as well as mental benefits.

Relaxation Response

A relaxing massage calms down your breathing and slows down your heart beat. This is referred to as a ‘relaxation response’. The relaxing sensation, in turn, boosts the level of a hormone called ‘serotonin’. Serotonin has a positive impact on our emotions and feelings. This is why one experiences an overall feeling of wellbeing during and after a massage session.

Massage geared towards a relaxation response is called ‘relaxation massage’.

Mechanical Response

The manual manipulation in massage therapy has two major effects on the body:

  • It increases blood and lymph circulation: Massage promotes manipulation of soft tissue which, in turn, boosts blood and lymph flow. This results in an improved supply of oxygen and nutrients to the cells. Enhanced cellular health leads to improved functioning of tissues which, in turn, leads to the effective elimination of waste products. In addition, there is a reduction in swelling in soft tissues.

  • Relaxation of soft tissue (which includes tendons, muscles, ligaments, and connective tissue). The normalisation of soft tissue also helps release deep connective tissue and nerves.

Massage geared towards manipulation of connective tissue is called ‘rehabilitative massage’.

Massage therapy helps minimise painful muscular spasms and contractions. It also helps alleviate nerve compression. To explain this further, muscles have a tendency to squeeze the nerves around them when they contract. This is called ‘nerve compression’. When nerves are compressed, they are no longer able to transmit messages to the brain in an efficient manner.

Once the nerves are relaxed, they are able to transmit messages and consequently, the brain is able to control the organs more effectively. All organs in the body share common neurological pathways that carry ‘pain signals’. They share these pathways with other nerves, bones, and muscles. Hence, when nerves get compressed, organs often display signs of distress and dysfunction. Massage helps soft tissues find improved alignment and balance


Massage therapy has a host of benefits to offer. Not only does it help relieve physical symptoms but it is also instrumental in relieving stress.

Stress and Tense Muscles

Almost all of us have experienced muscular aches, pains, and spasms at some point. Physical and mental stress can both result in muscular tension.

For example: We may experience pain after a slip or a fall. Repetitive typing and constantly peering at a computer monitor all day long (all too common these days) can likewise lead to a sore shoulder, neck, and back. Such muscular tensions are referred to as ‘repetitive stress injuries’ or RSIs.

Similarly, mental stress also leads to tense muscles. When we experience stress, the body reacts immediately with a ‘fight or flight’ response. The heart beats faster, your breathing becomes shallower, and your muscles become tenser. Your body is gearing you up either to run (as fast as possible) or fight. Once the stress is over, your body’s physiological reactions return to normal.

However, if you experience prolonged periods of stress, your muscles are subject to excessive ‘fight or flight’ responses repeatedly. These muscles then begin to experience permanent strain or tension. Even the frown or scowl from worrying over your tax returns can strain the facial muscles and result in a tension headache. Feeling stressed over long traffic queues and craning your neck in the process often leads to neck stiffness. The skeletal muscular system is composed of more than 400 muscles.

Prolonged stress can injure or fatigue any of these, leading to pain, tension, and stiffness over time. The underlying concept is that a muscle under sustained tension needs alternate relaxation phases in order to maintain its functionality. The lack of a relaxation phase leads to tightness and strain.

Massage is extremely beneficial in helping to relieve muscular tension and reduce inflammation. Recent research indicates that massaging tired or injured muscles results in the suppression of chemicals called ‘cytokines’. Massaging also stimulates ‘mitochondria’ or tiny hair-like structures found in cells that convert glucose into energy. The increase in mitochondrial stimulation and suppression of pain pathways helps ease muscular stress. As a matter of fact, massage techniques work in a way quite different from conventional drugs and painkillers.

Painkillers suppress muscular pain but do not promote internal healing. On the other hand, massage helps relieve pain as well as promote cell recovery.

A recent research study conducted by Cedars Sinai Medical Centre, Los Angeles, indicates that massage results in the decrease of cortisol, a stress hormone. This study actually shows that massage therapy is effective in mitigating the physiological effects of stress.

There are several significant benefits associated with therapeutic massage beyond the instant feeling of relaxation and wellbeing.

Here’s a look at the overall benefits associated with massage:

  1. Massage helps relieve stress by easing muscular tension. If you’re sitting in an office chair all day, chances are that your back, neck, shoulders, arms etc. are likely to feel sore and stiff. Massage therapy can help relax muscles.

  2. Massage encourages relaxation and the effects of a massage last long after the session is over.

  3. Massage helps reinforce correct posture and healthy movement. Poor posture causes some sets of muscles to work really hard while others become weak. Slumping, for example, not only looks unsightly but also increases pressure on internal organs and impacts the digestive system. Massage helps ease muscles that are strained due to poor posture. The body is then able to realign itself in a natural way.

  4. It helps improve blood circulation and flow. The improved blood circulation helps enhance body functions and provides tired muscles with the oxygen-rich blood that aids internal healing. The rubbing, kneading, and pulling also helps blood to flow through congested areas and flushes out lactic acid from muscles.

  5. Research indicates that a consistent massage therapy program can help reduce diastolic and systolic blood pressure. It also lowers urinary and salivary cortisol levels besides alleviating anxiety and stress levels.

  6. Massage helps improve range of motion and flexibility. We are more prone to muscle injuries today than say 50 years ago. This is not because we are exercising but because we are leading sedentary lives. Massage therapy works on muscles, tendons, ligaments, and connective tissues to improve natural joint lubrication. Regular massages can help stave off sports injuries as your flexibility levels improve.

  7. Massage boosts deeper, complete, and relaxed breathing. According to Ann Williams, Education Program Director at Associated Bodywork and Massage Professionals, regular massage can help improve breathing which, in turn, has a beneficial effect on respiratory conditions including bronchitis, sinus issues, allergies, and asthma. Massage works to loosen constricted respiratory tissues located at the front and back of the body. Massage techniques like ‘tapotement’ are known to loosen mucus and ease lung function by promoting airway clearance (more on medical massages in a later module).

  8. Massage helps ease headaches. More than 25 million people living in the UK report experiencing frequent headaches. About 8 million British individuals experience migraines. Consistent massage programs help relax trigger points and relax muscles. Massage also helps improve sleep quality and minimises distress symptoms, reducing the occurrence of headaches. The Indian head massage is particularly known as an effective panacea for tension headaches.

  9. Massage facilitates post-operative rehabilitation: The aftermath of surgery is an important period for recovery. This is the time when movement is re-learned and range of motion is gradually reinforced. Massage is an effective supplement to standard rehabilitation procedures and can help aid faster recovery. It helps break up scar tissue and keeps muscles supple and flexible. Massage helps increase body heat which promotes internal healing of muscular tissue.

  10. Massage therapy boosts the immune system: Regular massage stimulates the body’s natural cytotoxic capacity (this is action of the body’s natural ‘fighter cells’). Massage also helps boost the number of T-cells which act as a first line of defence against disease.


1.6: The Advantages of Massage

The emotional benefits

Massage is pleasant. Hardly a revelation, but it’s important to remember this when we are delving into the medical literature, or into heated debates over the benefits of massage. The good feeling that you get after a massage is hard to test and quantify, but no less real for that.

Since it is so difficult to conduct controlled studies of something as personal and subjective as wellbeing, clinical studies will commonly flatten the experience of patients down to something that they can attach a number to. Thus we get indexes of factors like ‘anxiety’ and ‘depression’ which give us some information, but scarcely capture the entirety of the benefits of massage.

In any case, massage therapy does, it seems, reduce anxiety and depression. It also has some effect on the experience of pain. It can’t necessarily reduce the immediate feeling of pain, but over the course of a series of massages, patients report lower overall pain.

The medical benefits

Medical studies have found that massage therapy does help patients in many ways. Studies haven’t been able to reproduce all the benefits claimed by massage and bodywork practitioners, but they have shown enough to conclude that massage isn’t entirely useless.

The placebo effect

The most important, and least controversial, benefit, is the placebo effect. This refers to the fact that if you are receiving treatment, you are more likely to get better – even if the treatment does nothing to you. This form of ‘mind over body’ health improvement (your health improves because you think your health is improving) is powerful, and has been demonstrated in clinical trials. It is particularly significant in areas such as pain relief, where the symptoms experienced are a blend of the physical and psychological.

Among other articles, see Moyer et al, 2004, a meta-analysis of massage therapy research. Psychological bulletin 130(1):3-18

So, any form of treatment in which the patient believes can benefit them. But massage probably has advantages beyond this. When we feel pain, our instinct is to touch the affected part of the body – and this seems to bring at least a minimal level of relief. If touch can relieve pain in this context, then why not also in massage?

Neurological effects

Slightly different again from the psychological effects are the neurological effects. This refers to the effect massage has on the low-level nervous system. Depending on the form of massage used, it can make the nervous system either more or less excitable, leading to greater or lesser responses to stimuli. This can be measured by testing “Hoffman’s sign” – the reflex motion of the thumb when a fingernail is flicked.

Mechanical effect

Mechanical pressure on muscles increases the flexibility of those muscles and decreases their stiffness. This is a purely mechanical effect, dependent on the physical structure of the muscles.

The lymphatic system

Your body drains waste away from muscles and other tissue through the lymphatic system. This is far from perfect, and when it slows down, your body can be left feeling (and looking) puffy and unpleasant. This tends to happen overnight, when the entire lymphatic system slows down, and it is also worsened by poor diet.

Fortunately, the circulation of lymph can be improved by manual manipulation – that is, by massage.

Circulatory system

Of the physical effects of massage, perhaps the clearest are on the circulatory system. When you touch, squeeze, or press any part of your body, you increase the circulation to that area. Massage takes this effect, and systematically applies it. As a result, massage is a good way to deal with minor problems of the circulatory system.

Meanwhile, massage will be having other effects on the central circulatory system, reducing blood pressure and heart rate. Why this happens isn’t fully understood, but it seems to be a reaction to changing levels of hormones circulating in the body.

Hormonal system

Massage can measurably alter the levels of certain hormones circulating in the body. Cortisol, known as a ‘stress hormone’, is reduced by a massage. Meanwhile, a good massage raises the levels of dopamine and serotonin circulating around the body. Dopamine and serotonin make you feel good – they relax your heart, they reduce your sensitivity to pain, and they reduce blood pressure.

In the longer term, low levels of dopamine and serotonin are associated with depression. That doesn’t mean massage can cure depression, but it does highlight the link between having a back-rub and feeling good.

So, here is one mechanism by which massage makes you feel good. It isn’t clear why massage has these effects on the hormones, but that doesn’t stop it being a good thing.