What Is Massage Therapy and Bodywork? Pressure, Comfort, Consent and What to Expect

What Is Massage Therapy

NCCIH describes massage therapy as manipulating the soft tissues of the body, used to help manage a health condition or to enhance wellness. [2] In the research world, a Cochrane review defined massage as soft-tissue manipulation using the hands or a mechanical device. [3] The most common form in Western countries is Swedish, or classical, massage, which is the core of most massage training programs. [2] Other styles include sports massage and clinical massage aimed at specific goals. [2]

In 2022, 10.9 percent of US adults reported using massage therapy, more than double the share in 2002. [2] The full range of definitions and how regulators phrase them is on what massage is and how terms are grouped.

What Is Bodywork

"Bodywork" is an everyday word rather than a single method. The sources we read give no one formal definition, although one US certifying body uses it in its name: the National Certification Board for Therapeutic Massage & Bodywork. [4] On this site it covers hands-on approaches beyond classic massage, such as Thai massage and shiatsu, reflexology and manual lymphatic drainage. Each is judged on its own evidence. A pleasant session and a proven treatment are not the same thing. How the terms massage, bodywork and manual therapy differ has the details.

Pressure, Comfort and Consent

Consent is ongoing, not a form signed once. Ontario's regulator of massage therapists, the College of Massage Therapists of Ontario (CMTO), says clients should know they can withdraw consent at any time, and requires therapists to keep monitoring consent throughout treatment. [5] It also requires therapists to explain which part of the body they intend to treat and to ask whether touch should be directly on skin or through a cloth barrier. [6] Clients are draped unless they arrive in suitable clothing and prefer to stay clothed. [6] A client may also ask to have another person accompany them. [6]

These are one regulator's published rules, not a universal law. See practitioner qualifications, consent and boundaries and how to talk to your therapist.

What Research Shows

Studies of massage are hard to run well. People know when they are being massaged, so blinding is difficult, and the Cochrane review of low-back pain named performance and measurement bias as the most common problem. [3]

1. Does one session lower momentary anxiety?

   Promising but limited

   A 2004 meta-analysis of 37 randomized studies found lower state anxiety, blood pressure and heart rate after single sessions, but not lower negative mood, immediate pain or cortisol. [7]

2. Does massage lower stress hormones?

   No good evidence of benefit

   A later review found the cortisol effect very small and mostly not distinguishable from zero. [8]

3. Does it help low-back pain?

   Promising but limited, mostly short-term

   The Cochrane review rated the evidence low to very low quality. [3] NCCIH reports only weak evidence. [2]

Increased pain was the most common side effect in the back-pain trials, reported by 1.5% to 25% of participants, with no serious adverse events reported in those trials. [3] Details by goal are on massage evidence by goal, and low-back pain has its own page: what trials found.

Finding a Qualified Therapist

Rules differ by place. NCCIH reports that most US states regulate massage therapists by requiring a license, certification or registration, and that being licensed is not always a guarantee of being qualified. [10] It suggests asking about training, experience and credentials. [2] We do not list or rank therapists or spas; use how to choose a qualified massage therapist and the guide to checking a spa or clinic.

Explore the Massage and Bodywork Library

• Foundations: how touch and pressure work and muscles, fascia and connective tissue.
• Styles and techniques: massage types compared and Swedish massage.
• Bodywork systems: Tui Na and the pages linked above.
• Evidence for body and mind: anxiety and depression.
• Populations and settings: pregnancy and older adults.
• Getting started: your first massage.
• Research and evidence: how massage is studied.
• Self-massage and tools: gentle self-massage basics.
• Comparisons: massage and physical therapy.
• Glossary: terms in plain language.

The wider section is at Massage and Bodywork.