Massage

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Massage — Evidence & Practitioners | Gyfts

Background

Origin & History

Massage therapy is one of the oldest healing practices, with evidence of its use dating back thousands of years across multiple civilizations. Ancient Egyptian tomb paintings depict massage being performed, while traditional Chinese medicine incorporated massage techniques (Tui Na) as early as 2700 BCE. In India, Ayurvedic medicine has long featured massage as a core therapeutic practice for balancing the body's energies.

During the Renaissance and into the 19th century, European physicians began systematizing massage techniques, with Swedish physician Per Henrik Ling developing Swedish massage in the 1830s—one of the most widely practiced forms today. Ling's approach emphasized anatomical knowledge and specific strokes designed to improve circulation and muscle function, helping legitimize massage within Western medical frameworks.

Massage gained significant popularity in the late 20th century as part of the broader complementary health movement. Research into its physiological effects expanded considerably from the 1980s onward, leading to its integration into sports medicine, physical rehabilitation, and wellness programs worldwide. Today, massage therapy exists in many forms—from traditional Eastern practices to modern clinical approaches—making it one of the most accessible and widely sought complementary therapies globally.

The practice

How It Works

Massage stimulates specialised nerve fibres in the skin and underlying tissues, triggering the body's pain-inhibiting pathways whilst simultaneously activating the parasympathetic nervous system — the physiological state associated with relaxation and recovery. Sustained pressure on muscles and fascia causes gradual lengthening of connective tissue, releasing chronic tension patterns; concurrently, therapeutic touch reduces cortisol (the stress hormone) and increases oxytocin, creating a biochemical environment conducive to healing. The mechanical manipulation of soft tissues also enhances lymphatic drainage, reducing fluid accumulation and supporting the clearance of metabolic waste whilst improving circulation to fatigued or injured muscle groups.

What to Expect in a Session

Initial Consultation

Your first massage session typically begins with a consultation where the practitioner gathers information about your health history, current symptoms, medications, and specific concerns. This is your opportunity to discuss areas of tension, pain, or discomfort, as well as any injuries or conditions the practitioner should know about. The practitioner will explain the massage technique they recommend and answer any questions about the process. You'll also discuss pressure preferences—whether you prefer deep, medium, or light pressure—as this varies considerably between individuals and affects the therapeutic outcome.

Treatment

During the massage itself, you'll typically lie on a padded massage table in a warm, quiet room designed for relaxation. The practitioner will use oil or lotion to reduce friction and will drape you with sheets or towels, exposing only the area being worked on to maintain your comfort and privacy. Common techniques include kneading, stroking, circular motions, and gentle stretching, depending on the type of massage and your needs. A typical session lasts 30 to 90 minutes, with 60 minutes being standard. Throughout the treatment, communicate with your practitioner about pressure intensity and any discomfort—good practitioners adjust their approach based on your feedback.

After Treatment

Following your massage, you may feel deeply relaxed, and some people experience mild soreness similar to post-exercise soreness, particularly after deep tissue work—this usually subsides within 24-48 hours. It's common to feel slightly lightheaded or drowsy, so take time to rehydrate and move slowly when getting up. Many practitioners recommend avoiding strenuous activity, heavy meals, and excessive caffeine or alcohol immediately after your session to maximize the benefits. Some people experience improved sleep or a sense of calm for hours or days following treatment.

Follow-up Sessions

The frequency of follow-up sessions depends on your condition, goals, and budget. For acute issues like a recent injury, weekly sessions may be recommended initially. For chronic conditions or stress management, sessions might occur every 2-4 weeks. Some people benefit from regular maintenance massage (monthly or quarterly), while others use it occasionally for specific problems. Your practitioner will discuss a treatment plan based on your individual needs and may adjust frequency based on how you respond to initial sessions.

Mechanisms

How It’s Proposed to Work

The biological and psychological processes proposed to underlie how Massage is thought to work.

Mechanoreceptor Stimulation and Pain Gate Theory

Neurological

Massage activates large-diameter Abeta nerve fibres through touch and pressure. These signals travel faster than pain signals from smaller C-fibres and can inhibit pain transmission at the dorsal horn — the neurological basis of Melzack and Wall's gate control theory of pain relief.

Cortisol Reduction and Oxytocin Release

Biochemical

Therapeutic touch consistently reduces salivary and urinary cortisol while increasing oxytocin — the bonding and safety hormone. This dual biochemical effect underlies massage's well-documented anxiolytic and stress-reducing outcomes, independent of specific technique.

Lymphatic and Venous Return

Physiological

Effleurage and directional strokes mechanically stimulate lymphatic vessels, improving drainage of interstitial fluid and metabolic waste. This reduces oedema, accelerates muscle recovery from exercise, and supports immune function.

Myofascial Tension Release

Evidence Assessment

Massage therapy has a substantial body of research supporting its effectiveness for various conditions, though the overall evidence quality is mixed due to methodological variations across studies. Well-designed clinical trials demonstrate moderate evidence for conditions like chronic low back pain, neck pain, and headaches, with consistent findings showing massage provides benefit comparable to or supplementing standard care. Research on stress reduction and relaxation shows strong support, with measurable changes in cortisol levels and heart rate variability documented across multiple studies.

However, limitations exist in the evidence base. Many studies are small, lack appropriate control groups, or struggle with blinding (since recipients know they're receiving massage). Publication bias may favor positive results, and some claims about massage—particularly regarding specific toxin removal or energy manipulation—lack scientific support. Additionally, research quality and design vary significantly across the literature, making it difficult to draw universal conclusions.

Current evidence is strongest for musculoskeletal pain conditions, stress-related outcomes, and quality of life measures. Emerging evidence suggests potential benefits for conditions like fibromyalgia and anxiety, though more rigorous research is needed. The evidence base continues to grow, with ongoing studies examining mechanisms of action and optimal treatment protocols for specific conditions.

Evidence varies by condition and individual response. This information is for educational purposes only and does not constitute medical advice.

References

Questions

Frequently Asked Questions

What happens in a typical massage session?

A typical session begins with a brief consultation about your health and preferences, followed by 30-90 minutes of hands-on manipulation of your muscles and soft tissues while you lie on a padded table. The practitioner uses techniques like kneading, stroking, and gentle stretching, adjusting pressure based on your comfort. The environment is usually quiet and warm to promote relaxation, and you remain draped with sheets or towels throughout.

How many sessions do I need to see results?

This varies significantly depending on your condition and goals. Some people experience relief after a single session, while others benefit from a series of treatments. For acute issues, 2-4 sessions weekly may be recommended initially. For chronic conditions, ongoing sessions every 2-4 weeks are often more effective. Your practitioner can recommend a personalized plan based on your response to initial treatments.

What are the different types of massage?

Common types include Swedish massage (gentle, flowing strokes), deep tissue massage (more intense pressure targeting deeper muscles), sports massage (focused on athletic performance and injury prevention), Thai massage (assisted stretching and pressure), Shiatsu (acupressure-based), and reflexology (focused on feet and hands). Each technique has different goals and benefits—your practitioner can help determine which is best for you.

Is massage painful?

Massage should not cause severe pain. Some techniques, particularly deep tissue work, may involve pressure that feels intense or slightly uncomfortable as tight muscles release, but this should be tolerable and improve as muscles relax. Always communicate with your practitioner about pain levels—good practitioners adjust their approach to your comfort threshold.

Can massage help with chronic pain?

Many people find massage helpful for chronic pain conditions like back pain, fibromyalgia, and arthritis. It works by reducing muscle tension, improving circulation, and promoting relaxation. However, results vary, and massage is often most effective as part of a broader pain management approach that may include exercise, other therapies, and medical care.

Are there any side effects?

Most people tolerate massage well. Minor side effects can include temporary soreness (similar to post-exercise soreness), mild bruising if pressure was deep, or brief emotional release (crying or mood shifts as tension releases). These typically resolve quickly. Serious side effects are rare when performed by trained practitioners, but inform your provider of any concerning symptoms.

Is massage safe during pregnancy?

Massage can be beneficial during pregnancy when performed by a practitioner trained in prenatal massage, but you should obtain clearance from your healthcare provider first. Prenatal massage uses modified techniques and positioning to accommodate pregnancy changes and address common discomforts like back pain and swelling.

How much does massage cost?

Costs vary widely by location, practitioner experience, and session length, typically ranging from $40-$200+ per session. Some insurance plans cover massage therapy if prescribed by a physician for specific conditions. Many practitioners offer package discounts for multiple sessions, and some sliding scale rates may be available.

Ask Vidi about Massage

Origin & History

How It Works

How It Works

What to Expect in a Session

How It’s Proposed to Work

Mechanoreceptor Stimulation and Pain Gate Theory

Cortisol Reduction and Oxytocin Release

Lymphatic and Venous Return

Myofascial Tension Release

References

Frequently Asked Questions

Who Is This For?

Best for

Not ideal for

Commonly used for

Fibromyalgia

Calf cramps

Chronic pain

Back Pain

Neck & Shoulder Pain

Arthritis

Burnout

Cancer Support

Restless Leg Syndrome

Chronic fatigue syndrome

Joint Pain

Multiple sclerosis

Symptoms practitioners commonly work with

Parasympathetic Activation