Choosing Between Body Massages: What the Research Says About Pain, Pressure and Safety

Spa menus list body massages by technique, scent or tool, and the names don’t tell you much about what to expect. Health sources give a clearer guide, along with a few limits worth knowing.

What massage therapy covers

The US National Center for Complementary and Integrative Health (NCCIH) describes massage therapy as a hands-on treatment used to help with a health problem or to support general health. The most common Western style is Swedish massage. Other styles include sports massage and methods from Asia, such as Shiatsu and Tuina. The NCCIH page was last updated in May 2019, so newer research may not be on it.

What the research shows for pain

NCCIH is careful in how it rates the research:

• Low-back pain: A 2015 review found short-term improvements, but its authors had “very little confidence” that massage works as a treatment. A 2017 guideline included massage for short-term low-back pain and left it out for long-term pain.
• Neck and shoulder pain: Massage may help, but the relief often does not last long. A 2016 review suggested relief when sessions were long and frequent enough.
• Cancer-related pain and anxiety: A 2016 review found some signs of help, but the quality of the research was very low.

For a visitor on a short trip, massage fits a goal of relaxing or feeling better for a while. It is a weaker fit for treating a problem that has lasted a long time.

Pressure matters for safety

NCCIH states that the risk of harm from massage appears to be low. It also reports rare serious problems, including a blood clot, nerve injury or a broken bone. These were linked to strong types of massage, such as deep tissue massage, and to people at higher risk of injury, such as older adults. People with cancer may need the therapist to use less pressure in some areas.

The advice on the page is clear: don’t use massage to delay seeing a doctor about a medical problem.

A note on lymphatic drainage claims

Lymphatic drainage appears on many menus. A review in Research, Society and Development looked at this technique for swelling in the legs (edema). The authors searched four databases for articles from 1995 to 2019 and found 52. Eight of them met the review’s rules. The patients all had problems with blood flow or the lymph system. The review reported less swelling and less pain, using slow, gentle, steady pressure.

Because the patients in that review had diagnosed conditions, the findings apply to medical care. A spa session is different. A visitor with swelling that has no clear cause should see a doctor before booking a session.

Wooden-tool and stone massages

None of the sources used for this article tested wooden-tool massage, hot stone massage or similar spa techniques, so there is no research here on them. A visitor can still book them to relax, and can ask the studio what effect it expects from them.

Questions to ask before booking

Question	Why it matters
How much pressure will the therapist use, and can it be changed during the session?	NCCIH links rare serious problems to strong massage
What training and qualifications does the therapist have?	NCCIH advises asking about training, experience and qualifications
How many sessions are suggested, and what do they cost?	NCCIH lists number of sessions and cost as questions to ask
Is there anything I should tell the therapist first?	Older adults and cancer patients may need changes to the session

Readers choosing between body massages on a studio menu can take this table along and ask each question in turn. A studio that talks about relaxation or short-term comfort is claiming no more than the research supports.

Reading the numbers in the lymphatic review

The review is a good example of how to read any claim about research. The authors found 52 articles, and 8 met their rules. That is about 15%. The other 85% were left out, so the findings come from a small number of studies. When a menu says “studies show,” a fair question is how many studies, in whom, and for which condition.

Planning the visit

Arrive a few minutes early to fill in any health form, and tell the therapist about any injuries. Both cost nothing. It is much easier to ask for more pressure during a session than to ask for less after it starts to hurt.

The takeaway

The research shows small, short-term benefits for comfort and relaxation, with low risk when the pressure suits the person. Pick a style that fits a realistic goal, and see a doctor about any medical problem.