(also known as “The Tomb of the Physician”) in Saqqara
depicts two men having work done on their feet and hands, presumably massage.
BC 722-481: Huangdi Neijing is composed during the Chinese Spring and Autumn period (the beginning of recorded history). The Nei-jing is a compilation of medical knowledge known up to that date, and is the foundation of Traditional Chinese Medicine. Massage is referred to in 30 different chapters of the Nei Jing. It specifies the use of different massage techniques and how they should be used in the treatment of specific ailments, and injuries. Also known as “The Yellow Emperor’s Inner Canon”, the text refers to previous medical knowledge from the time of the Yellow Emperor (approx 2700 BC), misleading some into believing the text itself was written during the time of the Yellow Emperor (which would predate written history).
BC 700 Bian Que, the earliest known Chinese physician uses massage in medical practice.
BC 500 Jīvaka Komarabhācca, also known as Shivago Komarpaj, the founder of Traditional Thai massage (Nuad Boran) and Thai medicine. According to the Pāli Buddhist Canon, Jivaka was Buddha‘s physician. He codified a healing system that combinesacupressure, reflexology, and assisted yoga postures. Traditional Thai massage (Nuad Boran) is generally based on a combination ofIndian and Chinese traditions of medicine. Jivaka is known today as “Father Doctor” in Thailand.
BC 493: A possible biblical reference documents daily “treatments” with oil of myrrh as a part of the beauty regimen of the wives of Xerxes (Esther, 2:12).
BC 460: Hippocrates wrote “The physician must be experienced in many things, but assuredly in rubbing”.
BC 300 Charaka Samhita believed to be the oldest of the three ancient treatises of Ayurvedic medicine, including massage. Sanscrit records indicate that massage had been practiced in India long before the beginning of recorded history.
AD 581: Dr Sun Si Miao introduces ten new massage techniques and systematized the treatment of childhood diseases using massage therapy.
AD 581: China establishes a department of massage therapy within the Office of Imperial Physicians.
AD 1150: Evidence of massage abortion, involving the application of pressure to the pregnant abdomen, can be found in one of the bas reliefs decorating the temple of Angkor Wat in Cambodia. It depicts a demon performing such an abortion upon a woman who has been sent to the underworld. This is the oldest known visual representation of abortion.
AD 1776: Jean Joseph Marie Amiot, and Pierre-Martial Cibot, French missionaries in China translate summaries of Huangdi Neijing, including a list of medical plants, exercises and elaborate massage techniques, into the French language, thereby introducing Europe to the highly developed Chinese system of medicine, medical-gymnastics, and medical-massage. 
AD 1776 Pehr Henrik Ling, a Swedish physical therapist, and teacher of medical-gymnastics is born. Ling has often been erroneously credited for having invented “Classic Massage” aka “Swedish Massage”, and has been called the “Father of Massage”.
AD 1779: Frenchman Pierre-Martial Cibot publishes ‘Notice du Cong-fou des Bonzes Tao-see’ also known as “The Cong-Fou of the Tao-Tse”, a French language summary of medical techniques used by Taoist priests. According to Joseph Needhan, Cibot’s work “was intended to present the physicists and physicians of Europe with a sketch of a system of medical gymnastics which they might like to adopt—or if they found it at fault they might be stimulated to invent something better. This work has long been regarded as of cardinal importance in the history of physiotherapy because it almost certainly influenced the Swedish founder of the modern phase of the art, Per Hendrik Ling. Cibot had studied at least one Chinese book, but also got much from a Christian neophyte who had become expert in the subject before his conversion.” 
AD 1813 The Royal Gymnastic Central Institute for the training of gymnastic instructors was opened in Stockholm, Sweden, with Pehr Henrik Ling appointed as principal. Ling developed what he called the “Swedish Movement Cure” with the help of a friend named Ming (full name never recorded) who was an expert in the martial arts and Kung-Fubased Tui na massage. Ling died in 1839, having previously named his pupils as the repositories of his teaching. Ling and his assistants left little proper written account of their methods. 
AD 1878: Dutch massage practitioner Johan Georg Mezger takes a sub-set of techniques from Dr. Ling’s system, and coins the phrase “Swedish massage system”. Notably, Ling’s techniques, having been borrowed by Mezger, are still known by their French names (effleurage (long, gliding strokes), petrissage (lifting and kneading the muscles), friction (firm, deep, circular rubbing movements), tapotement (brisk tapping or percussive movements), and vibration (rapidly shaking or vibrating specific muscles)). Each of these techniques are fundamental elements of Tui na, and had been practiced in China for several thousand years prior.
Marathon runners receiving massages at the 2004 ING Taipei International Marathon
China: Massage has developed continuously in China for over 5000 years. Western ideas are considered within the traditional framework. It is widely practiced and taught in hospital and medical schools and is an essential part of health maintenance and primary healthcare.
United States: Massage started to become popular in the United States in the middle part of the 19th century and was introduced by two New York physicians based on Per Henrik Ling‘s techniques developed in Sweden.
During the 1930s and 1940s massage’s influence decreased as a result of medical advancements of the time, while in the 1970s massage’s influence grew once again with a notable rise among athletes. Massage was used up until the 1960s and 1970s bynurses to help ease patients’ pain and help them sleep.
United Kingdom: Massage is popular in the United Kingdom today and gaining in popularity. There are many private practitioners working from their own premises as well as those who operate from commercial venues.
Massage in sports, business and organizations: Massage developed alongside athletics in both Ancient China and Ancient Greece. Taoist priests developed massage in concert with their Kung Fu gymnastic movements, while Ancient Greek Olympians used a specific type of trainer (“aleiptes”) who would rub their muscles with oil. Pehr Ling’s introduction to massage also came about directly as a result of his study of gymnastic movements.
The 1996 Summer Olympics in Atlanta was the first time that massage was offered as a core medical service to the US Olympic Team. Massage has been employed by businesses and organizations such as the U.S. Department of Justice, Boeing and Reebok. Notable athletes such as Michael Jordan and LeBron James have personal massage therapists that at times even travel with them.
Types and methods of massage
Main article: Acupressure
Acupressure (a portmanteau of “acupuncture” and “pressure”) is a traditional Chinese medicine (TCM) technique derived from acupuncture. With acupressure physical pressure is applied to acupuncture points by the hand, elbow, or with various devices.
Indian Traction Massage forintervertebral disc prolapse
Breast massage (Lymphatic breast massage)
Lymphatic breast massage is a type of breast massage designed to stimulate lymphatic movement in the breast tissue.
Main article: Anma
Anma is a traditional Japanese massage involving kneading and deep tissue work.
Ayurveda is a natural health care system originating in India that incorporates massage, yoga, meditation and herbal remedies. Ayurvedic massage, also known as Abhyangha is usually performed by one or two therapists using a heated blend of herbal oils based on the ayurvedic system of humors.
Main article: Balinese massage
Balinese massage techniques are gentle and aim to make the patient feel relaxed and calm throughout. The techniques include skin folding, kneading, stroking,and other techniques. The massage therapist applies aromatheraphy oil throughout the massage. A patient’s blood, oxygen and energy flow is said to increase due to the treatment. Balinese hot stones are an option.
Barefoot deep tissue massage
Barefoot deep tissue, also known as barefoot compressive deep tissue, or barefoot sports massage, is a blend of Eastern barefoot techniques, such as barefoot Shiatsu massage, coupled with a Western manual medicine, encompassing deep tissue, myofascial release, trigger point therapy, transverse friction, compression, tension, shear,proprioceptive neuromuscular facilitation (PNF), stretching, as well as parasympathetic response, on clothed clients using no oil. Dara Torres, 41-year-old Olympian, received barefoot compression massage on a daily basis in her training program.
This modality typically uses the heel, sesamoid, arch and/or whole plantar surface of foot, and offers large compression, tension and shear forces with less pressure than elbow or thumb, and is ideal for large muscles, such as in thigh, or for long-duration upper trapezius compressions. The unclothed cousins of this modality are Keralite, Yumeiho, Barefoot Lomi Lomi, Fijian Barefoot, Chavutti Thirummal.
Ashiatsu Oriental Bar Therapy, which is a form of barefoot effleurage, combines western science and contemporary American ingenuity, for therapists who specialize in deep tissue work using myofascial and Swedish techniques performed by the massage therapist’s feet.
Main article: Bowen technique
Bowen technique involves a rolling movement over fascia, muscles, ligaments, tendons and joints. It is said not to involve deep or prolonged contact with muscle tissues as in most kinds of massage, but claims to relieve muscle tensions and strains and to restore normal lymphatic flow. Because this technique is so gentle, Bowen Therapy can be suitable for newborn baby to elderly. It is based on practices developed by Australian Tom Bowen and the practitioners are all over the world. 
Main article: Breema
Breema bodywork is performed on the floor with the recipient fully clothed. It consists of rhythmical and gentle leans and stretches.
Cranial Release Technique
Main article: Champissage
Champissage is a massage technique focusing on the head, neck and face that is believed to balance the chakras.
Couples massage is a service offered by some spas and massage parlors where two people (usually, but not always, couples), are massaged side-by-side on separate tables and by separate providers. It adds a social element to massage.
Deep tissue massage
Deep tissue massage is designed to relieve severe tension in the muscle and the connective tissue or fascia. This type of massage focuses on the muscles located below the surface of the top muscles. Deep tissue massage is often recommended for individuals who experience consistent pain, are involved in heavy physical activity (such as athletes), and patients who have sustained physical injury. It is not uncommon for receivers of deep tissue massage to have their pain replaced with a new muscle ache for a day or two.
The term “deep tissue” is often misused to identify a massage that is performed with sustained deep pressure. Deep tissue massage is a separate category of massage therapy, used to treat particular muscular-skeletal disorders and complaints and employs a dedicated set of techniques and strokes to achieve a measure of relief. It should not be confused with “deep pressure” massage, which is one that is performed with sustained strong, occasionally intense pressure throughout an entire full-body session, and that is not performed to address a specific complaint. Deep tissue massage is applied to both the superficial and deep layers of muscles, fascia, and other structures. The sessions are often quite intense as a result of the deliberate, focused work. When a client asks for a massage and uses the term “deep tissue”, more often than not he or she is seeking to receive a full-body session with sustained deep pressure throughout. If a practitioner employs deep tissue techniques on the entire body in one session, it would be next to impossible to perform; it might lead to injury or localized muscle and nerve trauma, thereby rendering the session counterproductive.
Main article: Erotic massage
Erotic massage (or sensual massage) is the use of massage techniques to achieve or enhance sexual arousal. It can used as part of sex, either as foreplay or as the final sex act. Erotic massages typically feature massages in erogenous zones of the body to increase sexual arousal.
Main article: Esalen Institute
Esalen Massage was developed at the Esalen Institute based on a combination of many massage and bodywork techniques. The two main influences were Swedish massage and the Sensory Awareness work of Charlotte Selver. Esalen Massage works with gentle rocking of the body, passive joint exercises and deep structural work on the muscles and joints, together with an energetic balancing of the body.
While various types of reflexology related massage styles focus on the feet, massage of (usually) the soles of the feet is often performed purely for relaxation or recreation.
Main article: Hilot
Hilot is a traditional healing technique from the Philippines that also includes massage techniques. The massage techniques relax stressed muscles. Hilot also includes joint manipulations to help relax stressed muscles.
Hilot encompasses a wide variety of techniques beyond the treatment of stressed muscles. Hilot can be used to reset sprained joints, diagnose and treat musculoligamentous and musculoskeletal ailments, and even to aid in giving birth and to induce abortion.
Dislocated joints can also be reset by hilot after an X-ray has been done on affected body parts and medical experts advised that the same body parts are safe to be massaged.
After giving birth, hilot can be done on the mother and the baby born of normal delivery for 10 consecutive days so that they may recover easily. Hilot should not be done on mothers who deliver via caesarian section.
Hilot also uses banana leaves and herbs for enhanced efficacy.
Main article: Infant massage
cf Pediatric massage
Infant massage is a type of complementary and alternative treatment that uses massage therapy for human infants. This therapy has been practiced globally, and has been increasingly used in Western countries as a treatment for infants.
Main article: Kum Nye
Kum Nye and sKu-mNyé are a wide variety of Tibetan religious and medical body practices. The two terms are different spellings in the Latin alphabet of the same Tibetan phrase (Wylie: sku mnye), which literally means “massage of the subtle body”. Some systems of sku mnye are vaguely similar to Yoga, T’ai chi, Qigong, or therapeutic massage. “Kum Nye”, Ku Nye, and Kunye are also used to transcribe the Tibetan phrases dku mnye (“belly massage”) and bsku mnye (“oil massage”), which are pronounced identically to sku mnye. dKu mnye and bsku mnye manipulate the physical body, rather than the subtle (energetic) one.
Lomi Lomi and indigenous massage of Oceania
Main article: Lomi Lomi
Lomilomi is the traditional massage of Hawaii. As an indigenous practice, it varies by island and by family. The word lomilomi also is used for massage in Samoa and East Futuna. In Samoa, it is also known as lolomi and milimili. In East Futuna, it is also called milimili, fakasolosolo, amoamo, lusilusi, kinikini, fai’ua. The Māori call it roromi andmirimiri. In Tonga massage is fotofota, tolotolo, and amoamo. In Tahiti it is rumirumi. On Nanumea in Tuvalu, massage is known as popo, pressure application is kukumi, and heat application is tutu. Massage has also been documented in Tikopia in the Solomon Islands, in Rarotonga and in Pukapuka in Western Samoa.
Lymphatic drainage massage
Massage technique used to gently work and stimulate the lymphatic system, to assist in reduction of localised swelling
Medical Massage is a controversial term in the massage profession. Many use it to describe a specific technique. Others use it to describe a general category of massage and many methods such as deep tissue massage, myofascial release and triggerpoint therapy as well as reiki, osteopathic techniques, cranial-sacral techniques and many more can be used to work with various medical conditions. Massage used in the medical field includes decongestive therapy used for lymphedema which can be used in conjunction with the treatment of breast cancer. Light massage is also used in pain management and palliative care. Carotid sinus massage is used to diagnose carotid sinus syncope and is sometimes useful for differentiating supraventricular tachycardia (SVT) from ventricular tachycardia. It, like the valsalva maneuver, is a therapy for SVT.However, it is less effective than management of SVT with medications.
In Mesoamerica as in other areas of the world an indigenous form of soft tissue and structural massage has developed. Today this art survives thanks to the many Sobadoras/es or Hueseros/as that have handed-down these techniques via oral tradition.
Main article: Metamorphic Technique
The Metamorphic Technique is a gentle form of foot, hand and head massage that can be carried out by anyone with a brief training in the technique. It draws on reflexology in its theory and approach.
Given some of the main benefits of massage, many people prefer to have a therapist come to them to perform the treatment as opposed to visiting the therapist. Amongst other things, this type of treatment has the benefits of allowing the recipient to remain in their own environment with which they are likely most comfortable, to avoid the pre and post stresses of travelling to the therapist to receive their massage and of course to retire directly to a place of rest immediately following their massage. Therapists can bring a dedicated table with them on which to perform the massage or perform the treatment on the floor or the client’s own bed. Mobile (or outcall) massages are particularly popular in big cities around the world where life can be more hectic than elsewhere and there are many operators of such services in places like London and New York.
Myofascial release massage
Main article: Myofascial release
Myofascial release refers to the manual massage technique for stretching the fascia and releasing bonds between fascia, integument, and muscles with the goal of eliminatingpain, increasing range of motion and equilibrioception. Myofascial release usually involves applying shear compression or tension in various directions, or by skin rolling.
An integration of techniques including basic Swedish massage, aromatherapy, reflexology, shiatsu, energy balancing, tuina Chinese medical massage, acupressure andcraniosacral therapy along with other modalities in conjunction with instruction in nutrition, meditation and yoga. The term Myomassology was coined by Irene Gauthier to describe her combined work of Swedish massage, craniosacral therapy, reflexology and body mechanics.
Main article: Pediatric massage
cf Infant massage
Pediatric massage is the complementary and alternative treatment that uses massage therapy, or “the manual manipulation of soft tissue intended to promote health and well-being” for children and adolescents.
Postural integration (PI)
Main article: Postural Integration (PI)
Postural Integration (PI) is a process-oriented bodywork combining deep tissue massage with breathwork, body movement and awareness as well as emotional expression.
Main article: Prostate massage
Prostate massage was once the most popular therapeutic maneuver used to treat prostatitis. According to the Prostatitis Foundation “it used to be, in the age before antibiotics (before about 1960 for prostatitis), doctors performed massage when their patients had prostatitis. In some cases it was enough to cure them of the disease. … it fell out of common practice with the advent of antibiotics.”
Main article: Reflexology
Reflexology is based on the principle that there are reflexes in the hands and feet that relate to every organ, gland, and system of the body.
Massage techniques such as sports massage, trigger point therapy and PNF stretching combined for an overall curative approach.
A few various techniques that are practiced on oneself, such as stroking the temples with strong pressure from front to back, rubbing the bottoms of the feet with one’s knuckles or a wooden massage tool, and circular movement with thumb on palm of hand.
Main article: Shiatsu
Shiatsu (指圧) (shi meaning finger and atsu meaning pressure) is a Japanese therapy that uses pressure applied with thumbs, fingers and palms to the same energy meridians as acupressure and incorporates stretching. It also uses techniques such as rolling, brushing, vibrating, grasping and, in one particular technique developed by Suzuki Yamamoto, pressure is applied with the feet on the person’s back, legs and feet.
Main article: Manual therapy
Also known as manual therapy, manipulative therapy, or manual & manipulative therapy, this is a physical treatment primarily used on the neuromusculoskeletal system to treat pain and disability. It most commonly includes kneading and manipulation of muscles, joint mobilization and joint manipulation.
Main article: Stone massage
A stone massage uses cold or water-heated stones to apply pressure and heat to the body. Stones coated in oil can also be used by the therapist delivering various massaging strokes. The hot stones used are commonly Basalt stones (or lava rocks) which over time have become extremely polished and smooth. As the stones are placed along the recipient’s back, they help to retain heat which then deeply penetrates into the muscles, releasing tension.
Main article: Structural integration
Structural integration‘s aim is to unwind the strain patterns residing in the body’s myofascial system, restoring it to its natural balance, alignment, length, and ease. This is accomplished by deep, slow, fascial and myofascial manipulation, coupled with movement re-education. Various brands of Structural Integration are Kinesis Myofascial Integration and Rolfing.
Swedish massage uses five styles of long, flowing strokes to massage. The five basic strokes are effleurage (sliding or gliding),petrissage (kneading), tapotement (rhythmic tapping), friction (cross fiber) and vibration/shaking. Swedish massage has shown to be helpful in reducing pain, joint stiffness, and improving function in patients with osteoarthritis of the knee over a period of eight weeks. The development of Swedish massage is often inaccurately credited to Per Henrik Ling, though the Dutch practitionerJohan Georg Mezger adopted the French names to denote the basic strokes. The term “Swedish” massage is actually only recognized in English and Dutch speaking countries, and in Hungary. Elsewhere (including Sweden) the style is referred to as “classic massage”.
A massage by two or more therapist. It is occasionally called a four hand massage. Therapist usually work simultaneously in a rhythmic fashion providing a great relaxing stimuli on the nervous system.
Main article: Neotantra
A massage technique popularized by the neotantra movement, and drawing on modern interpretations of tantra.
Main article: Thai massage
Known in Thailand as นวดแผนโบราณ (Nuat phaen boran, IPA: [nûət pʰɛ́ːn boːraːn]), meaning “ancient/traditional massage”, TraditionalThai massage (Nuad Boran) is generally based on a combination of Indian and Chinese traditions of medicine. It is a unique form of Buddhist physiotherapy that blends yoga, acupressure and reflexology.
Traditional Chinese massage
Two types of traditional Chinese massage exist – Tui na (推拿) which focuses on pushing, stretching and kneading the muscle and Zhi Ya (指壓) which focuses on pinching and pressing at acupressure points. Both are based on principles from Traditional Chinese Medicine. Though in the Western countries Tui Na is viewed as massage, it is not. Massage of Chinese Medicine is known as Anmo (按摩), which is the foundation of Japan’s Anma.
Within the foundation of Tui Na, Traditional Chinese Medicine principles are followed, from Meridian Applications to Herbal Formulas, Qigong Therapy and heated herbal application (Moxa). Technique applications such as friction and vibration are used as well.
Main article: Trager Approach
The Trager approach combines movement and touch to educate the body/mind.
Trigger point therapy
Sometimes confused with pressure point massage, this involves deactivating trigger points that may cause local pain or refer pain and other sensations, such as headaches, in other parts of the body. Manual pressure, vibration, injection, or other treatment is applied to these points to relieve myofascial pain. Trigger points were first discovered and mapped by Janet G. Travell (president Kennedy’s physician) and David Simons. Trigger points have been photomicrographed and measured electrically. and in 2007 a paper was presented showing images of Trigger Points using MRI. These points relate to dysfunction in the myoneural junction, also called neuromuscular junction (NMJ), in muscle, and therefore this modality is different from reflexology, acupressure and pressure point massage.
Aside from erotic applications, studies[which?] have shown that vaginal and perineal massage during pregnancy can reduce the tearing of the vaginal canal during childbirth and reduce pain
One form is Mayan abdominal massage which is practiced in many countries in Latin America. This type of massage may have been developed by Elijio Panti of Belize and brought to the United States by Rosita Arvigo.
Zoku Shin Do
Zoku Shin Do is an ancient Chinese system of foot massage that claims to treat the foot as a system related to the whole body and stimulate energy flow.
EquipmentWatsu is the combination of hydrotherapy and shiatsu developed by Harold Dull.[importance?] The work is done in skin temperature water with both the therapist and practitioner in the water, usually a pool that is between 3.5 ft to 4 ft (100–120 cm) deep. The work entails much movement in the water, and practitioners believe that it incorporates the activation of the energy lines derived from shiatsu. In a more advanced version, called waterdance, the receiver is taken underwater during the therapy to increase the sensations of peace, relaxation and weightlessness.
Tables and chairs
Specialized massage tables and chairs are used to position recipients during massages. A typical commercial massage table has an easily cleaned, heavily padded surface, and a horseshoe-shaped head support that allows the client to breathe easily while lying face down and can be stationary or portable, while home versions are often lighter weight or designed to fold away easily. An orthopedic pillow or bolster can be used to correct body positioning.
Ergonomic chairs serve a similar function as a massage table. Chairs may be either stationary or portable models. Massage chairs are easier to transport than massage tables, and recipients do not need to disrobe to receive a chair massage. Due to these two factors, chair massage is often performed in settings such as corporate offices, outdoor festivals, shopping malls, and other public locations.
A Vichy shower is a form of hydrotherapy which uses a series of shower nozzles which spray large quantities of water over the client while they lie in a shallow wet bed, similar to a massage table, but with drainage for the water. The nozzles may usually be adjusted for height, direction, and temperature to suit the clients needs.
Dry-water massage bed
A dry-water massage bed uses jets of water to perform the massage of the client’s muscles. These beds differ from a Vichy shower in that the client usually stays dry. Two common types are one in which the client lies on a waterbed-like mattress which contains warm water and jets of water and air bubbles and one in which the client lies on a foam pad and is covered by a plastic sheet and is then sprayed by jets of warm water, similar to a Vichy shower. The first type is sometimes seen available for use in malls and shopping centers for a small fee.
Many different types of oils can be used including jojoba oil, fractionated coconut oil, grape seed oil, olive oil, almond oil, macadamia oil, sesame oil, pecan oil, mustard oiland (mineral) baby oil. Each oil has different properties and serves different purposes. Lotions, cremes and gels may also be used. Each lubricant has slightly different properties, and the choice tends to be a therapists preference. There are different views about the extent to which various oils and other substances are absorbed into the body via the skin. Salts are also used in association with oils to remove dry skin.
A body rock is a serpentine-shaped tool, usually carved out of stone. It’s used to amplify the therapist’s strength and focus pressure on certain areas. It can be used directly on the skin with a lubricant such as oil or corn starch or directly over clothing.
Bamboo & rosewood tools are also commonly implemented. They originate from practices in SE Asia, Thailand, Cambodia, and Burma. Some of them may be heated, oiled, or wrapped in cloth.
Much massage takes place in homes or other informal settings for relaxation or as part of a sexual relationship. A wide range of books, videos, classes, oils, and other equipment is marketed at informal recreational massage. Commercial or therapeutic massage may take place in a setting hotel, spa, or massage parlor (typical of relaxation focussed or recreational massage), or in a therapist’s practice (typical of therapeutic massage).
Therapeutic or medical use
The main professionals that provide therapeutic massage are massage therapists, athletic trainers, physical therapists and practitioners of many traditional Chinese and other eastern medicines. Massage practitioners work in a variety of medical settings and may travel to private residences or businesses. Contraindications to massage includedeep vein thrombosis, bleeding disorders or taking blood thinners such as Warfarin, damaged blood vessels, weakened bones from cancer, osteoporosis, or fractures, bruising, and fever.
Practitioner associations and official recognition of professionals
The US based National Center for Complementary and Alternative Medicine recognizes over eighty different massage modalities. The most cited reasons for introducing massage as therapy have been client demand and perceived clinical effectiveness.
Many types of practices are associated with massage and include bodywork, manual therapy, energy medicine, and breathwork. Other names for massage and related practices include hands-on work, body/somatic therapy, and somatic movement education. Body-mind integration techniques stress self-awareness and movement over physical manipulations by a practitioner. Therapies related to movement awareness/education are closer to Dance and movement therapies. Massage can also have connections with the New Age movement and alternative medicine as well as being used by mainstream medical practitioners.
Peer-reviewed medical research has shown that the benefits of massage include pain relief, reduced trait anxiety and depression, and temporarily reduced blood pressure, heart rate, and state of anxiety. Theories behind what massage might do include blockingnociception (gate control theory), activating the parasympathetic nervous system, which may stimulate the release of endorphins andserotonin, preventing fibrosis or scar tissue, increasing the flow of lymph, and improving sleep, but such effects are yet to be supported by well-designed clinical studies.
Massage is hindered from reaching the gold standard of scientific research, which includes placebo-controlled and double blind clinical trials. Developing a “sham” manual therapy for massage would be difficult since even light touch massage could not be assumed to be completely devoid of effects on the subject. It would also be difficult to find a subject that would not notice that they were getting less of a massage, and it would be impossible to blind the therapist. Massage can employ randomized controlled trials, which are published in peer reviewed medical journals. This type of study could increase the credibility of the profession because it displays that purported therapeutic effects are reproducible.
Single dose effects
Pain relief: Relief from pain due to musculoskeletal injuries and other causes is cited as a major benefit of massage.Acupressure or pressure point massage may be more beneficial than classic Swedish massage in relieving back pain.However, a meta-study conducted by scientists at the University of Illinois at Urbana-Champaign failed to find a statistically significant reduction in pain immediately following treatment.
- State anxiety: Massage has been shown to reduce state anxiety, a transient measure of anxiety in a given situation.
- Blood pressure and heart rate: Massage has been shown to reduce blood pressure and heart rate as temporary effects.
Multiple dose effects
- Pain relief: When combined with education and exercises, massage might help sub-acute, chronic, non-specific low back pain.Furthermore, massage has been shown to reduce pain experienced in the days or weeks after treatment.
- Trait anxiety: Massage has been shown to reduce trait anxiety; a person’s general susceptibility to anxiety.
- Depression: Massage has been shown to reduce subclinical depression.
Massage has been shown to reduce neuromuscular excitability by measuring changes in the Hoffman’s reflex (H-reflex) amplitude. A decrease in peak-to-peak H-reflex amplitude suggests a decrease in motoneuron excitability. Others explain, “H-reflex is considered to be the electrical analogue of the stretch reflex…and the reduction” is due to a decrease in spinal reflex excitability. Field (2007) confirms that the inhibitory effects are due to deep tissue receptors and not superficial cutaneous receptors, as there was no decrease in H-reflex when looking at light fingertip pressure massage. It has been noted that “the receptors activated during massage are specific to the muscle being massaged”, as other muscles did not produce a decrease in H-reflex amplitude.
Massage and proprioception
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. 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”. 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” .
Because the art and science of massage is a globally diverse phenomenon, different legal jurisdictions sometimes recognize and license individuals with titles, while other areas do not. Examples are:
- Registered Massage Therapist (RMT) Canada
- Remedial Massage Therapist (RMT) New Zealand
- Certified Massage Therapist (CMT) New Zealand
- Licensed Massage Practitioner (LMP)
- Licensed Massage Therapist (LMT)
- Licensed Massage and Bodywork Therapist (LMBT) North Carolina
In some jurisdictions, practicing without a license is a crime.
In Canada only three provinces regulate massage therapy: British Columbia, Ontario, and Newfoundland and Labrador. The College of Massage Therapists of Ontario (CMTO) has set a level of 2,200 practice hours in both Ontario and Newfoundland and Labrador, and 3,000 hours in British Columbia, which has the highest education standard in North America. Quebec has a voluntary registration under the Quebec Federation of massage therapists (FMQ) or the Alliance Québécoise des Thérapeutes Naturels (AQTN), but neither are regulated by provincial law.
Most types of massage, with the exception of some traditional Chinese medicine are not regulated in China. Although illegal in China, some of the smaller massage parlors are fronts for prostitution. These are called falangmei (发廊妹 “hairdressing salon sisters”).
France requires three years of study and two final exams in order to get a license 
In Germany massage is regulated by the government on a federal and national level. Only someone who has completed 3,200 hours of training (theoretical and practical) can use the professional title “Masseur und Medizinischer Bademeister” or Medical Masseur and Spa Therapist. This person can prolong his training depending on the length of professional experience to a Physiotherapist (1 year to 18 months additional training). The Masseur is trained in Classical Massage, Myofascial Massage, Exercise and Movement Therapy. During the training they will study: Anatomy, Physiology, Pathology, Gynecology, Pediatry, Psychiatry, Psychology, Surgery, and probably most importantly Dermiatry and Orthopedics. They are trained in Electrotherapy, and Hydrotherapy. Hydrotherapy includes: Kneipp, Wraps, underwater Massage, therapeutic washing, Sauna and Steambath. A small part of their training will include special forms of massage which are decided by the local college, for example: Foot reflex zone massage, Thai Massage etc. Finally a graduate is allowed to treat patients under the direction of a doctor. He is regulated by the professional body which regulates Physiotherapists. This includes the restriction on advertising and oath of confidentiality to clients.
In India, massage therapy is licensed by The Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) under the Ministry of Health and Family Welfare (India) in March 1995. Massage therapy is based on Ayurveda, the ancient medicinal system that evolved around 600 BC. In ayurveda, massage is part of a set of holistic medicinal practices, contrary to the independent massage system popular in some other systems. In Siddha, Tamil traditional medicine from south India, Massage is termed as “Thokkanam” and is classified in to nine types, each for specific variety of disease.
In Japan, shiatsu is regulated but oil massage and Thai massage are not. Although prostitution is illegal, prostitutes posing as massage therapists in fashion health shops andpink salons are fairly common in the larger cities.
In Mexico massage therapists, called “sobadores“, combine massage using oil or lotion with a form of acupuncture and faith. Sobadores are used to relieve digestive system problems as well as knee and back pain. Many of these therapists work out of the back of a truck, with just a curtain for privacy. By learning additional holistic healer’s skills in addition to massage, the practitioner may become a curandero.
In many parts of Mexico prostitution is legal and prostitutes are allowed to sell sexual massage. These businesses are often confined to a specific area of the city, such as theZona Norte in Tijuana.
In New Zealand, massage is unregulated. There are two levels of registration with Massage New Zealand, the professional body for massage therapists within New Zealand, although neither of these levels are government recognised. Registration at the Certified Massage Therapist level denotes competency in the practice of relaxation massage. Registration at the Remedial massage therapist denotes competency in the practice of remedial or orthopedic massage. Both levels of registration are defined by agreed minimum competencies and minimum hours.
In South Korea, blind and visually impaired people can become licensed masseurs.
There are no national regulations relating to commercial massage or massage therapy in the UK, although various jurisdictions have licensing requirements for businesses performing massage.
According to research done by the American Massage Therapy Association, as of 2012 in the United States there are between 280,000 and 320,000 massage therapists and massage school students. Most states in the United States have licensing requirements that must be met before a practitioner can use the title “massage therapist”, and some states and municipalities require a license to practice any form of massage. If a state does not have any massage laws then a practitioner need not apply for a license with the state. However, the practitioner will need to check whether any local or county laws cover massage therapy. Training programs in the US are typically 500–1000 hours in length, and can award a certificate, diploma, or degree depending on the particular school. There are around 1,300 programs training massage therapists in the country and study will often include anatomy and physiology, kinesiology, massage techniques, first aid and CPR, business, ethical and legal issues, and hands on practice along withcontinuing education requirements if regulated. The Commission on Massage Therapy Accreditation (COMTA) is one of the organizations that works with massage schools in the U.S. and currently (Aug 2012) there are approximately 300 schools that are accredited through this agency.
Forty-three states, the District of Columbia and five Canadian provinces currently offer some type of credential to professionals in the massage and bodywork field—usually licensure, certification or registration. Thirty-eight states and the District of Columbia require some type of licensing for massage therapists. In the US, 32 states use the National Certification Board for Therapeutic Massage and Bodywork‘s certification program as a basis for granting licenses either by rule or statute. The National Board grants the designation Nationally Certified in Therapeutic Massage and Bodywork (NCTMB). There are two tests available and one can become certified through a portfolio process with equivalent training and experience. Between 10% and 20% of towns or counties regulate the profession. The National Certification offered by the NCBTMB does not mean that you can practice massage in any state. These local regulations can range from prohibition on opposite sex massage, fingerprinting and venereal checks from a doctor, to prohibition on house calls because of concern regarding sale of sexual services.
In the US, licensure is the highest level of regulation and this restricts anyone without a license from practicing massage therapy or by calling themselves that protected title.Certification allows only those who meet certain educational criteria to use the protected title and registration only requires a listing of therapists who apply and meet an educational requirement.
In late 2007, the Federation of State Massage Therapy Boards launched a new certification exam titled the MBLEx. Currently, 41 states have accepted this certification exam.
In 1997 there were an estimated 114 million visits to massage therapists in the US. Massage therapy is the most used type of alternative medicine in hospitals in the United States. Between July 2010 and July 2011 roughly 38 million adult Americans (18 percent) had a massage at least once.
People state that they use massage because they believe that it relieves pain from musculoskeletal injuries and other causes of pain, reduces stress and enhances relaxation, rehabilitates sports injuries, decreases feelings of anxiety and depression, and increases general well being.
In a poll of 25-35 year olds 79% said they would like their health insurance plan to cover massage. Companies that offer massage to their employees include Allstate, Best Buy, Cisco Systems, FedEx, Gannett (publisher of USA Today), General Electric, Google, Hewlett-Packard, Home Depot, JC Penney, Kimberly-Clark, Texas Instruments andYahoo!. In 2006 Duke University Health System opened up a center to integrate medical disciplines with CAM disciplines such as massage therapy and acupuncture. There were 15,500 spas in the United States in 2007 with about a third of the visitors being men.