How Does Massage Therapy Work?

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Whether you're an experienced massage therapist or a curious student, this infographic is a valuable reference when attempting to better understand the multidimensional benefits of massage therapy in alleviating pain and enhancing quality of life across a range of health issues.

How Does Massage Therapy Work?

Massage therapy can improve the health and well-being for individuals with a number of health-related conditions through interplay of immunological, neurological, and psychological components (Keter et al., 2025; Packheiser et al., 2024). The overall impact massage, known as the total treatment effect, can be analyzed through three lenses:

1. Specific effects: These are directly attributable to the massage techniques themselves. They include: 

  • Affective touch: Touch stimulates CT afferents (specialized receptors for gentle touch) and has been shown to influence neurobiological processes (dopaminergic and analgesic, opioidergic pathways) involved with relaxation and pain relief.

  • Mechanical factors: The effect that massage therapy can have on the musculoskeletal system (mediated by nerves, hormones, cytokines, neuropeptides and chemokines).

  • Neurological factors: Therapeutic massage may influence plasticity and adaptive changes in neuro-immune networks in such a way that pain subsides

2. Contextual effects: These consider the environment and relationships surrounding the treatment. The patient-therapist rapport, expectations (set), and physical surroundings (setting) can all influence outcomes.

3. Non-specific effects: These encompass natural recovery processes, like the body's inherent healing ability and spontaneous improvement over time.

In terms of clinical response to massage therapy, outcomes may be attributed to a complex interplay of biological, psychological, and social factors. This evidence-based explanation of why massage therapy works can help develop a cohesive message of this conservative approach and the value that massage therapists deliver.

References and Sources

With over 15 years of clinical experience and extensive study of massage therapy research, I'm committed to creating resources that foster the professional development of massage therapists globally. Whether you're a seasoned massage therapist or a curious newcomer, this massage therapy glossary is here to be your one-stop shop for understanding terms as it relates to massage therapy. Additionally this post highlights a substantial body of evidence supporting the use of massage therapy in alleviating pain and enhancing quality of life across a range of health issues

This is a selection of sources I used to help formulate my ideas based on over-lapping concepts from massage therapy, physiotherapy, chiropractic, osteopathy.

Cashin, A. G., McAuley, J. H., Lamb, S. E., & Lee, H. (2021). Disentangling contextual effects from musculoskeletal treatments. Osteoarthritis and cartilage, 29(3), 297–299. https://doi.org/10.1016/j.joca.2020.12.011

Degenhardt, B., van Dun, P. L. S., Jacobson, E., Fritz, S., Mettler, P., Kettner, N., Franklin, G., Hensel, K., Lesondak, D., Consorti, G., Frank, L., Reed, W. R., MacDonald, C., Kremen, V., Martin, C., Landels, B., & Standley, P. (2024). Profession-based manual therapy nomenclature: exploring history, limitations, and opportunities. The Journal of manual & manipulative therapy, 32(1), 96–110. https://doi.org/10.1080/10669817.2023.2288495

Kennedy, A. B., Cambron, J. A., Sharpe, P. A., Travillian, R. S., & Saunders, R. P. (2016). Clarifying Definitions for the Massage Therapy Profession: the Results of the Best Practices Symposium. International journal of therapeutic massage & bodywork, 9(3), 15–26. https://doi.org/10.3822/ijtmb.v9i3.312

Keter, D. L., Bialosky, J. E., Brochetti, K., Courtney, C. A., Funabashi, M., Karas, S., Learman, K., & Cook, C. E. (2025). The mechanisms of manual therapy: A living review of systematic, narrative, and scoping reviews. PloS one, 20(3), e0319586. https://doi.org/10.1371/journal.pone.0319586

Langevin, H. M. (2024). Health and Well-Being: Distinct and Intertwined Concepts. Medical care, 62(12 Suppl 1), S13–S14. https://doi.org/10.1097/MLR.0000000000002061

Lebert, R., Noy, M., Purves, E., & Tibbett, J. (2022). Massage Therapy: A Person-Centred Approach to Chronic Pain. International journal of therapeutic massage & bodywork, 15(3), 27–34. https://doi.org/10.3822/ijtmb.v15i3.713

Packheiser, J., Hartmann, H., Fredriksen, K., Gazzola, V., Keysers, C., & Michon, F. (2024). A systematic review and multivariate meta-analysis of the physical and mental health benefits of touch interventions. Nature human behaviour, 8(6), 1088–1107. https://doi.org/10.1038/s41562-024-01841-8

Saueressig, T., Pedder, H., Owen, P. J., & Belavy, D. L. (2024). Contextual effects: how to, and how not to, quantify them. BMC medical research methodology, 24(1), 35. https://doi.org/10.1186/s12874-024-02152-2