Forms of massage at a glance

“Massage” means “kneading”. Sometimes the sole aim of massage is to help someone relax and improve their wellbeing. But often the goal is to relieve symptoms and treat medical conditions. Such therapeutic massages aim to relax your muscles, relieve pain, reduce stress, improve your metabolism, as well as influence the nervous system or certain organs. For example, massage may be used to treat problems like musculoskeletal disorders, neurological disorders, rheumatism, as well as injuries and symptoms that may be caused by stress, such as headaches and sleep problems. Therapeutic massages can sometimes be painful, particularly when a lot of pressure is applied to the affected area. It is usually the skin, the connective tissue under the skin, or the muscles that are massaged.

It is not easy to keep track of all the different kinds of massage that are available nowadays. In the following we describe some, but not all, of the most common forms of massage and different techniques.

The various kinds of massage differ in terms of the hand movements used, the parts of the body that are massaged, the amount of pressure applied, and the instruments and parts of the body that the massage therapist might use. Different massages are also based on different theories about how medical conditions develop and how the body works. In traditional Chinese medicine, for instance, it is thought that massage improves the flow of energy in the body. The fact that the following kinds of massage are included in the list below does not mean that they all help in the treatment of symptoms and medical conditions. You can find information about how effective some kinds of massage are here.

Classic forms of massage

Classic (Swedish) massage
In Europe, when we talk about a “classic” massage we mean a Swedish massage. Classic massage involves directly massaging the skin and muscles in the affected area. Five different hand movements are used: stroking, kneading, rubbing, tapping and vibrating. The basic idea behind this approach is that pain is often caused by tense and tight muscles that affect blood circulation and irritate the nerves. The aim of classic massage is to relax the muscles and improve circulation by directly treating these problems.

Manipulation
In this approach, ligaments, tendons and muscles are treated using massage moves, and they are also stretched and moved. The aim is to improve mobility and relieve pain. Manipulation therapy is not necessarily “purely” massage: it has many elements of physiotherapy too.  

Mobilisation
Here the therapist moves joints in the body or the spine in addition to massaging muscles. Like manipulation, mobilisation aims to improve mobility, and includes elements of both massage and physiotherapy. It is also used to relax your muscles and improve posture and positioning.

Connective tissue massage
Connective tissue connects the different structures of the body – such as organs, muscles and nerves – with each other. The aim of massaging connective tissue is to treat illnesses by relieving tension and also positively influencing organs elsewhere in the body.

Deep tissue massage
Here it is mainly the deeper layers of muscle that are massaged. Strong pressure is applied to muscles and tendons using the fingers to try to relieve tension in the body. The deeper the massage, the more painful it can be.

Trigger point therapy
In trigger point therapy, pressure is specifically applied to certain “pain-triggering” points (trigger points). These points are oversensitive, tense muscle fibres which the treatment aims to relax.  

Periosteal massage
The “periosteum” is the “bone covering” – a thin layer of tissue that covers all bones. It has a lot of nerves and blood vessels in it. The periosteum is massaged with the aim of relieving certain forms of pain.    

Massage techniques based on traditional Chinese medicine

Acupressure and similar kinds of massage
In acupressure, the therapist applies gentle to moderate pressure to certain points on the body with his or her fingertips, using rotating movements. Acupressure comes from traditional Chinese medicine (TCM) and is based on the idea that there are energy pathways (meridians) in the body through which life energy (chi) flows. Massaging certain points along these pathways is believed to affect people’s life energy.
Acupuncture massage is similar to acupuncture and acupressure in its approach. It involves stimulating points on the meridians using metal instruments. Although the name “acupuncture massage” may suggest otherwise, no needles are used in this approach.

Foot reflexology massage
In this treatment, gentle pressure is applied to the soles of the feet and the toes. The underlying idea is that certain points on the foot correspond to certain organs in the body, and these are connected via so-called “reflex pathways” (not to be confused with nerve tracts). Massaging these points is believed to have a healing effect.

Vacuum cupping (“cup massage”)
This kind of massage involves creating a vacuum using a vacuum pump that is attached to a glass cup. The cup is placed on the skin, and the vacuum pulls the skin into the cup, massaging it in this way. If larger areas of the body have to be massaged, the suction cup is moved.

Other kinds of Asian massage

Thai massage
Thai massage involves stretching and pulling the limbs. The massage therapist applies strong, rhythmical pressure to the body with his or her hands, elbows, knees or feet. According to traditional beliefs, “energy lines” run through the body, connecting the various organs and parts of the body, and these can be manipulated in order to treat illnesses. The modern-day medical explanation is that Thai massage has an effect on muscles, bones and blood circulation.

Shiatsu
Shiatsu is a Japanese form of trigger point massage therapy.

Ayurvedic massage
Ayurveda is a system of traditional Indian medicine. Ayurvedic massage involves gently massaging the body using rhythmical stroking movements and herbal oils. According to the principles of Ayurveda, this has a cleansing and relaxing effect.

As well as the massage techniques described here, there are a lot of devices that you can try out yourself at home, such as small massage balls or electric massage chairs.


Author: German Institute for Quality and Efficiency in Health Care (IQWiG)

© IQWiG (Institute for Quality and Efficiency in Health Care)