Does massage really lower stress? What the science says

Almost everyone leaves a good massage feeling that the stress has been left on the couch. But is it just a pleasant impression, or does massage have real, measurable effects? And how long do they last?

Research on massage and stress is abundant, but of uneven quality. Many websites repeat that “massage lowers cortisol by 30%” or “increases serotonin”. The reality is more nuanced and, in some respects, more interesting.

How touch acts on stress

Stress in two lines

When we face a threat or pressure, the body activates the sympathetic nervous system (the heart speeds up, muscles tense, vigilance increases) and releases hormones such as adrenaline and cortisol. It is a useful response in the short term. The problem arises when it stays switched on for weeks: muscle tension, poor-quality sleep, irritability, tiredness.

What massage does

• It activates nerves specialised in affective touch. The skin has nerve fibres (called C-tactile fibres) that respond mainly to slow, gentle stroking at skin temperature. These fibres connect to areas of the brain associated with emotion and wellbeing, and not so much with the perception of touch itself (McGlone et al., 2014). It is one of the explanations for the calming effect of touch.
• It stimulates the parasympathetic system. Pressure on the skin and muscles activates receptors that favour rest mode. In one study, moderate-pressure massage increased vagal activity (a parasympathetic marker) and lowered heart rate, whereas very light massage had the opposite, more stimulating effect (Diego and Field, 2009).
• It reduces muscle tension, which in turn decreases the warning signals the body sends to the brain.
• It creates a context of pause: a calm space, with no screens, no demands, with dedicated attention. This component is not secondary: it is part of the effect.

Taken together, massage helps the body “change mode”, from alert to rest. For those who live in a constant state of alert, that change can be rare and precious.

What the studies say

Anxiety and tension: the most consistent effect

The reference meta-analysis in this area pooled 37 controlled studies and concluded that massage reduces “state” anxiety (the anxiety of the moment) immediately after a session. In series of sessions, it also reduced “trait” anxiety (the general tendency towards anxiety) and depressive symptoms, with effects of a size similar to some psychotherapies (Moyer et al., 2004). It is a robust result and one of the most cited.

Generalised anxiety

Two trials in people with generalised anxiety disorder give a balanced picture:

• In a trial with 68 participants, ten massage sessions improved anxiety, but so did relaxation with heat and music relaxation therapy, with no significant differences among the three (Sherman et al., 2010). In other words: the active ingredient may be, in large part, relaxation.
• In a more recent trial, six weeks of Swedish massage reduced anxiety symptoms more than a light-touch control (Rapaport et al., 2016).

Conclusion: massage helps, is pleasant and safe, but is not “magic”. Other forms of relaxation also work. And in clinical anxiety, it should complement, not replace, treatment.

And cortisol?

A myth needs dispelling here. For years it was cited that massage reduces cortisol by around 30%, based mainly on studies from a single research group. A quantitative review that analysed all the available studies concluded that the average effect of massage on cortisol is small and of little significance (Moyer et al., 2011). Another review found inconsistent results in physiological markers of stress (Moraska et al., 2010).

This does not mean that massage does not work against stress: it means that the benefit is more noticeable in how a person feels, in muscle tension and in the autonomic nervous system than in a large drop in hormones. A study of a single Swedish massage session observed modest changes in stress hormones and in immune system cells, compared with light touch (Rapaport et al., 2010). These are interesting results, but preliminary.

Heart rate and blood pressure

Several studies show slight, temporary falls in heart rate and blood pressure after massage. They are consistent with relaxation, but do not replace treatment of hypertension.

Sleep

Stress and sleep are linked in both directions. Reviews suggest that massage may improve sleep quality in some groups, such as people with chronic pain, older people or cancer patients (Field, 2016), although the evidence is limited.

What to take from this

How to get more out of massage

• Regularity: one session helps in the moment. Regular sessions (for example, weekly or fortnightly in harder phases, monthly for maintenance) have longer-lasting effects.
• Moderate pressure: comfortable and enveloping, without pain. Neither a superficial touch nor pressure that makes you tense up.
• Switch off: phone on silent, arrive a few minutes early, avoid booking a meeting straight afterwards.
• Breathing: slow breathing using the abdomen boosts the parasympathetic effect.
• Prolonging the effect: after the session, a calm walk, a warm bath or a quiet evening help to maintain the state of relaxation.
• Combine: massage works best as part of a whole that includes sleep, exercise, breaks and relationships that do us good.

The limits of massage

Massage does not eliminate the causes of stress, such as work overload, financial problems or conflict. It does not treat anxiety disorders, depression or burnout, although it can be a good complement.

Seek help from a psychologist or your doctor if:

If you have thoughts of despair or that life is not worth living, speak now to someone you trust and seek help: SNS 24 (808 24 24 24) offers psychological counselling, and in a situation of danger call 112.

Chest pain, sudden shortness of breath or palpitations with fainting should not be attributed to stress without assessment: call 112.

At Luxmed Clinic

At Luxmed Clinic, in Algés, relaxing massages are carried out with moderate pressure and a slow rhythm, in an environment designed for switching off. We adjust the session to the way stress shows up in you, whether as tension in the neck and shoulders, a clenched jaw or difficulty sleeping. Massages are carried out by a massage therapist.

Massage is a wellbeing complement and does not replace medical or psychological assessment or treatment. Results vary from person to person.

Frequently asked questions