Not all pain is physical, but massage therapy can still be beneficial.
by David Malone, May 1, 2025
Massage therapy is not just a modality to help with physical aches and pains. It also provides many benefits for mental well-being, such as decreasing stress, anxiety and depression. Many massage techniques that your clients might request for help managing physical symptoms of illness, injury or stress, for example, can also help their overall emotional and mental well-being.
“The biopsychosocial model posits that the experience of health is multidimensional, composed of interdependent factors,” says Erika Larson, LMT. “Physical well-being and emotional well-being are interwoven. While some clients may seek treatment primarily focused on one dimension of health, treatment effects cannot be restricted to a single dimension.”
Sometimes emotions are discussed in relation to massage therapy as being “trapped.” One goal of massage is to release these trapped emotions, which can have both physical and mental/emotional benefits.
“When an emotion is trapped, what is really being held is the actions or reactions the person wanted to take at the time the emotion was felt,” says Cindy Carlton, LMT/Intuitive Healing Facilitator. “If someone holds back those emotional actions over and over again, it can cause distress in the tissues—muscles and fascia that were used to hold back the reactions become tight or taut.” Massage therapy can be used to help relax and release the taut tissues, releasing the “emotional energy” being held.
“Almost any massage modality can cause an emotional release during a session, but there are certain types of massage that lend themselves well to emotional processing and healing,” says Ariel F. Hubbard, LMT. “Lymphatic massage is especially effective because it does tend to directly affect emotions through the lymphatic system.”
According to Hubbard, other factors that influence more fluid emotional processing include:
Techniques such as reflexology, craniosacral therapy and Tui Na massage are also particularly effective in helping with emotional well-being. “Reflexology affects the nervous system and the endocrine system, and via these systems, all regions of the body wherever emotions may be stored,” Hubbard says. “Craniosacral therapy is also very effective because it treats the central nervous system and limbic system directly. Tui Na massage is effective because it can be used to address acupoints that treat certain emotions, but also because the movement in this modality can calm and reset the nervous system.”
Carlton also mentions using craniosacral therapy, as well as somatic emotional release (SER), even during sessions that may be primarily using deep tissue, Swedish and myofascial release techniques.
“Using the gentle touch techniques from craniosacral therapy/SER and energy work helps one to tune into the more subtle holding patterns in a person’s body. It’s in the ‘holding space’ for the tensions to release that the emotional energy can also be released,” Carlton says.
One factor of a massage therapy session that goes beyond technique that can drastically improve its effect on mental well-being is the therapist’s ability to honor the client’s conceptual boundaries.
“Conceptual boundaries are the way the client sees their world. Their belief systems about the nature of reality; their political beliefs; their experiences with race or gender; their age, and many more factors will affect their conceptual boundaries,” Hubbard says. “When a massage therapist listens to a client from the client’s perspective, and does their best to reduce or eliminate their own implicit bias, clients feel safe, listened to, nurtured, validated and relaxed. Then, they tend to process emotions more easily.”
It is always important to respect a client’s boundaries, both physical and emotional, as doing so creates an environment of trust, which, in turn, can help a client relax and in some cases experience an emotional release.
Massage therapists are not psychotherapists, however, and that is critical to remember when working with all clients. If any client experiences some sort of emotional release during a massage session, the massage therapist should simply allow it to happen and not attempt to intervene or offer any advice.
“What really makes the massage session a safe place for emotional well-being and healing is the practitioner and how comfortable they are with the client releasing emotional energy,” says Carlton. “If the practitioner is uncomfortable with a client crying or needing to express how their feeling about something, then the client’s physical body isn’t going to feel comfortable or safe to release the emotional energy being held in the tissues.”
The communication between a client and the massage therapist can help the client improve their interoceptive awareness, which includes a sense of one’s emotional state.
“In addition, the style of communication between the therapeutic massage and bodywork practitioner and client encourages the view of symptoms as messages, fostering the act and art of noticing,” Larson says.
One study1 examined infant massage as a stress management technique—not for the infants, but for the parents of hospitalized extremely preterm infants. The stress of having a newborn in the NICU for an extended period can be very stressful for the parents of these preterm infants.
Parent-administered infant massage is a well-established intervention for preterm infants that has been shown to have benefits for both the infants and the parents. Still, the majority of the published literature has mostly examined the impact via self-reported or observational measures of stress. This study sought to measure the reduction of stress via salivary cortisol, a biomarker for stress.
The salivary cortisol of both the infants and the mothers in 22 participant pairs was measured via buccal swab immediately pre- and post-parent-administered massage to detect any potential changes in physiological stress.
The study found a clinically significant decrease in maternal cortisol levels immediately post-parent-administered massage, indicating decreased physiological stress and suggesting that the act of administering the massage can help improve the mental and emotional well-being of the mother.
Another study2 assessed the effect of music therapy and hand massage on pain, fear and stress among 12–18 year old adolescents in the pediatric intensive care unit.
The participants were divided into three groups comprising 33 receiving hand massage, 33 receiving music therapy and 33 in a control group. Results were measured using the Wong- Baker FACES Pain Rating Scale, Children’s Fear Scale (CFS) and blood cortisol levels.
The study found that both the music therapy group and the hand massage group had lower CFS mean points by a significant level before and during the blood draw procedure compared to the control group.
Researchers concluded hand massage and music therapy were more effective than standard care at reducing both pain and fear levels during blood drawing among 12–18 year-old adolescents. Mean cortisol levels, however, did not show a significant difference among any of the groups.
I often also ask about mood changes during treatments, and most clients report a mood elevation of a 30–50% change or higher.
Ariel R. Hubbard, LMT
A third study3 evaluated the objective and subjective impact of daily self-massage on visible signs of stress on facial skin as well as emotional well-being. The clinical study assessed visible signs of facial aging with an objective 10-point scale and a subjective skin and well-being assessment with an online self-questionnaire. The participants performed a three-minute self-massage routine at home that included 14 gestures, including stretching, flicking, deep typing, friction and smoothing on the face.
The study observed statistically significant improvements on skin aging signs. Subjective benefits were also indicated. Overall, 85% of participants agreed their skin looked smoother with a reduction in fine lines and 100% of women indicated that the massage boosted their feeling of well-being.
“I see massage assist with the symptoms of depression, anxiety and chronic stress every single day of my practice,” Hubbard says. “I log stress on a 1–10 ordinal scale before and after treatments. When I ask clients these questions, I can quantify how much they consider their stress levels have changed during and after treatment. I often also ask about mood changes during treatments, and most clients report a mood elevation of a 30–50% change or higher.”
Massage therapy is a unique approach to emotional well-being as compared to other mental health practices because it addresses the somatic part of emotions. “When we feel emotions, there is always a body response to the emotion,” says Carlton. “If we can help the body ease these physical reactions to the emotion, then the person is better able to see what’s needed to process what is really happening to them.”
This unique approach makes massage therapy a great addition to other mental health practices. Many massage therapists are beginning to see a shift from within the mental health field toward making more connections between the mind and the body, and massage therapy is proving to be a helpful bridge between the two.
“Often, clients who do not achieve full resolution of issues with psychotherapy alone can benefit from adding massage to their treatment plan to clear emotions out of the body and the heart,” Hubbard says.
According to Hubbard, massage therapy can also help clients who are under psychiatric care for depression or anxiety because it can complement the intake of their medications because it elevates endogenous opioid release, which elevates mood.
It can be difficult for clients to broach the topic of massage for emotional well-being and health. From the massage therapist’s side, the best thing to do is foster an environment where the client feels safe and comfortable. This can both help a client to feel comfortable enough to bring up the topic to a massage therapist, but also can help so the massage therapist feels comfortable holding the space for any emotional releases that may happen during the session.
With this safe environment created, Carlton’s advice is simple: “My advice to someone who is curious about trying massage therapy to support their emotional health would be to work closely with their massage therapist about what they need.”
Touch is a powerful medicine.
Erika Larson, LMT
For Hubbard, when it comes to massage therapy’s benefit for emotional well-being, the proof is in the pudding. “If your stress levels are a 7 out of 10 or higher as a baseline daily number, consider getting a massage once a week for a month, and then check your baseline stress level,” says Hubbard. “If it drops to a 4 or a 5 out of 10, consider getting massage one to two times a month as preventive health care.”
“The unique blend of factors common to other therapies are presented in the setting specific to a therapeutic massage and bodywork session can enhance emotional well-being,” Larson says. “Touch is a powerful medicine.”
In many cases, emotional distress such as stress and anxiety can manifest itself in physical ways. Stress, specifically, can lead to physical symptoms such as headaches, chest pain, general body aches and tense muscles, and dizziness.
For example, a study4 investigated mental stress-induced physiological changes in the human masseter muscle (the primary chewing muscle). The study hypothesized there would be some hemodynamic (changes in blood pressure, cardiac output, for example) and electromyographic (changes in muscle electrical activity in response to nerve stimulation) changes in jaw-closure muscles related to sympathetic nervous system activity.
Volunteers performed a two-hour mental stress task and then had their electromyographic activity of the temporal and masseteric muscles recorded, as well as the hemodynamic changes of the masseter muscle measured non-invasively.
The study found that despite little change in integrated electromyographic activity, notable changes were found in hemodynamic parameters, suggesting that the hemodynamics of jaw muscles is susceptible to mental stress.
This mental stress can cause people to clench their jaws and/or grind their teeth, which can, in turn, manifest itself as jaw and ear pain, headaches, and muscle spasms. Masseter massage can help alleviate this pain.
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1. McCarty D, Silver R, Quinn L, Dusing S, O’Shea TM. “Infant massage as a stress management technique for parents of hospitalized extremely preterm infants.” Infant Ment Health J. 2024 Jan;45(1):11-21.
2. Küçük Alemdar D, Bulut A, Yilmaz G. “Impact of music therapy and hand massage in the pediatric intensive care unit on pain, fear and stress: Randomized controlled trial.” J Pediatr Nurs. 2023 Jul-Aug;71:95-103.
3. Flament F, Maudet A, Bayer-Vanmoen M. ”The objective and subjective impact of a daily self-massage on visible signs of stress on the skin and emotional well-being.” Int J Cosmet Sci. 2023 Dec;45(6):761-768.
4. Hidaka O, Yanagi M, Takada K. "Mental stress-induced physiological changes in the human masseter muscle." J Dent Res. 2004 Mar;83(3):227-31