As one of the oldest forms of physical therapy, the benefits of massage are well documented. Massage is known to reduce muscle tension and promote relaxation, improve joint mobility and flexibility, and help with recovery from soft tissue injuries1. But can a massage help with anxiety?
In this article we explore what anxiety is, how it affects the body, and how massage can be used as part of a holistic management plan to help alleviate the symptoms of anxiety.
What is anxiety?
Every year, over two million Australians experience anxiety. It’s the most common mental health condition in Australia and will affect one in three women and one in five men at some stage in their lives2.
While most of us feel anxious from time to time, anxiety is more than an occasional feeling of worry or stress. According to Lifeline, anxiety is ‘the excessive, uncontrollable and often irrational anticipation of future threats.’ It is characterised by persistent feelings of anxiety which often happen without an obvious cause and can make it difficult to cope with everyday tasks and activities.
There are many different types of anxiety disorders, including:
- Generalised anxiety disorder, where a person feels anxious about many different things, for more days than not over an extended period.
- Social anxiety, where a person’s anxiety is connected to social interactions in everyday situations.
- Specific phobias, where a person is fearful of a particular object or situation (e.g. spiders, or being in an enclosed space).
- Panic disorder, where a person has severe and frequent panic attacks.
In addition to these conditions, anxiety can also be a common symptom of other mental illnesses.
What are the signs and symptoms of anxiety?
When left untreated, anxiety can have a significant negative impact on sufferers’ quality of life. And the effects of anxiety are not only psychological. Anxiety often causes a range of physical effects due to its activation of the body’s stress response. Also known as the ‘flight or fight response,’ our stress response is activated by the sympathetic nervous system in response to a perceived threat.
Common signs and symptoms of anxiety include:
- Excessive worry or fear
- Panic attacks
- Body tension
- Increased heart and breathing rates
- Avoiding situations that make you anxious
Over time, continued activation of the stress response takes a toll on the body and can result in longer-term health impacts, including increased risk of heart attack and stroke, digestive issues and weight gain.
Does massage help anxiety?
Anyone who has ever had a massage knows how good that deep feeling of relaxation is after an hour on the massage table. But what does the science say about whether a massage can help anxiety?
Numerous studies have been conducted to quantify the extent to which massage helps to alleviate anxiety, and the general consensus is that there is a positive correlation between massage and reduced levels of anxiety.
For example, a 2011 study focused on investigating the effectiveness of therapeutic massage for people with generalised anxiety disorder found that massage can be an effective tool to alleviate the symptoms of anxiety. During the study, 68 participants with generalised anxiety disorder were randomly assigned to one of three treatments—therapeutic massage, thermotherapy or relaxing room therapy—which they had ten sessions of over 12 weeks. By the end of the three-month program, researchers found that all participants had experienced an improvement in their anxiety, as measured by changes in their Hamilton Anxiety Rating Scale (HARS). Interestingly, the researchers also found that participants continued to experience a reduction in their HARS rating even after the therapy had finished, at the 26-week follow-up period.
Similarly, an older study involving children and adolescents with severe mental illness, found that the children who received a 30 minute back massage each day for five days experienced lower levels of anxiety and had lower levels of cortisol than those who participated in other forms of relaxation.
How does massage work to help alleviate anxiety?
Massage works to alleviate anxiety in several inter-connected ways. Specifically, massage helps to relieve the symptoms of anxiety by:
- Reducing cortisol levels in the body. Cortisol is the body’s stress hormone, and is often associated with high levels of stress, anxiety and depression. When our bodies are tense and in pain, more cortisol is released. By alleviating pain and tightness in muscles, massage is therefore able to reduce the amount of cortisol that is produced, helping to reduce our levels of stress and anxiety3.
- Relieving tightness—and therefore stress levels—by promoting lymphatic drainage. When metabolic waste accumulates after injury or overuse, it can contribute to increased muscle fatigue, weakness, pain and swelling. By stimulating the lymphatic system, massage can help remove waste from the body more quickly, helping to increase freedom of movement4.
- Creating a peaceful space for relaxation. Massage is known to induce a physical relaxation response, slowing down our heart and breathing rates. But it also provides an opportunity to practice mindfulness in a calming environment. Slow breathing, progressive muscle relaxation and staying present in the moment are all well-regarded strategies for reducing the signs and symptoms of anxiety5.
What are the best massages for anxiety?
There are many different types of massages available, each of which has a slightly different focus. The best massage for your anxiety will depend on your symptoms and what you want to get out of the massage. While some people find relieving body tension through remedial massage to be the most effective strategy, others prefer a gentler form of massage, such as aromatherapy-based massage which focuses more on mindfulness.
Some common types of massage that are helpful for managing anxiety include:
- Remedial massage, which uses therapeutic techniques to alleviate tension within the body’s muscles, ligaments and tendons. It is a more clinical form of massage and is commonly used to assist in the treatment of pain and for rehabilitation after an injury. Some techniques specific to remedial massage include deep tissue massage and trigger point therapy, stretch therapy, joint mobilisation, myofascial release and thermotherapy or cryotherapy.
- Swedish massage, which focuses on de-stressing the body and calming the mind. It’s a full-body massage that’s less therapeutic in its focus than remedial massage, but still aims to relieve tension within the body.
- Aromatherapy massage, which typically combines a soft and gentle full-body massage with the use of aromatic oils. In addition to reducing body tension, this type of massage is focused on creating a relaxing experience.
- Shiatsu massage, which is a Japanese massage focused on relieving tension and promoting relaxation. Shiatsu massage uses massage techniques at specific points all over the body, with pressure typically applied in a rhythmic manner.
- Thai massage, which is an active form of massage focused on reducing pain and stress. During a Thai massage, the therapist uses their hands and arms to apply firm pressure, while also stretching you into different positions.
- Chinese massage, which combines both the ‘push-pull’ style techniques of Western remedial massage, with a pinching and pressing method similar to that used in reflexology. While Chinese massage does relax the muscles and relieve stress, its main focus is on healing the whole body by focusing on the flow of Qi (or energy) through the body. It does this by treating acupressure points across the body, which are areas capable of triggering biochemical and physiological changes.
How often should I get a massage for anxiety?
There are no strict rules about how often you should get a massage for anxiety. How often you get a massage is entirely up to you and how you want to incorporate massage into your broader approach to anxiety management. The right massage frequency will also depend on whether you are using massage to treat a specific injury. Generally speaking, you may need more frequent massages if you are using massage to treat injury or relieve pain than if you are only using the massages for anxiety management.
If you’re new to massage, it can be a good idea to schedule a few sessions in a row—say, once a week for a couple of weeks—to find out how massage affects your body and how helpful it is for reducing your anxiety. After that, you should be able to determine a rhythm that works for you, whether that be once a week, once a month, or less frequently. Your massage therapist should also be able to work with you to find a massage schedule that suits you best.
Regardless of the frequency, scheduling your massages in advance can be a good strategy to reduce your anxiety as it gives you something to look forward to, and provides certainty that you have time set aside for relaxation.
Can I use self-massage to relieve anxiety?
If you can’t afford regular massages, but find massage to be an effective way to help manage your anxiety, self-massage can be a useful alternative. Numerous at-home massage devices are available to help relieve muscle tightness, and your massage therapist should be able to teach you some basic techniques.
- Massage - Better Health Channel, Better Health Channel, Victoria State Government
- Anxiety - Beyond Blue, Beyond Blue
- Tiffany Field, Maria Hernandez-Reif, Miguel Diego, Saul Schanberg, Cynthia Kuhn, 2005, Cortisol decreases and serotonin and dopamine increase following massage therapy, International Journal of Neuroscience
- Jamie Eske, Debra Rose Wilson, 2019, Lymphatic drainage massage: How-to guide and benefits, Medical News Today
- Karen J. Sherman, PhD, MPH, Evette J. Ludman, PhD, Andrea J. Cook, PhD, Rene J. Hawkes, BS, Peter P. Roy-Byrne, MD, Susan Bentley, DO, Marissa Z. Brooks, MPH, LMP, and Daniel C. Cherkin, PhD1, 2010, Effectiveness of Therapeutic Massage for Generalized Anxiety Disorder: A Randomized Controlled Trial, Depress Anxiety