HealthyRetired · Massage
Shiatsu is a Japanese form of hands-on bodywork. Its name is usually translated as “finger pressure,” although practitioners may use their palms and other techniques as well.
For someone exploring massage and relaxation, shiatsu offers a different experience from an oil massage: it is usually received fully clothed, with pressure, stretches and gentle movement adapted to the person.
What is shiatsu?
Modern shiatsu developed in Japan, drawing on earlier massage traditions. Many styles use East Asian medical concepts such as ki, commonly translated as vital energy, and meridians or pathways. Other approaches place more emphasis on anatomy and physical assessment. [1]
A practitioner may apply sustained pressure, mobilise joints or use stretches. The session is generally organised around the whole person, rather than only pressing one painful spot.
Ki and meridian explanations belong to a traditional framework. They are not established anatomical structures or a substitute for a medical diagnosis. Someone can appreciate the experience of bodywork without assuming that every traditional explanation has been scientifically confirmed.
What happens during a session?
The practitioner should first ask about your health, symptoms, medication and what you want from the session. It is useful to explain what pressure you enjoy—and what you do not.
You normally wear loose, comfortable clothes. Treatment may take place on a padded mat or futon on the floor, although a treatment couch or adapted position can be used. You may lie on your back, side or front, depending on your comfort and the approach. [2]
For older readers, getting down to the floor and back up may be less comfortable than the treatment itself. Ask about a couch before booking if mobility is an issue.
Pressure should be adjusted to you. You can request a change in position, less pressure or a pause. Pain is not a test you have to pass to benefit from a session.
How does it compare with Thai massage and Do-In?
| Approach | Typical characteristics |
|---|---|
| Shiatsu | Japanese bodywork, often using sustained pressure and gentle mobilisation; usually received clothed |
| Traditional Thai massage | Thai bodywork combining pressure and assisted movement, sometimes with more extensive stretches; many forms are also received clothed |
| Do-In | Self-care practices that may include self-massage, breathing and movement; you work on your own body |
There is considerable variation within both shiatsu and Thai massage. The practitioner's training and ability to adapt the treatment matter more than a promise that one style is always gentle and another always strong.
Do-In can complement a person's interest in shiatsu, but a few self-massage techniques do not qualify someone to diagnose or treat another person.
Why do people choose it?
People may seek shiatsu for relaxation, a sense of wellbeing or help coping with tension and discomfort. A quiet appointment, attentive touch and an opportunity to rest can be valuable experiences. [3]
However, feeling better after a session and demonstrating an effective treatment for a medical condition are different questions.
A 2011 systematic review found that the evidence specifically for shiatsu was limited and weak. It also reviewed acupressure, but those results cannot simply be assumed to apply to an entire shiatsu session. A later research discussion stressed the need to distinguish the two approaches. [4, 5]
A 2022 evidence-surveillance report included a small trial of shiatsu for chronic low-back pain and reported no statistically significant difference from usual care in pain or function at short-term follow-up. [6]
These findings leave room for further study, but do not justify claiming that shiatsu cures disease, restores organ function or reliably treats every kind of pain. It is better presented as optional complementary bodywork, with realistic expectations.
Choosing a practitioner
Look for relevant training, clear communication and experience working with older adults. Ask whether the practitioner can adapt pressure and positioning to your needs. Professional registration requirements vary between countries, so the label “therapist” alone does not tell you what training someone has completed.
A good practitioner should explain what they offer and when medical assessment is more appropriate. Be cautious about promises to diagnose an internal disease from pressure points alone or advice to stop prescribed treatment.
When extra care is needed
Tell the practitioner if you use blood-thinning medication, bruise easily, have osteoporosis, have had recent surgery or have another condition that could affect pressure or stretching. Adaptation or advice from your clinician may be needed. [3]
Deep pressure should not be applied over a suspected blood clot, injured tissue or an area with an acute infection. New unexplained pain, weakness or swelling needs assessment rather than being interpreted automatically as an energy blockage.
Afterwards, there is no need for a special “detox” drink or extreme routine. Drink according to your usual needs and notice how you feel. Significant pain, bruising or other worrying symptoms should not be dismissed as toxins leaving the body.
Where shiatsu fits in healthy ageing
Shiatsu may be a pleasant way to include rest and hands-on care in your life. It works best as an informed choice alongside movement, adequate food, sleep and appropriate medical care.
You do not need to endure painful pressure or believe a promise of miraculous healing. A worthwhile session starts with something simpler: a trained practitioner who listens and respects your comfort.
A note for readers: This article provides general information, not a diagnosis or personal treatment plan. Discuss bodywork with your health practitioner if you have a condition or take medication that affects its safety. Shiatsu should not replace assessment of new symptoms or prescribed treatment.
Sources
- Shiatsu Society: discover shiatsu. A professional association's account of its practice and traditional framework.
- Shiatsu Society: what happens during a session.
- Cancer Research UK: shiatsu, evidence and precautions.
- The evidence for shiatsu: systematic review, 2011.
- Shiatsu and acupressure: distinct techniques, 2018.
- Non-invasive treatments for chronic pain: evidence-surveillance report, 2022.
Sources checked on 13 October 2026. The dates of the evidence reviews are shown explicitly; they should not be mistaken for comprehensive coverage of every recent study.