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What is Shiatsu Massage?

By S. Mithra
Updated May 21, 2024
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Shiatsu or “finger pressure” massage, sometimes called Zen shiatsu, is a Japanese form of physiotherapy. It is often described as the equivalent of acupressure, but this comparison is not entirely accurate, because the technique looks beyond specific pressure points, incorporating other methods such as stretching, breathing and rotating for a more whole-body approach to restoring energy balance. Although many of the claimed benefits have yet to be conclusively proven, advocates assert that it can work to treat many different spiritual, physical and emotional problems. Generally considered to be safe, its roots are thousands of years old, and today, the technique is growing in popularity around the world.

Underlying Principles

The main concept behind shiatsu massage is that energy, qu or chi, circulates along channels or meridians in the body. When it flows freely, chi brings fresh, positive yang energy while carrying away negative yin energy, keeping an individual physically, emotionally and spiritually well. Under this view, a nearly infinite number of things can disrupt the delicate balance of yin and yang, and as a result, chi can become diverted, rushed, slowed or blocked, causing problems in wellness. Conditions such as sleeplessness, indigestion, swollen joints, headaches or depression are viewed not as sources of discomfort, but rather as symptoms of hyperactive, underproductive, blocked or misdirected chi. Practitioners of shiatsu or shiatsupractors assert that, by manipulating pressure points along specific meridians and relaxing the body, they can get energy back in balance and, therefore, treat numerous ailments.

The Meridians

Experts do not necessarily agree on a specific number of meridians within the body, but in general, they recognize 12 to 14 major channels through which chi is said to flow. These are named for organs, such as heart, lungs and stomach. Shiatsupractors associate them not only with the physical functions of these body parts, but also with spiritual, emotional or even social connotations those organs have. If someone told a client her lungs channel needed work, for example, it could refer to breathing, but it also could relate to feeling emotionally choked, overwhelmed or stifled. Supporters of shiatsu massage believe that this multifaceted view of health is necessary because the mind and body are inextricably connected, and that, on a broader level, all things in the world affect each other in some way.

What to Expect In a Session

A major difference between this type of massage and other forms is that clients don’t need to undress for a session. They typically can wear regular clothing, although it should be loose and comfortable. Shiatsu also does not involve the use of oil.

During a session, the shiatsupractor usually has a client relax on the floor, a beaded mat, low table or futon, but it is also possible to adapt this form of massage to a seated position. He asks some basic questions to find out about current health conditions or treatments, after which he uses very light massaging and other techniques such as physical observation to figure out where to adjust chi. Once he is confident in his assessment, he gently but firmly applies pressure using his fingers, knuckles, thumbs, palms, toes, feet or elbows, stretching and rotating the client’s body and guiding deep breathing to get energy to move.

Most people who go through this process describe the manipulation of pressure points as feeling intense, slightly uncomfortable, “good” pain, tender or tickling. Some individuals also say they are a little sore, although not as much as with muscular tissue massage. Reports of elation, emotional release and crying and extreme relaxation are all common.

Benefits and Effectiveness Debate

Advocates of this technique claim that, because energy connects to the entire body, adjusting chi can open up the door for the body to heal itself from a variety of conditions, including headaches, depression, tiredness, premenstrual syndrome and digestive problems, just to name a few. There is little scientific evidence to support most of these claims, but some studies suggest that the relaxation that happens during shiatsu and other types of massage can result in some measurable health benefits, such as a reduction in blood pressure. Many people argue that it is the belief in shiatsu’s helpfulness that prompts improvements — that is, it might work as a placebo effect, with people getting well simply because they are positive and think the methods are good.


In general, shiatsu massage is considered completely safe, including for women who are pregnant. Major organizations such as the medical department of the Japan’s Ministry of Welfare and the United States National Certification Council for Acupuncture and Oriental Medicine recognize it as an alternative treatment option. Shiatsupractors usually have to undergo regulated training and licensure in order to practice, as well.


Although it is difficult to pin down a precise date for the start of shiatsu massage, experts believe that its roots in traditional Chinese medicine date as far back as the 5th century B.C. Chinese medical professionals of the time brought their skills to Japan around the 6th century A.D., and over hundreds of years, the Japanese further refined them. In the 1800s, European methods began blending with the more ancient techniques, and around 1919, Tamai Tempaku, now considered the father of modern shiatsu, published a groundbreaking book called Finger Pressure Therapy. His students developed multiple schools with their own take on Tempaku’s methods, which continue to develop today.

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Discussion Comments
By anon312091 — On Jan 05, 2013

I love both thai and shiatsu massage.

By anon256907 — On Mar 23, 2012

Do you tip the masseuse after he/she is done?

By anon134608 — On Dec 15, 2010

Hi there - could you tell me if this type of massage is safe for people with type 2 diabetes?

By anon133887 — On Dec 12, 2010

i am doing a project on shiatsu massage and its benefits to the body and i wanted to know if it is all right if i use your comments in my paper? please and thank you.

By momothree — On Jul 11, 2010

@cmsmith10: I don’t have arthritis but I had shiatsu massages when I was pregnant. I was overdue by two weeks and it was suggested to me to have a shiatsu massage. Not only was it the most relaxing thing I have ever done, I went into labor the next day!

By christym — On Jul 11, 2010

@calabama71: Shiatsu massages are usually provided in half-hour increments. They can range anywhere from $40 and $120 per hour, depending on where you are and the service you are seeking. It can also depend on the experience and level of skill or your provider.

By calabama71 — On Jul 11, 2010

Does anyone know how much a Shiatsu massage costs?

By cmsmith10 — On Jul 11, 2010

I have suffered from rheumatoid arthritis for several years now. My best friend is a physical therapist and she suggested that I have a shiatsu massage. I thought it was a little farfetched. My friend, being as wonderful as she is, treated me to a shiatsu massage for my birthday. It was the best thing I have ever done and I have had several since then.

They massage my hands and feet, where I suffer the most, and the relief is almost immediate. I would highly recommend this for anyone suffering from arthritis.

By fluffy4 — On Jul 09, 2010

Shiatsu massages are a great alternative to acupuncture for those who are scared of needles. The massages relieve the pressure and pain without having to look like a porcupine.

As a migraine sufferer, I have had shiatsu massages. They can be more affective than any aspirin I've ever taken.

Because the pressure points are connected to each other throughout the body, a masseuse working to loosen one point can relieve pain in more than one spot in the body. Shiatsu massages would help my headaches, but sometimes I would also get relief from my knee pain as well.

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