Shiatsu: The Japanese Finger Pressure Therapy

It is thought to have developed from the practice of anma, a Japanese style of massage that was founded by Akashi Kan Ichi in 1320. The modern process of shiatsu was created, or rather popularized by Tokujiro Namikoshi. According to legend, Tokujiro discovered this style of healing as a child. His mother suffered from rheumatoid arthritis and since they lived in a small village on the island Hokkaido, there were no doctors. The children took turns treating her, but it was Tokujiro who showed the most competence.

Though shiatsu is viewed by many as merely another form of massage therapy, true practitioners believe its power has a strong philosophical basis. Generally, it is an offshoot of traditional Chinese medicine practices and is closely related to acupressure.

According to the theory, our body contains a transport network for a vital energy called qi / chi or ki that flows through all living things. The energy flows through pathways called meridians and these meridians meet at different nodes that are commonly known as acupoints or vital points. By stimulating these places, a healer is able to encourage healing within the patient’s body.

In acupuncture a needle is used, but in shiatsu (and also acupressure) fingers, thumbs, and even more blunt parts of the body such as elbows or knees are used to stimulate these acupoints.

When one has their first shiatsu session, the therapist will do an analysis of their body and energy flows. This is done by administering massage and feeling for places of tension, which can be seen as a sign of blocked energy. It is not a “one size fits all” type of therapy.

The healer will design a specific massage plan based upon the particular needs of the client and will often encourage regular visits to help maintain a balanced energy system. One session a month should be enough for most people, but various factors such as a stressful job, family situation, or general poor health can necessitate more frequent treatment. It is not uncommon for practitioners to recommend lifestyle changes such as a better diet, an increased focus on relaxation techniques, posture work, and exercise plans to encourage a holistic approach to healing.

Keep in mind that in many cases shiatsu is just one of a large number of styles a massage therapist has at their disposal.

One barrier to any deep analysis of shiatsu’s efficacy is that there seems to be relatively few English-language studies on it. It is often lumped together with other related treatments such as acupressure, acupuncture, and massage in general, so direct research on shiatsu itself can be lacking.

It has been deeply studied for years in Japan and unfortunately, much of this research has not been published in English. Most current meta analyses on Pubmed only focus on studies published in the West. Hopefully, a combination of the worldwide research can help give a deeper understanding of its effects.

Shiatsu has been found to help relieve lower back pain and the anxiety caused by it. Another study showed that shiatsu may have some positive effects on schizophrenia sufferers. However, this study lacked a control group, so it is difficult to truly verify that there were not other variables at play.

A 2011 meta study by Robinson et.al. found that shiatsu studies have been generally pretty low in both quality and quantity, thus more evidence would be needed to make any bold conclusions. This meta review included the results from the aforementioned pain and schizophrenia studies. However, the researchers recognized the general similarities between shiatsu and acupressure and therefore concluded that there is a possibility that the findings of acupressure studies can be applied to shiatsu.

The researchers accept acupressure as having a proven effect on reducing many types of pain including headaches, back pain, and neck pain. There seems to be some positive effects on menstrual cramps and labor pain as well. Acupressure has also been shown to possibly help with nausea, inducing sleep in the elderly who are institutionalized, and improving alertness in the classroom.

Some of the observations made by shiatsu massage therapists in their treatments are supported by recent studies. For example, a 2022 study examining the benefits of shiatsu for traumatized children found improvements in internal tension, sleep, attention, social interaction, verbalization of emotions and traumatic experiences, and perception of one’s own body boundaries.

In addition, a study published in 2023 looked at how shiatsu affected the quality of sleep in people with persistent low back pain. Participants’ Pittsburgh Sleep Quality Index scores improved overall, suggesting that shiatsu can improve sleep quality in addition to conventional therapy.

Shiatsu in general “creates a very relaxing parasympathetic response, the catalyst for the body to heal itself,” says Shirley Scranta, director of the International School of Shiatsu. “Shiatsu can have long-lasting effects – hours, days or weeks.” Shiatsu allows clients to benefit from massage in a more comprehensive way. In a holistic way, the body, mind and spirit are all affected by the health benefits of shiatsu.

Despite some positive effects shown by the use of shiatsu, the scientific community is sceptical about the philosophies that stand behind it. There seems to be little concrete evidence of qi / chi or ki or any other vital energy that surrounds living things. Some believers have argued that there has been some proof that this force may be electromagnetic radiation. There is some suggestion that by combining these massage techniques with the philosophy of Chinese traditional medicine may increase its efficacy, at least as a placebo because it gives the treatment a deeper “meaning response”.

Like all other forms of massage, it has been shown to promote relaxation. Numerous studies have shown the benefits of being in a relaxed state. This helps reduce stress. There is a marked connection between cortisol levels and adverse health effects.

At the moment, it remains an underexplored method of healing in itself, at least in the West. Hopefully, as more studies are conducted and the results of the Japanese studies are analysed in concert with European studies, we will be able to get a clearer picture on the specific health benefits shiatsu may offer.

Updated: July 23, 2024. – This article was originally published on February 1, 2021.