Shiatsu is a manipulative therapy developed in Japan and incorporating techniques of anma (Japanese traditional massage), acupressure, stretching, and Western massage.

Shiatsu involves applying pressure to special points or areas on the body in order to maintain physical and mental well being, treat disease, or alleviate discomfort. This therapy is considered holistic because it attempts to treat the whole person instead of a specific medical complaint.

All types of acupressure generally focus on the same pressure points and so-called energy pathways, but may differ in terms of massage technique. Shiatsu, which can be translated as finger pressure, has been described as needle-free acupuncture.


Shiatsu is an offshoot of anma that developed during the period after the Meiji Restoration in 1868. Traditional massage (anma) used during the age of the shoguns was being criticized, and practitioners of koho anma (ancient way) displeased with it introduced new practices and new names for their therapies.

During the twentieth century, shiatsu distinguished itself from anma through the merging of Western knowledge of anatomy, koho anma, ampuku (abdominal massage), acupressure, Do-In (breathing practices), and Buddhism.

Based on the work of Tamai Tempaku, shiatsu established itself in Japan and worldwide. The Shiatsu Therapists Association was found in 1925 and clinics and schools followed.

Students of Tempaku began teaching their own brand of shiatsu, creating branch disciplines. By 1955, the Japanese Ministry of Health and Welfare acknowledged shiatsu as a beneficial treatment and licensing was established for its practitioners.


Shiatsu has a strong reputation for reducing stress and relieving nausea and vomiting. Shiatsu is also believed to improve circulation and boost the immune system.

Some people use it to treat diarrhea, indigestion, constipation, and other disorders of the gastrointestinal tract; menstrual and menopausal problems; chronic pain; migraine; arthritis; toothache; anxiety; and depression.

Shiatsu can be used to relieve muscular pain or tension, especially neck and back pain. It also appears to have sedative effects and may alleviate insomnia. In a broader sense, shiatsu is believed to enhance physical vitality and emotional well-being.


Shiatsu and other forms of Japanese acupressure are based on the concept of ki, the Japanese term for the allpervading energy that flows through everything in the universe. (This notion is borrowed from the Chinese, who refer to the omnipresent energy as qi or chi.) Ki tends to flow through the body along special energy pathways called meridians, each of which is associated with a vital organ.

In Asian systems of traditional medicine, diseases are often believed to occur due to disruptions in the flow of this energy through the body. These disruptions may stem from emotional factors, the climate, or a host of other causes including stress, the presence of impurities in the body, and physical trauma.

The aim of shiatsu is to restore the proper flow of bodily energy by massaging the surface of the skin along the meridian lines. Pressure may also be applied to any of the 600 or so acupoints.

Acupoints, which are supposedly located just under the skin along the meridians, are tiny energy structures that affect the flow of ki through the body.

When ki either stagnates and becomes deflected or accumulates in excess along one of these channels, stimulation of the acupoints, which are sensitive to pressure, can unblock and regulate the ki flow through toning or sedating treatment.

Western medicine hasn’t proven the existence of meridians and acupoints. However, in one study, two French medical doctors conducted an experiment at the Necher Hospital in Paris to test the validity of theory that energy is being transported along acupuncture meridians.

They injected and traced radioactive isotopes with gamma-camera imaging. The meridians may actually correspond to nerve transmission lines.

In this view, shiatsu and other forms of healing massage may trigger the emission of naturally occurring chemicals called neurotransmitters. Release of these chemical messengers may be responsible for some of the therapeutic effects associated with shiatsu, such as pain relief.


People usually receive shiatsu therapy while lying on a floor mat or massage table or sitting up. The massage is performed through the clothing—preferably a thin garment made from natural fibers—and disrobing is not required.

Pressure is often applied using the thumbs, though various other parts of the body may be employed, including fingertips, palms, knuckles, elbows, and knees—some therapists even use their feet.

Shiatsu typically consists of sustained pressure (lasting up to 10 seconds at a time), squeezing, and stretching exercises. It may also involve gentle holding as well as rocking motions. A treatment session lasts anywhere from 30 to 90 minutes.

Before shiatsu treatment begins, the therapist usually performs a general health assessment. This involves taking a family medical history and discussing the physical and emotional health of the person seeking therapy.

Typically, the practitioner also conducts a diagnostic examination by palpating the abdomen or back for any energy imbalances present in other parts of the body.


While shiatsu is generally considered safe, there are a few precautions to consider. Because it may increase blood flow, this type of therapy is not recommended in people with bleeding problems, heart disease , or cancer. Massage therapy should always be used with caution in those with osteoporosis, fresh wounds or scar tissue, bone fractures, or inflammation.

Applying pressure to areas of the head is not recommended in people with epilepsy or high blood pressure, according to some practitioners of shiatsu.

Shiatsu is not considered effective in the treatment of fever, burns, and infectious diseases.

Shiatsu should not be performed right after a meal.

Side effects

When performed properly, shiatsu is not associated with any significant side effects. Some people may experience mild discomfort, which usually disappears during the course of the treatment session.

Research and general acceptance

Like many forms of massage, shiatsu is widely believed to have a relaxing effect on the body. There is also a significant amount of research suggesting that acupressure techniques can relieve nausea and vomiting associated with a variety of causes, including pregnancy and anesthetics and other drugs.

In one study, published in the Journal of Nurse-Midwifery in 1989, acupressure was shown to significantly reduce the effects of nausea in 12 of 16 women suffering from morning sickness. Five days of this therapy also appeared to reduce anxiety and improve mood.

Another investigation, published in the British Journal of Anaesthesia in 1999, studied the effects of acupressure on nausea resulting from the use of anesthetics. Pressure applied to an acupoint on the inside of the wrist appeared to alleviate nausea in patients who received anesthetics during the course of laparoscopic surgery.

Shiatsu may also produce sedative and analgesic effects. The sedative powers of acupressure were investigated in a study published in the Journals of Gerontology in 1999, which involved over 80 elderly people who suffered from sleeping difficulties. Compared to the people in the control groups, the 28 participants who received acupressure were able to sleep better.

They slept for longer periods of time and were less likely to wake up during the night. The researchers concluded that acupressure may improve the quality of sleep in older adults. The use of acupressure in postoperative pain was investigated in a study published in the Clinical Journal of Pain in 1996.

In this study, which involved 40 knee surgery patients, one group received acupressure (15 acupoints were stimulated) while the control group received sham acupressure. Within an hour of treatment, members of the acupressure group reported less pain than those in the control group. The pain-relieving effects associated with acupressure lasted for 24 hours.

Shiatsu may benefit stroke victims. The results of at least one study (which did not include a control group) suggest that shiatsu may be useful during stroke rehabilitation when combined with other treatments.