Written by Katherine Nicholls

Katherine Nicholls

Therapy Directory Content Team

Last updated February 2023 | Next review due August 2024

Shiatsu is a physical therapy originating from Japan that supports the body's natural ability to self-heal. Working holistically, this therapy addresses emotional, spiritual and physical aspects of health.

A deeply relaxing therapy, shiatsu can be used to reduce stress and promote overall health and well-being. We share more information about how this approach works, its benefits, and what to expect from a shiatsu session.

What is shiatsu massage?

Shiatsu was developed in Japan by Tokujiro Namikoshi in the 1920s and is based on the principles of traditional Chinese medicine (TCM). Traditional Chinese medicine includes a range of medicine practices that share common concepts. These concepts are based on over 2000-year-old traditions. While shiatsu does stem from TCM, it also contains influences from more western therapies. The word shiatsu means 'finger pressure' in Japanese and uses comfortable pressure, touch, and manipulative techniques designed to balance energy flow and adjust elements of the body's physical structure.

Holistic therapists who offer shiatsu

Shiatsu works with the body's energy, known as qi (pronounced ‘chee’). In traditional Chinese medicine, it is believed that when this energy becomes blocked, it causes illness or pain. In shiatsu, pressure is used to stimulate the energy channels (called 'meridians'), which aims to unblock stuck energy. This is thought to help the body heal itself.

As well as working on this spiritual level, shiatsu works on a physical level, too. Massage and manipulation techniques are used alongside postural awareness, breath work, and physical exercises. Often referred to as shiatsu massage, this work can be very deep - to remove tension from the body - or light and gentle to encourage relaxation. Visualisation and breathing exercises may also be incorporated.

These days, there are many different styles and philosophical approaches to shiatsu. Some approaches focus more so on acupressure points and energy pathways, while others incorporate other diagnostic systems. All, however, are based on traditional Chinese medicine theories.

How does shiatsu work?

The body and mind are inextricably linked. This means when we have poor posture and hold tension in our muscles, it can affect how we feel emotionally. Equally, when we feel low, we tend to become more tense and lethargic physically. Bodywork, such as massage, recognises this and uses supportive touch to encourage healing.

Shiatsu takes this theory one step further, working on a physical, emotional, and spiritual level. Modalities that include awareness of the body's vital energy offer a way of understanding how our experience is stored in the body.

In traditional Chinese medicine, these things are considered expressions of our qi. Our qi flows throughout the body using pathways, called meridians.

The meridians

The meridians can be thought of as a system of 'rivers' used by our qi to flow freely throughout the body. In Eastern medicine, it is believed that when these channels become blocked or disrupted, illness or pain can occur. By freeing up these blockages and allowing the energy to flow freely, the body is in a better position to heal itself.

Unblocking the meridian lines is the basis for most traditional Chinese medicine. Shiatsu uses touch and gentle pressure to stimulate meridian points on the body to encourage energy flow. On a physical level, shiatsu massage increases circulation, helps to release toxins/tension and encourages the hormonal system to function correctly.

Shiatsu practitioners will be able to tell where areas of pent-up/blocked energy are. Working with the meridian points, they will apply pressure to the areas in question, to re-balance the body and promote healing.

TCM (traditional Chinese medicine) practitioners say there are 12 key meridians in the body, all of which link to a physical organ or function within the body. Six of them represent 'yin' and six represent 'yang'.

Yin and yang

Originally the word ‘yang’ meant 'the sunny side of the valley' and ‘yin’ meant 'the shady side of the valley'. The concept of yin and yang revolves around balance, depicting the way the world works as a whole.

Yang represents characteristics such as heat, excitement and light. Yin represents passiveness, cold and quiet reflection. Keeping yin and yang balanced is important in traditional Chinese medicine and shiatsu looks to accomplish this.

What is shiatsu massage good for?

As shiatsu is a holistic and natural therapy it can benefit most people. Many use it as a form of stress management or as part of a preventative health care programme. Helping to maintain balance, the therapy can promote overall well-being, even if you are fit and healthy.

If you are suffering from a medical or emotional complaint, shiatsu can offer support for both your body and mind. It is important to stress that shiatsu is a complementary therapy. This means it is best used alongside conventional treatment. If you are suffering from a medical condition, be sure to speak to your doctor about any complementary therapies you are looking to pursue.

Practitioners of shiatsu say the therapy is especially useful for helping people to cope with the following:

  • Anxiety - Helping the body to physically relax can help the mind relax, so it can be especially useful to those with anxiety.
  • Depression - Reducing stress levels can be helpful for those dealing with depression. Shiatsu can encourage a sense of calm and restful sleep.
  • Circulatory and digestive issues - Shiatsu massage gives circulation a boost. It also aids the digestive process so it is an ideal therapy for those suffering from digestive problems.
  • Menstrual cramps - This therapy is often used to ease menstrual cramps while re-balancing the hormones.
  • Migraines - These headaches are usually caused by a rapid widening and narrowing of blood vessels in the head. Shiatsu relaxes the body and increases blood flow, which can reduce the symptoms of migraines.
  • Muscle pain - Shiatsu helps improve circulation and releases tension which can help with muscle pain.
  • Arthritis - Many people report reduced symptoms of arthritis using shiatsu massage.
  • Nausea - Shiatsu practitioners believe nausea is caused by 'rebellious' qi. Rebalancing this qi and encouraging the body to relax can relieve nausea.
  • Stress - Our stress levels tend to reduce when our bodies are relaxed. Regular shiatsu sessions encourage a more stress-free way of being for the body and can be incredibly beneficial.

People often seek the benefits of shiatsu during periods in their life of major changes. This may include pregnancy, menopause, or adjusting to later life.

Pregnancy and birth

Pregnancy is a time of change for women and people that give birth, allowing them to experience their bodies in new ways. Shiatsu can be a powerful tool for pregnant people to connect to this change and remain balanced and well throughout pregnancy. Be sure to speak to your doctor if you want to try shiatsu to ensure it is a safe option for you and the baby.


Cancer Research UK highlights the practice of shiatsu helpful in managing symptoms and side-effects of cancer and cancer treatments, including:

  • low mood
  • poor appetite
  • sleep problems

When is shiatsu not recommended? 

Whilst shiatsu is very safe, we always advise speaking to your GP if you have any concerns about whether it’s right for you. Make sure to tell your therapist your full medical history, so they can do an appropriate assessment.

There may be some instances where shiatsu is not recommended, such as if you have uncontrolled heart disease, high blood pressure, or diabetes. Similarly, tell your shiatsu practitioner if you have any open wounds, inflammation, recent scars or varicose veins and they will make sure these areas are avoided during the treatment.

If you are in the early stages of pregnancy, have osteoporosis or low platelet levels, they may take a different, more gentle approach.

What to expect from a shiatsu session

When you see your shiatsu practitioner for the first time, you are likely to have an initial consultation. Your therapist will take this time to ask you questions about why you are seeking shiatsu. They will discuss any symptoms you have and what you hope to gain from your sessions. They may also ask questions about your lifestyle and mood to gain a clearer understanding of your concerns.

After your consultation, your practitioner will gently touch your abdominal area. This helps them to understand your body's energy levels and which areas of the body have too much (or not enough) energy flowing through them. This will allow them to understand which meridian points need to be stimulated to balance the energy.

After this diagnosis has taken place, the hands-on work can begin. This usually lasts between 40 and 50 minutes and takes place on a futon or mattress on the floor. If you are not comfortable lying down, shiatsu can also be used when sitting down. You will be clothed throughout the process. It is recommended that you wear loose-fitting clothes.

The experience should be pleasant and relaxing. If you feel uncomfortable at any point, be sure to tell your practitioner. After the bodywork has finished, there will be a short rest and then feedback. This is when you can talk to your practitioner about how you found the session. At this point, your practitioner may recommend exercises/activities for you to carry out at home to support the work from the session.

The number of sessions you require will depend on the nature of your concern. Most people attend shiatsu sessions at two to three-week intervals to start with. This may reduce to once a month and then once every six weeks as symptoms improve. Some people report that they feel the effects immediately after a shiatsu session, while others feel it after several days.

Getting the most from your session

The following tips can help to ensure you reap the most benefit from your shiatsu massage:

  • Avoid eating a heavy meal before the session.
  • The therapy works best when muscles are relaxed, so try not to tense up when your practitioner is working.
  • Rest for at least an hour after your session (the effects of shiatsu continue working after the physical work has taken place).
  • Stay hydrated to help the body flush out released toxins.

Shiatsu is a very safe therapy, though some people say they experience mild side effects after their session. Such side effects include muscle stiffness and headaches. This should subside within a few hours, but be sure to speak to your therapist if these symptoms persist.

What training does a shiatsu practitioner need?

Shiatsu is an unregulated therapy in the UK. This means there are no laws to state what level of training someone needs to become a shiatsu practitioner. There are however professional bodies that voluntarily regulate such therapies. These bodies only list therapists with relevant qualifications and insurance and abide by a code of ethics. When searching for a shiatsu practitioner it can offer peace of mind to opt for someone who is either a member of a professional body or has relevant qualifications and insurance.

On Therapy Directory, we ensure all our therapists provide relevant qualifications and insurance or are members of a recognised professional body.

Finding a professional 

If you’d like to give shiatsu massage a try, you can contact a professional using our search tool. We recommend you browse a few profiles so that you can be sure to find a therapist that best resonates with you. 

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