Does Massage Help Anxiety and Stress? What the Trials Found, and the Cortisol Myth

Does massage help anxiety and stress? For how you feel straight afterwards, yes: in a review of 37 randomised studies, a single massage lowered anxiety, heart rate and blood pressure. For a diagnosed anxiety disorder, the answer depends on what massage is compared with. It beat a light-touch session in one trial, and in another did no better than warm towels and heating pads, or than lying on the massage table listening to music. The claim you will read most often, that massage cuts the stress hormone cortisol by about a third, does not hold up once massaged people are compared with a control group. We are Nghê Prana, a riverside hotel and spa on the Thu Bồn at Cẩm Nam in Hội An, and we sell massages, so this page sets out what the studies found, including the parts that do not flatter us.

Does massage help anxiety? The short answer

What one massage does: you feel calmer, and that has been measured

The largest review of massage trials pooled 37 studies in which people were randomly assigned to massage or to something else. A single massage reduced state anxiety, blood pressure and heart rate. It did not reliably change negative mood, pain measured straight afterwards, or cortisol (Moyer, Rounds and Hannum, 2004).

State anxiety is how anxious you feel right now, measured with a short questionnaire before and after the session. Trait anxiety is how anxious you tend to be most of the time. The same review found that courses of massage lowered trait anxiety and depression, and that these were massage's largest effects: "a course of treatment providing benefits similar in magnitude to those of psychotherapy". That finding rests on few studies, and in none of them could people be kept from knowing they were being massaged.

Massage for diagnosed anxiety: two trials, two answers

In Seattle, 68 adults with generalised anxiety disorder were randomly given ten sessions over twelve weeks of either therapeutic massage; "thermotherapy", in which the therapist slowly laid heating pads and warm towels on the body; or a relaxing room, lying on the massage table listening to music they had chosen. All three shared the same room, the music and some deep breathing. All three groups improved, by 10 to 13 points on the Hamilton anxiety scale, and kept the gains at six months, but massage did no better than the other two. The authors put the improvement down to "some beneficial but generalized relaxation response" and noted that the relaxing room cost the least (Sherman and colleagues, 2010).

At Emory University in Atlanta, 47 untreated adults with the same diagnosis had Swedish massage or a light-touch session twice a week for six weeks. Anxiety scores fell by 11.7 points with massage and 8.4 with light touch; the 3.3-point difference was significant from the third week (Rapaport and colleagues, 2016). One of the authors works for the Atlanta School of Massage, which the paper declares.

The two results fit together once you look at the comparison. Light touch is close to no treatment; warmth, music and lying still in a quiet room are relaxation treatments in their own right. Read together, massage beats almost nothing and roughly matches other ways of lying still somewhere warm and quiet. That is not nothing. It is the honest reason an hour in a spa can help, and it is why we do not describe a massage as a treatment for an anxiety disorder.

Britain's NICE guideline on generalised anxiety disorder (CG113, published 26 January 2011, last updated 15 June 2020) sets out stepped care: information and monitoring first, then self-help based on cognitive behavioural therapy, then CBT, applied relaxation or medication. Massage is not on the list. Applied relaxation is a skill you are taught and practise, and in Seattle a quiet room with music and deep breathing did as well as massage.

The cortisol claim: where "31 percent" comes from

Cortisol is the hormone most pages name when they say massage relieves stress. The figure usually traces back to a 2005 review from the Touch Research Institute at the University of Miami, which reported that in the studies it covered, cortisol fell by an average of 31 percent after massage, while serotonin rose by 28 percent and dopamine by 31 percent (Field and colleagues, 2005).

In 2011 a team led by Christopher Moyer, who wrote the 2004 review above, re-analysed the cortisol studies the conventional way, comparing people who were massaged with people who were not. The effects were "almost all small" and not statistically significant. Their conclusion: "MT's effect on cortisol is generally very small and, in most cases, not statistically distinguishable from zero. As such, it cannot be the cause of MT's well-established and statistically larger beneficial effects on anxiety, depression, and pain" (Moyer and colleagues, 2011). The one exception was a larger effect in children over several sessions, from only three studies.

Why the two numbers differ: a percentage drop measured only in the massaged group, before and after, also picks up everything else that happened in that hour. Cortisol falls naturally across the day, for one thing. Moyer's team showed that this percentage method gives results inconsistent with a proper comparison and called it unsuitable for judging a treatment.

A third review sits in between. It found 25 studies and reported that salivary cortisol and heart rate fell consistently within a single session, but that no lasting reduction was supported, and that the research "lacks the necessary scientific rigor" to say more (Moraska and colleagues, 2010). In one careful single-session study in 53 healthy adults, 45 minutes of Swedish massage lowered cortisol only slightly compared with light touch (Rapaport, Schettler and Breese, 2010).

So the calm people report is real and measured; the hormone story does not explain it. We do not claim that our massages lower cortisol. An older page on our own site said that cortisol "drops most steeply" during massage; we corrected it on 2 November 2026, and the correction is dated on that page.

Which massage is best for stress?

The trials do not say. The Seattle trial used therapeutic massage and the Emory trial Swedish massage, and the 2004 review found no factor that significantly changed the size of the effect. A review of massage before and after surgery (25 trials, 2,494 patients) found larger effects for acupressure-point and reflex-area massage than for general massage, the reviewers recommended sessions of 10 to 20 minutes, and massage by non-professionals helped too (Guo and colleagues, 2020). That was in hospital, not on holiday.

Planning a trip around this? See dates at our quiet riverside hotel on the Thu Bồn. Check availability →

In practice, choose the treatment you will relax into. If firm pressure makes you brace, a strong Thai session is the wrong hour for calm; a slow oil massage or the warm herbal compresses of the Vietnamese herbal massage are gentler. The difference between Thai and oil massage is on the Thai vs Swedish page.

How long the calm lasts

The single-session effects in the 2004 review describe how people felt around one massage. The effects on how anxious people felt over weeks came from courses: ten sessions in twelve weeks in Seattle, two a week for six weeks at Emory, where massage first pulled ahead in week three. A massage on holiday is one session. Expect a calmer evening, not a change in how you feel next month. How often people book, and what the trials used, is on the how often to get a massage page.

When a massage is not the answer

• If anxiety or panic is stopping you from working, sleeping or going out, see a doctor. On the evidence above, massage is a comfort alongside treatment, not instead of it.
• If you are thinking about harming yourself, call emergency services now; in Vietnam the medical emergency number is 115.
• If being touched or lying face down makes you more anxious, tell the therapist at the consultation. You can ask for lighter pressure, a different position or a stop at any point in the session.
• If you cry during a massage, it happens and it is not a problem; what therapists see and what to do is on the emotional release page.

Our treatments for an unhurried hour, and what they cost

Prices per person, read from our live spa menu on 2 November 2026; at the 26,000₫ rate we use across the site, an hour of the oil massage is about US$17 and 90 minutes about US$23. Before or after, the private herbal steam room (listed as Sauna on the menu) is 300,000₫ for 20 minutes alone or 250,000₫ each for two, and the private jacuzzi, just off the room, is 400,000₫ for 30 minutes alone or 300,000₫ each for two. Which order to take them in is on the steam before or after massage page, and what a hot tub does and does not do is on the hot tub page.

What nobody has measured

No massage trial can stop people from knowing they were massaged, and many compare massage with nothing or with light touch, so they cannot separate the massage from the attention, the rest and the expectation. The best evidence for anxiety comes from people with a diagnosis, not from travellers. We found no trial of herbal compresses for anxiety, and one of hot stones: 99 patients in Iran, a day or two after orthopaedic surgery, given 10 to 15 minutes of hot-stone or slow-stroke back massage twice a day, were less anxious half an hour later than patients given routine care (Hojat Ansari and colleagues, 2025). On 2 November 2026 we searched PubMed for systematic reviews and meta-analyses with massage and anxiety in the title: all seven were in patients (surgery, cancer, burns, pregnancy, HIV, palliative care), none in healthy adults, so the 2004 review is still the broadest evidence for an ordinary massage on an ordinary day.

How to book

Nghê Prana Riverside Hotel & Spa, Hẻm 384 Nguyễn Tri Phương, Cẩm Nam, Hội An, on the Thu Bồn, 3.2 km from the Old Town. The spa is open from 9:00 to 21:00 every day and takes visitors as well as hotel guests. Book on the online form or by phone or WhatsApp on +84 896 687 961; an hour's notice is enough, and walk-ins are welcome when the room is free. Tell us at the consultation what pressure you like and anything you would rather we avoid. Coming as two? Two massages side by side in a private room, with the jacuzzi just outside, are on the couple spa page.

Sources: Moyer CA, Rounds J, Hannum JW, Psychological Bulletin 130(1), 2004; Sherman KJ et al., Depression and Anxiety 27(5), 2010; Rapaport MH et al., Journal of Clinical Psychiatry 77(7), 2016; NICE clinical guideline CG113, 2011, last updated 15 June 2020; Field T et al., International Journal of Neuroscience 115(10), 2005; Moyer CA et al., Journal of Bodywork and Movement Therapies 15(1), 2011; Moraska A et al., Evidence-Based Complementary and Alternative Medicine 7(4), 2010; Rapaport MH, Schettler P, Breese C, Journal of Alternative and Complementary Medicine 16(10), 2010; Guo PP et al., Complementary Therapies in Clinical Practice 41, 2020; Hojat Ansari M, Aemmi SZ, Esmaily H, Journal of PeriAnesthesia Nursing 40(5), 2025. All read 2 November 2026; prices from the Nghê Prana spa menu the same day.