A Stress & Anxiety Study

By Kelly Skellinger (BS, LMT), April Neufeld (BS, LMT, BCTMB), 2018-7-30

A Stress & Anxiety Study

By Kelly Skellinger (BS, LMT), April Neufeld (BS, LMT, BCTMB),

There is an indispensable component to the massage therapist and client discourse – an ever-increasingly open dialogue surrounding the cause and effect of client stress and anxiety. Massage therapists, now more than ever, commonly gauge client stress and anxiety levels upon first meeting and seek to address the physical symptoms of both through a variety of massage techniques.

Stress & Anxiety

Stress and anxiety disorders affect 40 million U.S. adults aged 18 and older, or 18.1 percent of the U.S. population each year, according to the Anxiety and Depression Association of America (ADAA).1 As a result, some researchers are looking beyond traditional medicine and beginning to put complementary and alternative practice modalities, such as massage therapy, energy work, meditation, and yoga to the test to see if they can play an integral part in client stress and anxiety reduction.

Per the ADAA, anxiety disorders are highly treatable, yet only 36.9 percent of those suffering receive treatment.2 For this very reason, massage therapists – already engaging clients in this dialogue – may have an opportunity to play a unique role in addressing and possibly reducing client stress and anxiety.

While very little research has been published to prove complementary and alternative practices significantly reduce stress and anxiety, the Massage Therapy Foundation (MTF) Writing Group recently reviewed a research study titled, "Massage and Reiki used to reduce stress and anxiety: Randomized Clinical Trial," published by Revista Latino-Americana de Enfermagen (RLAE) and conducted at the Institute for Integrated and Oriental Therapy in São Paulo, Brazil. The study sets out to examine the effects of Japanese Anma massage and Reiki as reduction treatments for stress and anxiety.

Treatment Protocols

The study outlines the two treatment protocols: Japanese Anma massage and Reiki. Anma is a type of popular Japanese massage which aims to "re-balance the energy (of the body) based on (applied) pressure and rubbing in specific areas on the body." The study describes the use of Anma involving "kneading and putting pressure on the back, neck, thorax, lumbar, gluteus, rub-bing the thighs down to the feet (for 20 minutes), using the special meridian line from the bladder and small intestine," and goes on in detail to describe the Anma massage sequence.

Reiki is defined as a practice of very light "laying on of hands" for 2.5 minutes on specific areas of the body, such as the eyes, laryngeal region, and heart region, with the goals of mobilizing the vital universal energy that gives support to the innate and natural ability of the body to cure itself. Reiki is said to rebalance the body's chakras, or energetic centers, to encourage a healthy mental and emotional state.

Study Groups

The study consisted of three groups: the Anma Massage + ten minutes of Rest Group (G1), the Anma Massage + ten minutes of Reiki Group (G2), and the Control Group (G3) which received no intervention treatments. Of the 101 participants in the study, the majority were female, an average age of 35 years, and fit within four professional groups of military personnel (30), healthcare professionals (15), students (nine), and other (47).  The participants' stress and anxiety levels were measured through Vasconcelo's Stress Symptoms List (LSS) which lists a variety of physical and psychological symptoms.

Reiki was performed for ten minutes following each massage. The duration time for each massage treatment was not recorded in the study. Treatment sessions were performed two times per week with a total of eight sessions in a month. A team of students trained by the Institute for Integrated and Oriental Therapy (ITIO) performed the treatments with the oversight of instructors trained in the techniques.

A Positive Outcome

The LSS symptoms that showed statistically significant improvement in both the G1 (Massage + Rest Group) and G2 (Massage + Reiki Group) compared to the G3 (Control Group) were the reduction in patients' feeling faint, suffering from lack of energy, physical exhaustion, headaches, and an appetite that oscillated.

LSS symptoms that were reduced in G1 compared to G3 included patient thoughts that caused anxiety, feelings of wanting to be alone, and feelings of worry. The symptoms that improved in G2 compared to G3 were patient feelings of being worn out at the end of the day, lack of appetite, tightened jaw, waking up tired, and symptoms of insomnia, anger, anxiety, irritation, speechlessness, watery eyes, and obscured vision. Overall, in relation to anxiety-state, the Massage + Rest Group and Massage (G1) + Reiki Group(G2) produced better stress and anxiety reduction results than the Control Group (G3).

As with most research studies, there are limitations inherent in this study. Authors of this study chose to use Anma massage and Reiki technique throughout this study but did not describe in detail why they chose these particular modalities over another. Future researchers pursuing this topic may consider participants in the Control Group (G3) simply lay on the massage table and utilize breathing techniques, nap for a short duration of time, or be subject to practitioners mimicking Reiki techniques without the intention of hands-on healing. Results may fluctuate as a result.

Future research that focuses on complementary and alternative practices as a means to reduce stress and anxiety is necessary. The Massage Therapy Foundation continues to offer resources to researchers interested in pursuing these studies via their website: http://massagetherapyfoundation.org/massage-research/.


  1. ADAA. Facts & Statistics. Anxiety and Depression Association of America, 2018.
  2. ADAA. Understanding the Facts of Anxiety Disorders and Depression is the First Step. Anxiety and Depression Association of America, 2018.


  1. Kurebayashi LFS, Turrini RNT, et al. Massage and Reiki used to reduce stress and anxiety: Randomized Clinical Trial. Rev Latino-Am Enferma-gem, 2016;24:e2834.