It seems to need no explanation — getting a massage is relaxing. But have you ever wondered why? The answer is less about soothing music, and more about how a massage affects your nervous system.

Research has shown that massage has a direct impact on lowering the levels of stress hormones that create the “fight-or-flight” response, and can boost “feel good” neurotransmitters like dopamine, serotonin, endorphins and oxytocin.

The takeaway? Massage is a strategy worth adding to your self-care arsenal.

The Nervous System

First, a quick review. The function of the nervous system is to relay messages to and from the brain and different parts of the body. The autonomic nervous system regulates the body’s response to danger, and it has two divisions: the sympathetic and the parasympathetic.

The sympathetic nervous system activates the fight-or-flight response, and helps you respond to a threat. Your heart beats faster, muscles contract, and you start breathing faster.

“Rest and digest” is the work of the parasympathetic nervous system, bringing you back down after the threat has passed. Your breathing returns to normal, and energy goes back to maintenance activities such as digestion.

To put it all together, let’s imagine you’re a zebra. Out you stand, quietly grazing when you hear a lion approach. Your autonomic nervous system activates flight-or-flight to help you flee your predator. Once you’ve outrun her, and the danger is gone, you drop back into rest and digest, and go back to grazing.

Pretty neat, right? The problem is, as humans we have minds more advanced than those of zebras. We are capable not only of perceiving immediate threats, but also remembering events from the past, and creating anxieties about the future. Further, our sympathetic nervous system isn’t just activated for life-threatening events — it can be triggered by any number of stressors, such as work, family or a delayed subway train. As a result, we can get thrown into — and stuck in — fight-or-flight mode, making us feel stressed, worried, and overwhelmed.

If this sounds familiar, remember, it’s not your fault — it’s the body’s survival mechanism, just thrown into overdrive.

Stress Hormones

We’ll look now at the chemicals that cause the stress response (adrenaline, norepinephrine, and cortisol) and how a massage can help lower them.

Adrenaline and Norepinephrine

When danger presents itself, adrenaline and norepinephrine are hormones produced by the adrenal* gland that spring into action, activating the flight-or-fight response. Both hormones increase your heart rate, blood pressure, and the flow of blood to the muscles.

This is great when you need to run from a tiger, but if your brain is constantly interpreting being late for work and fights with your partner as life threatening situations, you’ll probably just end up feeling anxious.

How Massage Helps

Massage can help activate the parasympathetic state, thus reducing levels of adrenaline and norepinephrine. However, it may take a little time. In the initial response to touch, the sympathetic nervous system is activated — so a quick massage can help athletes amp up for an event. After about 15 minutes, the parasympathetic response kicks in. Plan on at least one hour of massage to truly relax, and advise your therapist that relaxation is your primary objective. He or she will probably use long fluid strokes to lull you into serenity.


Cortisol is a steroid hormone produced by the adrenal gland when you experience a stressful event. It takes a little longer than adrenaline and norepinephrine to kick in, but when it does it draws the body’s resources to deal with the threat, raising blood sugar and decreasing inflammation.

Complications can arise if you remain in a state of stress, and cortisol is released over a longer amount of time. This can cause suppression of the immune system, increased blood pressure, and weight gain.

How Massage Helps

Have you ever been so stressed that it seemed like you just kept getting one cold after another? That may be due to increased levels of cortisol, and the subsequent suppression of the immune system. A small study in 2010 found that after a Swedish massage, volunteers had lower levels of cortisol, and a higher white blood cell count. You shouldn’t get a massage while you have cold symptoms (you’ll probably feel worse) but regular massage can help give your immune system a boost.

“Feel Good” Neurotransmitters

We’ve seen now how massage can help bring stress hormones down — let’s take a look at how it can bring brain chemicals up.

Serotonin is a neurotransmitter that helps regulate mood, appetite and digestion. Synthesized in the brain and the intestines, it is theorized that low serotonin levels contribute to depression and anxiety.

Dopamine is associated with the reward centers of the brain. It’s the neurotransmitter that makes you feel giddy when you fall in love, positive when you complete a task, and is the chemical activated by many drugs, leading to addiction. Low dopamine levels are associated with a lack of motivation, low energy, and the inability to focus.

How Massage Helps

That floating on air sensation that you feel after a massage? You can thank serotonin and dopamine. Several studies have indicated that massage can increase both serotonin and dopamine levels, sometimes up to 30%. Serotonin can help you maintain a balanced mood, and the increase in dopamine can help you be productive and focused.


Endorphins are neurotransmitters produced to help relieve pain and improve mood — your own natural narcotic. Really. The chemical structure and effect of endorphins produced by the brain are similar to the opiate class of drugs derived from the poppy plant such as morphine.

Usually, endorphins are released in response to pain or stress, but there are other triggers, such as exercise (think “runner’s high). Endorphins are also released in response to laughter, dark chocolate, and you guessed it, massage.

How Massage Helps

There are only a couple of small studies demonstrating an increase of endorphins after massage. The most well known found an increase of about 16% in the blood tested from volunteers post connective tissue massage. It seems likely that more endorphins are released in the deep tissue modality (as opposed to lighter Swedish massage). In a deep tissue massage, you often experience that feeling of productive pain — the pressure hurts, but the pain is mixed with relief. Endorphins may be at least partially to thank.

Still, if you’re receiving a deep tissue massage, listen to your body. If the pain of the therapist’s pressure is rated on a scale from 1–10, aim for no more than a 7 — more than that and your muscles will probably start guarding against the pressure.


Oxytocin is called the “cuddle hormone,” helping to create trust and fortify relationships. It is released during sex to help bond you to your partner, and during childbirth. Probably the simplest way to increase your oxytocin is to give someone a hug.

How Massage Helps

Massage has been shown to increase oxytocin, but then again, so does touch. In fact, according to Dr. Kerstin Uvnäs Moberg, author of “The Oxytocin Factor,” massage therapists also get a boost in oxytocin levels from the act of giving a massage.

This seems like a good case for partner massage, or simply giving a brief shoulder rub to a friend. You can’t touch someone without them touching you, so you both reap the benefits.

Try to receive a massage the next time you are feeling overwhelmed. The effect on the body is measurable — massage can concretely help to reverse the stress response and boost your mood.

No money in the budget? Contact massage schools in your area. Many will offer affordable massages given by the students (supervised by licensed instructors). You’ll feel better, and give a future massage therapist an opportunity to practice their skills.

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*Norepinephrine is also produced by the brain.

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