In fact, says Field, what matters most is the level of pressure used in the massage – preferably moderate to light. Her 2010 study, published in the International Journal of Neuroscience, showed that stimulating pressure receptors, or nerves under the skin that convey pain-reducing  signals to the brain, with moderate pressure leads to reduced symptoms.

“The critical thing is using moderate pressure,” says Field. “Light pressure, just touching the surface of the skin or brushing it superficially, is not getting at those pressure receptors. Light pressure can be stimulating, not relaxing.”

How Does Massage Work?

While some studies show that massage can reduce pain and anxiety for people with arthritis, how exactly does massage make these results happen? Research has shown that massage can lower the body’s production of the stress hormone cortisol, and boost production of serotonin, which, in turn, can improve mood. Additionally, massage can lower production of the neurotransmitter substance P, often linked to pain, and improve sleep as a result.

In 2010, researchers at the University of California, Los Angeles, School of Medicine and the nearby Cedars-Sinai Medical Center studied 53 healthy adults receiving just one Swedish massage therapy session and found that the participants’ levels of key hormones and white blood cells were positively affected. For example, the hormone arginine-vasopressin, which may lower blood pressure, was decreased, along with some inflammatory cytokines like IL-4 and IL-10. Cortisol levels were reduced by massage in this study as well, although not significantly.

Massage’s mechanism for reducing stress is still unclear, says Christopher Moyer, PhD, a psychologist at the University of Wisconsin in Stout, Wis. “We know that massage reduces anxiety quite well and can reduce certain painful conditions rather well. But we don’t know how those things are happening,” says Moyer, a former competitive cyclist who uses massage to ease his own muscle aches.

In his study published in 2010, Moyer and his colleagues determined that massage therapy could slightly reduce levels of cortisol. However, this reduction was so slight that the researchers determined that its effects on cortisol levels was not the reason why massage seemed to reduce anxiety and stress.

“Cortisol is a key stress hormone, but it doesn’t mean that if we know a person’s cortisol level, we know how much stress this person is having,” he says. “Massage must be working in some other way.”