Shiatsu Therapy: A Japanese Approach to Pain Relief

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What’s in a name? Shiatsu therapy tacitly and proudly announces its Japanese heritage with every introduction. This unique bodywork modality evolved over hundreds of years from Traditional Chinese Medicine, and is considered ‘acupuncture without needles.’ Literally translated, the word ‘Shiatsu’ means ‘finger pressure.’ The therapist uses his or her thumbs, palms, and occasionally forearms and/or elbows to apply pressure along the meridians of the body. (More about meridians in a moment.)

When is Shiatsu therapy recommended? Treatment is most often sought for pain that has not been eliminated with other forms of care. It is also sought as an effective preventive measure against the long-term effects of stress. To be more specific, limited joint mobility, back pain, headaches and migraines, sleep and appetite disturbance, hormonal imbalance, and anxiety can all be treated with Shiatsu therapy. In other words, it can have a profound regulatory influence on the autonomic nervous system.


A meridian is not a material thing – it is not a ‘what,’ but a ‘where.’ Meridians are like the flight paths of migrating birds – if you look up after the birds have gone, you don’t see pavement and dotted lines, but the flight path is definitely there and is predictable from year to year.

The ‘energy’ that travels the meridians is the ‘thing,’ and it is electromagnetic in nature. The impulses are direct currents, and are transmitted via the matrix of Schwann cells – insulating cells that are wrapped around the rod of every neuron, like a sheath. The body’s network of neurons is therefore a dual network. Its first function is, of course, the conduction of nerve impulses.

Its second function is just as vital and possibly more complex, involving the maintenance of a normal electrical environment around each and every cell – or a stimulatory one when healing growth is required. The neurons are also responsible for transmitting injury-signalling currents to the central nervous system whenever injury is present. The very notable by-product of these currents is pain. For detailed information on this subject, I refer you to a marvellous book called The Body Electric by Dr. Robert O. Becker.

The 12 main meridians are individual currents, each one associated with one of the internal organs, and they literally take the paths of least resistance through the tissues of the body. It’s important to emphasize that the impulses do not travel the lengths of the neurons along with the nerve impulses. They cut their own paths across the matrix of neurons, hopping from Schwann cell to Schwann cell; these insulating cells are themselves the conductors.

One might visualize a rainforest, the trees all wrapped with vines, and 12 great tribes of monkeys swinging continuously from vine to vine in discrete pathways through the jungle. The trees are vital to the scenario, but the vines are the means of transport – the monkeys swing through the spaces between the trees as the vines and underbrush allow. However, it is actually the monkeys, not the vines, that connect the trees to each other and create a living forest.

It is life force that surges through the body in the predictable patterns known as meridians.


You may have heard that Shiatsu therapy is painful, but in my opinion, there is no need for painful treatment. A person should be able to achieve a state of deep relaxation during treatment, and any intense sensation that occurs should come in the form of relief.

In my practice, the person receiving treatment remains fully dressed, as there is no necessity for direct contact with the skin, and no oils are used. Treatment takes place on a futon on the floor – this is the classical approach, which allows me great freedom to modulate and direct the flow of pressure with my own body dynamics.

My own approach to treatment is something that is always evolving. These days, I rarely address a stated ‘problem area’ directly, but instead work my way in from the periphery. So, very roughly speaking, if a difficulty manifests in the back, most often I will approach through the arms and hands, or through the feet and legs, depending on the part of the back affected. Should a problem exist in the hands, I may well work from the shoulders toward the issue, and so on.

My client won’t necessarily be aware of it, but by gently vibrating his or her ankle in a particular way, for example, I am coaxing a very specific muscle group to let go of some of the tension it holds. I can observe it releasing. This allows me to then move closer to the problem, as the client opens up to the possibility of change.

It is not uncommon for me to perform an entire treatment with my client lying on his or her back while I work from underneath. In this scenario, gravity creates sufficient pressure, while the seeming absence of force precludes unconscious ‘tensing’ on the client’s part. On the other hand, if I choose to work with a client in side position, I will use from five to ten pillows as support for the limbs, creating a situation in which the spine can remain aligned and the large joints can ‘float’ rather than be scrunched underneath or stretched over the body.

Frequently I will pick up a limb during treatment and move and manipulate it gently. I do this to test resistance against gravity and against the client’s own range of motion potentials. This tells me what has changed and what still needs to change. Often, when there is pain in the back, a limb will feel like lead – an arm may feel as though it weighs 30 pounds, the head may not be willing to budge from the pillow, or a leg may feel like a sodden log.

But after gentle, quiet encouragement from the periphery, the muscle groups in the core of the body begin to surrender their grip on the limbs – the range of motion comes back to the large joints, the limbs and head seem to weigh literally less than half of what they did at the beginning of treatment, and the body pain is diminished significantly.

To my way of thinking, it is the ‘being’ part of a human being that comes to me with a problem or a pain. The bony structure and the soft tissue are like a suit of clothes that this being wears. After a lifetime of being lived in – consciously and unconsciously – that suit of clothes takes on a different shape and bearing than its original. It is my job to show my clients how they have come to inhabit their bodies – how their methods of living inside their skins may have shifted away from symmetry or efficiency or real ease.

This is work that my client and I do together. My client is passive during treatment, but very present. This work is a person’s passive exploration of his or her body structures and habits of movement and bearing. It is very much a learning experience. Healing is always done by the one who needs healing, not by the therapist treating them or by the technique that is applied. My job is to listen intently to my clients – to be as present as I can possibly be – and to help them become familiar with the bits of themselves that they’ve not been truly conscious of so that they can open or strengthen them as required. I show them that they have made choices that they weren’t aware of, and that they always have options.

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