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Saskia ten Brinke · October 2026

Shiatsu: what does the research say?

People often ask me what shiatsu can do for them, and whether there is any research on it. There is, and the results are encouraging. In a large European study, clients reported fewer symptoms, especially less tension and stress, and most had started looking after themselves better. Shiatsu is also a recognised and regulated profession in several countries. Research into shiatsu is still young. In this article I set out what we know, and where more research is needed.

What clients notice themselves

The largest study of shiatsu clients’ experiences was carried out by the University of Leeds (3, 4). Almost 950 clients in Austria, Spain and the UK completed questionnaires, and 633 of them were followed for six months.

  • Fewer symptoms. In Austria and the UK, all types of symptoms had clearly decreased after three and six months. The biggest improvement was in tension and stress. In Spain, muscle and joint problems and tension and stress had improved after six months.
  • Less medication and fewer visits to the doctor. Over the course of the study, clients used less medication and visited doctors and hospitals less often, because they had less reason to.
  • Looking after yourself better. After six months, about four in five clients had changed something in their lifestyle because of shiatsu, mainly by taking more rest and relaxation and exercising more. A third or more also noticed greater body awareness and more self-confidence.
  • Satisfied. Almost everyone said their expectations had been met or exceeded. At six months, only five of the 633 clients said they had not.

This study had no comparison group, so it shows what clients experience rather than exactly how much of it is due to shiatsu. It does give a good picture of what people notice in practice.

What the research shows

The most thorough recent assessment comes from the Australian Government, which in 2023 and 2024 had all available research on shiatsu evaluated: 27 studies covering 16 different conditions (1). With moderate certainty, shiatsu was found to improve the recovery of bowel function after keyhole surgery. There were tentative signs that shiatsu may help with stress and quality of life, period pain, constipation, recovery after a stroke, and pain and nausea after surgery.

In a small 2024 study of 80 women giving birth for the first time, those who received shiatsu had less pain and less anxiety during labour than those who did not (5).

Recognised in other countries

In Japan, shiatsu is a profession with a national licence from the Ministry of Health (7). In Switzerland there is a federal diploma for complementary therapists, including the shiatsu method, and many health insurers reimburse treatment (8, 9). In the UK, shiatsu is on the register of the CNHC, which is accredited by the Professional Standards Authority (10). And in Australia, after the assessment mentioned above, the government decided in 2025 to restore insurance rebates for shiatsu (11). In the Netherlands, about half of health insurers reimburse shiatsu under supplementary insurance (12).

Where more research is needed

For most complaints the evidence is still weak or missing. For long-lasting muscle and joint pain, the Australian assessment found little or no difference, based on one small study (1). An earlier British review also concluded that there is still little evidence for the effectiveness of shiatsu (2). Shiatsu works with pressure on points and along meridians, which makes it closely related to acupressure. Acupressure has been researched more. Compared with sham acupressure, it reduced vomiting after keyhole surgery and improved sleep quality in insomnia with moderate certainty; for labour pain and period pain there were tentative signs (17). In a Taiwanese study of 129 people with chronic low back pain, acupressure reduced pain and disability more than the physiotherapy given in that study, and the difference lasted six months (18). Research usually involves pressure on a few fixed points, often self-applied, whereas a shiatsu treatment is broader. So these results cannot be transferred one to one, but they do show that pressure-point treatment can have an effect.

The lack of evidence is mainly due to a lack of research. New studies are under way, such as a French hospital trial of shiatsu for fatigue in axial spondyloarthritis (6).

Stress and muscle and joint complaints

Long-term stress and low mood are important risk factors for muscle and joint complaints, and especially for those complaints persisting (13, 14). Treatments that target stress and the way you cope with pain, such as mindfulness and cognitive behavioural therapy, improve pain and function in low back pain (15, 16). Because shiatsu may help with stress, it is plausible that it can contribute to recovery in this way. That is reasoning, not proof: the little research that looked at this directly, in long-lasting muscle and joint pain, found no clear effect (1, 2). That is why, for these complaints, I like to combine shiatsu with Mensendieck exercise therapy, in which you actively learn to move and relax yourself.

Is it safe?

The scientific literature describes shiatsu as a safe treatment (2). You may notice a temporary reaction in the days afterwards; in the European study these were mostly short-lived and resolved by themselves (3).

How I work

I practise Iokai Shiatsu, given fully clothed on a futon on the floor or on a treatment table. I treat the whole body, along the meridians. Many people come to me for relaxation, stress and tension, sleep problems, or complaints around menstruation, pregnancy and menopause. Where it helps, I combine shiatsu with Mensendieck exercise therapy. After a few sessions we review together whether it is helping you.

Would you like to know whether shiatsu could help you? Feel free to contact me.

Sources

  1. HTANALYSTS for NHMRC. Natural Therapies Review 2024: shiatsu evidence evaluation. Australian Government, 2023 (approved May 2024). health.gov.au
  2. Robinson N, Lorenc A, Liao X. The evidence for shiatsu: a systematic review of shiatsu and acupressure. BMC Complement Altern Med. 2011;11:88. doi:10.1186/1472-6882-11-88
  3. Long AF, et al. The effectiveness of shiatsu: findings from a cross-European, prospective observational study. Final report, University of Leeds. White Rose eprints
  4. Long AF. The potential of complementary and alternative medicine in promoting well-being and critical health literacy: a prospective, observational study of shiatsu. BMC Complement Altern Med. 2009;9. White Rose eprints
  5. Norhapifah H, Isa MR, Abdullah B, Mohamed S. The impact of shiatsu massage on labour pain and anxiety: a randomized controlled trial. Int J Community Based Nurs Midwifery. 2024;12(4):243-253. PEDro
  6. Bernardinelli N, et al. Effectiveness of shiatsu on fatigue in patients with axial spondyloarthritis: protocol for a randomized cross-over pilot study. Rheumatol Ther. 2023;10(4):1107-1117. DOAJ
  7. City of Yokohama. Anma massage shiatsu, acupuncture, moxibustion and judo therapy practitioners. Yokohama
  8. OdA KT. Status Krankenkassen-Anerkennung BZ/ED, January 2025. oda-kt.ch
  9. Rosenfluh. Der neue Beruf Komplementärtherapie mit eidgenössischem Diplom, 2016. rosenfluh.ch
  10. Complementary and Natural Healthcare Council. Introduction leaflet. cnhc.org.uk
  11. NICM Health Research Institute. Reinstatement of private health insurance rebates for seven natural therapies, April 2025. westernsydney.edu.au
  12. Zorgwijzer. Vergoeding shiatsu 2026. zorgwijzer.nl
  13. Pincus T, Burton AK, Vogel S, Field AP. A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain. Spine. 2002;27(5):E109-E120. University of Huddersfield
  14. Lang J, Ochsmann E, Kraus T, Lang JWB. Psychosocial work stressors as antecedents of musculoskeletal problems: a systematic review and meta-analysis of stability-adjusted longitudinal studies. Soc Sci Med. 2012;75(7):1163-1174. doi:10.1016/j.socscimed.2012.04.015
  15. Cherkin DC, et al. Mindfulness-based stress reduction vs cognitive behavioral therapy or usual care for chronic low back pain. JAMA. 2016. NCCIH summary
  16. Hill JC, et al. Stratified primary care for low back pain (STarT Back). Lancet. 2011. Medical News Today summary
  17. HTANALYSTS for NHMRC. Natural Therapies Review 2024: shiatsu evidence evaluation, supplementary acupressure evidence. Australian Government, 2023. health.gov.au
  18. Hsieh LL, Kuo CH, Lee LH, et al. Treatment of low back pain by acupressure and physical therapy: randomised controlled trial. BMJ. 2006;332(7543):696-700. PEDro

This article is general information and not personal medical advice.