and Other Asian Bodywork
Other common names: acupressure, Tui Na, Shiatsu, Ohashiatsu®, Watsu®
Scientific/medical names: none
Bodywork refers to a variety of techniques that touch, manipulate, or otherwise work on the body. Massage and non-Asian types of bodywork are addressed separately (see Massage). Acupressure is a form of bodywork based on the Chinese principles of acupuncture (see Acupuncture). It uses touch or pressure rather than needles. Shiatsu is a Japanese bodywork practice that uses acupressure. Tui na also uses pressure on acupoints, and Ohashiatsu and Watsu are based on the practice of Shiatsu.
Available scientific evidence does not suggest acupressure and other types of Asian bodywork work to treat cancer, but they may be used to enhance quality of life for some patients. Some studies suggest that acupressure may help reduce early nausea related to chemotherapy (chemo), but it doesn't seem to affect vomiting. Small studies also suggest it may help nausea due to radiation and fatigue due to chemo. Many forms of bodywork may have the potential to help relieve pain and reduce stress, even though the effectiveness of these techniques has not yet been proven in scientific studies.
How is it promoted for use?
According to the theories and teachings of traditional Chinese medicine, acupoints lie along invisible meridians. These meridians are supposed to be channels for the vital energy or life force called qi (also spelled ch'i or ki, pronounced "chee" or "kee") that is present in all living things. Meridians also represent an internal system of communication that is supposed to connect certain organs or networks of organs. There are said to be 12 major meridians in the human body. According to traditional Chinese medicine theory, illness may occur when the energy flow along one or more meridians is blocked or out of balance. Acupressure and other elements of Asian bodywork have the goal of restoring health and balance to the energy flow. Some supporters claim that acupressure can be used to treat the body, mind, emotions, energy field, and spirit.
Some practitioners in the West reject the traditional philosophies of Chinese medicine, believing that any relief given by acupressure and acupuncture is caused by other factors, such as the stimulation of endorphin production. Endorphins are natural substances made by the body that help relieve pain. Some Western practitioners also believe that relief may be in part due to the placebo effect, which can be very powerful for short-term changes in symptoms. Researchers are now trying to separate those from actual effects (see our information, Placebo Effect.).
What does it involve?
All Asian bodywork uses pressure, soft tissue manipulation, and other techniques to stimulate the acupoints and energy meridians described in traditional Chinese medicine with the goal of balancing energy flow in the body.
Acupressure, also called pressure acupuncture, uses principles of acupuncture based on Chinese medicine. Practitioners use fingers or other body parts and devices to touch or apply pressure to acupoints along the body. Acupressure may also involve stretching, massage, and other methods to help balance and restore energy flow in the body. Some people consider acupressure to be a form of acupuncture without needles. There are many different types of acupressure.
Shiatsu is a Japanese word that literally means "finger pressure." The goal is to improve the body's ability to heal itself and to promote overall health through balancing the flow of qi. Shiatsu consists of touching or pressing on acupoints and energy meridians. Pressure on these vital points is intended to stretch and open pathways for the body's flow of qi. There are a number of subtypes of shiatsu, some of which focus on the use of stretching, special breathing techniques, meditation, and other practices.
Tui na is an older Chinese technique that uses pressure on acupuncture points (acupoints) along with other methods. Tui na has its roots in ancient Chinese medicine and may actually predate the popular practice of acupuncture. Tui na uses the theory of qi described above. Practitioners attempt to free these energy pathways through 13 basic hand massage techniques which include pushing, pressing, kneading, pulling, rolling, and other movements on the skin and soft tissue. Practitioners often target the muscles on either side of the spine.
Ohashiatsu is based on the practice of shiatsu. Supporters claim it can achieve balance and harmony by altering the flow of vital energy through the body rather than focusing on any one area. Promoters say it is a "step up" from shiatsu because it offers a more complete experience of healing and personal growth. According to its followers, successful Ohashiatsu sessions depend not only on the technical skill of the practitioner, but also on the feelings of compassion and empathy the practitioner is able to convey. A connection between the giver and receiver of this type of therapy is said to be important to the effectiveness of this practice. Ohashiatsu may also use exercise and meditation to induce a feeling of inner harmony and peace.
Watsu, also known as water shiatsu or aquatic shiatsu, is a form of bodywork that is practiced in warm water. A practitioner stretches, cradles, and massages clients while holding them afloat. The goal is to achieve a feeling of peace and to release emotional and physical blockages of the body's energy pathways. Promoters believe that being held and massaged in the water brings the recipient to a deep level of connection and trust, while the warmth of the water brings benefits such as greater freedom of movement. Proponents claim it can speed both physical and emotional healing processes.
What is the history behind it?
Acupressure was used in China as early as 2000 BC. Based on traditional Chinese medicine, it is widely practiced throughout Asia for relaxation, wellness, and treatment of disease. It uses the same energy meridians and acupoints as acupuncture.
Shiatsu came from Japan, but grew out of Tui na and traditional Chinese massage techniques. It was given the name Shiatsu in the early 20th century to distinguish it from older Japanese massage techniques. It was officially recognized by the Japanese government in 1955. Shiatsu has numerous subtypes and continues to develop.
Tui na is Chinese for "pushing and pulling." It uses acupressure points and emphasizes soft tissue work and realignment. Tui na is a traditional Chinese technique used for health maintenance and to treat pain and illness. It has been practiced for about four thousand years and is used most commonly in Chinese-American communities.
Ohashiatsu was developed in 1974 by a man named Ohashi, shortly after he learned shiatsu. He incorporated the energy principles of shiatsu, with an increased emphasis on balancing the body through seitai, a type of stretching. He proposed that the practitioner (the giver of the massage) should be in a state of meditation while working, in order to energize himself or herself as well as the recipient of the massage. Ohashiatsu calls itself the "touch for peace."
Watsu (also called aquatic shiatsu) was developed about 30 years ago by Harold Dull, who taught Zen Shiatsu. He noted that when shiatsu was practiced in a warm pool, this helped to support the joints and led to greater relaxation.
What is the evidence?
Available scientific evidence does not support use of Asian bodywork to treat cancer.
Many people who undergo one or more forms of Asian bodywork say that they feel more relaxed or can move with greater ease or less pain. Some people who have cancer may find that these therapies help to relieve stress, muscle tightness, and certain symptoms of cancer and side effects of treatments over the short term, but evidence is individual or based on very small research studies. Evidence supporting the use of Asian bodywork by cancer patients and survivors comes mainly from anecdotal reports and is related to symptom management and quality of life.
There is some early evidence from small studies with cancer patients suggesting acupressure might be helpful in reducing nausea and vomiting related to chemotherapy. When researchers reviewed these studies, though, it appeared that acupressure mostly helped the nausea that happened right after the chemotherapy. The reviewers found that it did not seem to help with vomiting or delayed symptoms.
Likewise, a study that looked at nausea and vomiting caused by radiation treatments found that wearing acupressure wristbands for a minute seemed to help some people with nausea. There was some relationship between how much the patients expected the band to help and how much it seemed to help. But patients had the same amount of vomiting and needed the same amounts of anti-nausea medicine as the patients without the wristbands.
Another small study looked at people with chemo-induced fatigue. The patients were taught to apply pressure at acupoints on the head, arms, legs, and feet. Those who did relaxation acupressure each day (for about 15 minutes) had improvement in their fatigue over a 6- to 12-week period. More study is needed on this.
Still, many of the studies on acupressure and other Asian bodywork does not meet the standards of scientific research, in part due to the challenges of setting up controlled clinical trials. But this is changing, with the hope of finding out what helpful effects these treatments can offer. More scientific research is needed to determine the benefits and limitations of acupressure and other forms of Asian bodywork.
Are there any possible problems or complications?
One concern about the use of Asian bodywork for people who have cancer is that tissue manipulation in the area of a tumor could increase the risk that cancer cells might travel to other parts of the body. It may be prudent for cancer patients to avoid massage near tumors and lumps that could be cancerous until this question is clearly answered.
Deep pressure and vigorous bodywork should be avoided during times of active treatment for cancer. People who have cancer that has spread to the bone or who have fragile bones should avoid physical manipulation or deep pressure because of the risk of fracture. Bodywork should be provided by a trained professional with expertise in working safely with people who have cancer and with cancer survivors. Generally, gentle massage and bodywork can be adapted to meet the needs of cancer patients. Patients and caregivers can also be taught to safely use some acupressure techniques.
People with rheumatoid arthritis, cancer that has spread to the bone, spine injuries, osteoporosis or other bone diseases that could be worsened by physical manipulation should avoid methods that involve body manipulation. People who have cancer and chronic conditions, such as arthritis and heart disease, should talk to their doctors before having any type of therapy that involves moving joints and muscles.
People with fevers, infections, seizures, or problems with bowel control should not use watsu.
Relying on this type of treatment alone and delaying or avoiding conventional medical care for cancer may have serious health consequences.
To learn more
More information from your American Cancer Society
The following information on complementary and alternative therapies may also be helpful to you. These materials may be found on our Web site (www.cancer.org) or ordered from our toll-free number (1-800-227-2345).
The ACS Operational Statement on Complementary and Alternative Methods of Cancer Management
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Bass SS, Cox CE, Salud CJ, et al. The effects of postinjection massage on the sensitivity of lymphatic mapping in breast cancer. J Am Coll Surg. 2001:9-16.
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Dibble SL, Chapman J, Mack KA, Shih AS. Acupressure for nausea: results of a pilot study. Ocol Nurs Forum. 2000;27:1-12.
Ezzo JM, Richardson MA, Vickers A., et al. Acupuncture-point stimulation for chemotherapy-induced nausea or vomiting. Cochrane Database Syst Rev. 2006 Apr 19;(2): CD002285.
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MD Anderson Cancer Center. Manipulative and body-based methods: Massage and related bodywork detailed scientific review. Reviews of Therapies. Accessed at www.mdanderson.org/departments/CIMER/index.cfm on June 2, 2008. Content no longer available.
National Institutes of Health/National Center for Complementary and Alternative Medicine. Massage Therapy as CAM. NCCAM Backgrounder, 2006. Accessed at: http://nccam.nih.gov/health/massage/ on June 2, 2008.
Ohashi Institute. What is Ohashiatsu? Accessed at www.ohashiatsu.org on November 24, 2010.
Pinkowish MD. Acupressure and acupuncture for side effects of radiotherapy. CA Cancer J Clin. 2009 Sep-Oct;59(5):277-80. Epub 2009 Aug 14.
Roscoe JA, Bushunow P, Jean-Pierre P, et al. Acupressure bands are effective in reducing radiation therapy-related nausea. Pain Symptom Manage. 2009 Sep;38(3):381-9. Epub 2009 Mar 28.
Rosser RJ. Sentinel lymph nodes and postinjection massage: It is premature to reject caution. J Am Coll Surg. 2001; 193:338.
Shin YH, Kim TI, Shin MS, J HS. Effect of acupressure on nausea and vomiting during chemotherapy cycle for Korean postoperative stomach cancer patients. Cancer Nursing. 2004;27:267-274.
Zick SM, Alrawi S, Merel G, et al. Relaxation acupressure reduces persistent cancer-related fatigue. Evid Based Complement Alternat Med. 2011;2011. pii: 142913. Epub 2010 Sep 2.
Note: This information may not cover all possible claims, uses, actions, precautions, side effects or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for consultation with your doctor, who is familiar with your medical situation.
Last Revised: 03/01/2011