Shiatsu

Shiatsu is a Japanese hands-on therapy built on the philosophy and theory of traditional Chinese medicine. Its name means "finger pressure" in Japanese, and the therapist presses on acupuncture points, called tsubo, on the body. An Australian Government evidence evaluation describes it as a complex, whole-system intervention.^[1] The Australian Government's healthdirect service describes it as a type of massage therapy.^[2]

Description

Underlying ideas

To understand shiatsu, a learner first needs its vocabulary. It draws on traditional Chinese ideas such as yin and yang, the energy meridians, the five elements and ki (energy). The therapist aims to find and correct imbalances in the flow of ki in a person's meridians, with the intention of supporting the body's own healing.^[1] These are the tradition's own concepts; the research described below measures outcomes such as pain or bowel recovery, not ki.^[1]

A session

A session usually starts with a health history and an examination, which the therapist uses to reach a traditional Chinese medicine diagnosis and tailor the treatment. Examination methods include feeling the abdomen (hara) or back, and pulse, tongue and face diagnosis. Shiatsu is traditionally given on a futon on the floor, with the person sitting or lying down and either fully clothed or covered by a sheet.^[1]

Shiatsu uses a wide range of techniques. Some are vigorous, such as kneading, rubbing, tapping and shaking; others are slow and firm or quick and gentle, such as pressure, stroking, stretches, rotations of the limbs and joints, and muscle release techniques. All styles use the therapist's body weight and physical pressure in some way.^[1]

Styles

Styles practised in Australia include barefoot (macrobiotic) shiatsu, healing shiatsu, Jin Shin Do, Namikoshi (or Nippon) shiatsu, Ohashiatsu, quantum shiatsu, Tao shiatsu, tsubo therapy, Zen shiatsu and watsu (water shiatsu).^[1]

What the evidence says

The evidence for shiatsu's effects is limited. A 2015 review for the Australian Government found no clear evidence that shiatsu was effective for any clinical condition. A 2023 systematic review for the Natural Therapies Review found moderate-certainty evidence, from one trial of 160 people, that shiatsu probably improves bowel recovery after minimally invasive surgery. It found low-certainty evidence, mostly from single small trials, of benefit for some outcomes in other groups, such as people with constipation, period pain, obesity, stress or high blood pressure and people recovering from stroke. It found low-certainty evidence of little or no effect on pain, disability or quality of life in chronic musculoskeletal pain, on pain intensity in period pain, and on the length of labour. The effects on diabetes and on care after childbirth are unknown.^[1]^[3] Its searches ran to April 2021.^[1]

Scope

What it includes

Pressure on acupuncture (tsubo) points and along meridians^[1]
Massage techniques, stretches and joint rotations^[1]
Assessment using traditional Chinese medicine methods^[1]
Other traditional oriental therapies taught in the Australian diploma, such as moxibustion, cupping, self-acupressure, oriental diet, corrective exercises, lifestyle advice, relaxation, breathing techniques and meditation^[1]

What it is not

Shiatsu is not the same as acupressure, although the two are closely related. Acupressure, pressure on acupuncture points, is one part of shiatsu, and some authors note differences in technique and philosophy between them; others, including World Health Organization terminology, use the words interchangeably.^[1]
Shiatsu is not a replacement for medical care: healthdirect advises that massage therapy should not replace care from your doctor.^[2]

Traditions and lineage

Shiatsu has a two-step lineage. It comes from traditional Japanese massage (Anma), which in turn has its origins in traditional Chinese (Tuina) massage. Shiatsu became popular in the West after Japan passed legislation on "Anma-Shiatsu-Massage" in the mid-twentieth century.^[1]

Context

Within Spiritualism

Spiritfold has found no published source linking shiatsu with Spiritualism.

In Australian Spiritualism

Spiritfold has found no published source linking shiatsu with Spiritualism in Australia.

A Spiritualist perspective

For a Spiritualist, shiatsu belongs to another tradition altogether, built on the ideas of traditional Chinese medicine: yin and yang, meridians and the flow of ki. Those ideas are not Spiritualist teaching, and a thoughtful Spiritualist would treat them with the respect due to a body of thought with its own history, without trying to fold them into our own.

Some people may notice an outward likeness between hands working along the body and the hands of a Spiritualist healer. The resemblance is only on the surface. Our healers understand themselves as channels for healing from the spirit world, and shiatsu therapists work from their own training and diagnosis. A Spiritualist may receive shiatsu, or train in it, with a clear conscience. What matters is honesty about which practice is being offered, consent before any touch, and encouragement to keep seeing a doctor for any health concern.

Shiatsu in Australia

Where shiatsu therapists work

Shiatsu therapists in Australia work in solo or group shiatsu clinics, multidisciplinary health clinics, from home, or in mobile practices that visit homes or offices. A 2016 survey of 121 shiatsu therapists in Australia found that the most common reasons they gave for providing shiatsu were stress, mental health, pain and musculoskeletal problems, rehabilitation and the management of chronic conditions.^[1]

Training and associations

The national HLT52215 Diploma of Shiatsu and Oriental Therapies is a current qualification in the Health Training Package. It describes shiatsu therapists as practitioners who provide shiatsu and other oriental therapies, either as self-employed practitioners or in a larger health service, and requires at least 200 hours of work as part of its assessment. No licensing, legislative or certification requirements apply to it.^[4]

The Shiatsu Therapy Association of Australia (STAA), a national peak body for shiatsu therapists, requires its practitioners to hold this diploma or an equivalent, complete at least 20 hours of continuing professional education each year and hold a current first aid certificate. Other associations may also recognise the diploma. Shiatsu therapists may hold different qualifications, and may be registered as shiatsu or oriental massage therapists with one or more Australian natural therapy associations.^[1]

Regulation

None of the natural therapies examined in the Natural Therapies Review, including shiatsu, is regulated in terms of who can provide it.^[3] The diploma and association membership described above are therefore the main ways to check a therapist's training.^[1]

Private health insurance

Since 1 April 2019, shiatsu has been one of 16 natural therapies that private health insurers can't cover.^[5] The Natural Therapies Review 2024 looked at the evidence again. Its Chair, Professor Michael Kidd, recommended re-inclusion for therapies with moderate-certainty evidence of effectiveness for at least one health outcome in one condition, and shiatsu was one of the seven therapies he recommended should become eligible again.^[3]

Safety and good practice

Shiatsu uses body weight and physical pressure, and some styles include vigorous techniques,^[1] so the general cautions for massage apply. The 2023 systematic review did not assess safety.^[1] healthdirect, which lists shiatsu among the types of massage therapy, says that massage in general is usually very safe but can cause minor pain or soreness, and very rarely damage to muscles, joints, blood vessels or nerves; the risk is higher with an unqualified therapist. It says massage may not be suitable for people with certain conditions, such as blood clots, burns, bleeding disorders, osteoporosis or infectious skin conditions, or for people having cancer treatment or recovering from surgery, and advises talking to your doctor first. Before treatment, a therapist should discuss your health history and medicines, informed consent and what to expect, and you should tell the therapist if you feel uncomfortable at any time.^[2]

Related modalities

References

↑ ^1.00 ^1.01 ^1.02 ^1.03 ^1.04 ^1.05 ^1.06 ^1.07 ^1.08 ^1.09 ^1.10 ^1.11 ^1.12 ^1.13 ^1.14 ^1.15 ^1.16 ^1.17 ^1.18 Health Technology Analysts Pty Ltd. Shiatsu for preventing and treating health conditions: evidence evaluation report. Prepared for the National Health and Medical Research Council, June 2023. Published by the Australian Government Department of Health as "Natural Therapies Review 2024 – Shiatsu evidence evaluation" (accessed 11 October 2026).
↑ ^2.0 ^2.1 ^2.2 "Massage therapy guide". healthdirect, Healthdirect Australia. Last reviewed June 2025 (accessed 11 October 2026).
↑ ^3.0 ^3.1 ^3.2 Kidd, Michael. Letter to the Minister for Health and Aged Care, 16 February 2025, with Natural Therapies Review 2024 – Report and recommendations. Australian Government Department of Health, published 27 March 2025 (accessed 11 October 2026).
↑ "HLT52215 Diploma of Shiatsu and Oriental Therapies". National Training Register, training.gov.au. Current; release 5, 22 December 2025 (accessed 11 October 2026).
↑ "Natural Therapies Review 2024". Australian Government Department of Health, Disability and Ageing. Last updated 1 June 2026 (accessed 11 October 2026).