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Short description: Japanese alternative medicine bodywork practice
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Shiatsu (/ʃiˈæts-, -ˈɑːts/ shee-AT-, -⁠AHT-soo;[1] 指圧) is a form of Japanese bodywork based on concepts in traditional Chinese medicine such as qi meridians. Having been popularized in the twentieth century by Tokujiro Namikoshi (1905–2000),[2] shiatsu derives from the older Japanese massage modality called anma.

There is no scientific evidence that shiatsu will prevent or cure any disease.[3] Although it is considered a generally safe treatment—if sometimes painful—there have been reports of adverse health effects arising from its use, a few of them serious.[2]


In the Japanese language, shiatsu means "finger pressure". Shiatsu techniques include massages with fingers, thumbs, elbow, knuckle, feet and palms; acupressure, assisted stretching; and joint manipulation and mobilization.[4] To examine a patient, a shiatsu practitioner uses palpation and, sometimes, pulse diagnosis.

The Japanese Ministry of Health defines shiatsu as "a form of manipulation by thumbs, fingers and palms without the use of instruments, mechanical or otherwise, to apply pressure to the human skin to correct internal malfunctions, promote and maintain health, and treat specific diseases. The techniques used in shiatsu include stretching, holding, and most commonly, leaning body weight into various points along key channels."[5]

The practice of shiatsu is based on the traditional Chinese concept of qi, which is sometimes described as an "energy flow". Qi is supposedly channeled through certain pathways in the human body, known as meridians, causing a variety of effects.[6] Despite the fact that many practitioners use these ideas in explaining shiatsu,[7] neither qi nor meridians exist as observable phenomena.[8][9]


There is no evidence that shiatsu is of any benefit in treating cancer or any other disease, though some evidence suggests it might help people feel more relaxed.[3] In 2015, the Australian Government's Department of Health published the results of a review of alternative therapies that sought to determine if any were suitable for being covered by health insurance; shiatsu was one of 17 therapies evaluated for which no clear evidence of effectiveness was found.[10] Accordingly, in 2017, the Australian government named shiatsu as a practice that would not qualify for insurance subsidy, to ensure the best use of insurance funds.[11]

Shiatsu's claims of having a positive impact on a recipient's sense of vitality and well-being have to some extent been supported by studies where recipients reported improved relaxation, sleep, and lessened symptom severity.[2] However, the state of the evidence on its efficacy for treating any malady is poor, and one recent systematic review did not find shiatsu to be effective for any particular health condition.[12] It is generally considered safe, though some studies have reported negative effects after a treatment with shiatsu,[2] and examples of serious health complications exist including one case of thrombosis, one embolism, and a documented injury from a "shiatsu-type massaging machine".[13]


Shiatsu practitioners believe that an energy called ki flows through a network of meridians in the body.

Shiatsu evolved from anma, a Japanese style of massage developed in 1320 by Akashi Kan Ichi.[14][15] Anma was popularised in the seventeenth century by acupuncturist Sugiyama Waichi, and around the same time the first books on the subject, including Fujibayashi Ryohaku's Anma Tebiki ("Manual of Anma"), appeared.[16]

Introduction page, Anma Tebiki

The Fujibayashi school carried anma into the modern age.[17] Prior to the emergence of shiatsu in Japan , masseurs were often nomadic, earning their keep in mobile massage capacities, and paying commissions to their referrers.[citation needed]

Since Sugiyama's time, massage in Japan had been strongly associated with the blind.[18] Sugiyama, blind himself, established a number of medical schools for the blind which taught this practice. During the Tokugawa period, edicts were passed which made the practice of anma solely the preserve of the blind – sighted people were prohibited from practicing the art.[14] As a result, the "blind anma" has become a popular trope in Japanese culture.[19] This has continued into the modern era, with a large proportion of the Japanese blind community continuing to work in the profession.[20]

Abdominal palpation as a Japanese diagnostic technique was developed by Shinsai Ota in the 17th century.[21][22]

During the Occupation of Japan by the Allies after World War II, traditional medicine practices were banned (along with other aspects of traditional Japanese culture) by General MacArthur. The ban prevented a large proportion of Japan's blind community from earning a living.[citation needed] Many Japanese entreated for this ban to be rescinded. Additionally, writer and advocate for blind rights Helen Keller, on being made aware of the prohibition, interceded with the United States government; at her urging, the ban was rescinded.[23]

Tokujiro Namikoshi (1905–2000) founded his shiatsu college in the 1940s and his legacy was the state recognition of shiatsu as an independent method of treatment in Japan. He is often credited with inventing modern shiatsu. However, the term shiatsu was already in use in 1919, when a book called Shiatsu Ho ("finger pressure method") was published by Tamai Tempaku.[24] Also prior to Namikoshi's system, in 1925 the Shiatsu Therapists Association was founded, with the purpose of distancing shiatsu from anma massage.[24][25]

Namikoshi's school taught shiatsu within a framework of western medical science. A student and teacher of Namikoshi's school, Shizuto Masunaga, brought to shiatsu a traditional eastern medicine and philosophic framework. Masunaga grew up in a family of shiatsu practitioners, with his mother having studied with Tamai Tempaku.[24] He founded Zen Shiatsu and the Iokai Shiatsu Center school.[26] Another student of Namikoshi, Hiroshi Nozaki founded the Hiron Shiatsu,[27] a holistic technique of shiatsu that uses intuitive techniques and a spiritual approach to healing which identifies ways how to take responsibility for a healthy and happy life in the practitioner's own hands. It is practiced mainly in Switzerland, France and Italy, where its founder opened several schools.[28]

See also


  1. Wells, John (3 April 2008). Longman Pronunciation Dictionary (3rd ed.). Pearson Longman. ISBN 978-1-4058-8118-0. 
  2. 2.0 2.1 2.2 2.3 Ernst, Edzard (2019). Alternative Medicine: A Critical Assessment of 150 Modalities. Cham: Springer Nature Switzerland. pp. 193–194. doi:10.1007/978-3-030-12601-8. ISBN 978-3-030-12600-1. 
  3. 3.0 3.1 "Shiatsu". Cancer Research UK. 13 December 2018. https://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/complementary-alternative-therapies/individual-therapies/shiatsu. 
  4. Jarmey, Chris; Mojay, Gabriel (1991). Shiatsu: The Complete Guide. Thorsons. pp. 8. ISBN 9780722522431. "Shiatsu therapy is a form of manipulation administered by the thumbs, fingers and palms, without the use of any instrument, mechanical or otherwise, to apply pressure to the human skin" 
  5. "Welcome to Ministry of Health, Labour and Welfare". https://www.mhlw.go.jp/english/. 
  6. "Shiatsu". Cancer Research UK. 13 December 2018. https://www.cancerresearchuk.org/about-cancer/cancer-in-general/treatment/complementary-alternative-therapies/individual-therapies/shiatsu. 
  7. E.g., Beresford-Cooke, Carola (2003). Shiatsu Theory and Practice: A Comprehensive Text for the Student and Professional. Churchill Livingstone. ISBN 9780443070594.  pp. 1–2.
  8. Healing, Hype or Harm?: A Critical Analysis of Complementary or Alternative Medicine. Andrews UK Limited. 2013. p. 203. ISBN 978-1-84540-712-4. https://books.google.com/books?id=k7O7BAAAQBAJ&pg=PT203. "Vitalism generates no testable hypotheses and can neither be proven nor disproven. Detection of a signal on any type of physical apparatus implies that the signal mush have a physical origin—it must be a form of thermal, kinetic, electrical, electromagnetic, chemical, gravitational, or nuclear energy and, be definition, part of the mechanistic universe outside of which the hypothetical vital force dwells. Equally, even though we can't observe it directly in any way, it may still be there, in the same way that God may be there or in the same way that Russel's teapot may be there." 
  9. Ahn, AC; Colbert, AP; Anderson, BJ; Martinsen, ØG et al. (2008). "Electrical properties of acupuncture points and meridians: A systematic review". Bioelectromagnetics 29 (4): 245–56. doi:10.1002/bem.20403. PMID 18240287. https://onlinelibrary.wiley.com/doi/abs/10.1002/bem.20403. "Based on this review, the evidence does not conclusively support the claim that acupuncture points or meridians are electrically distinguishable.". 
  10. Baggoley C. "Review of the Australian Government Rebate on Natural Therapies for Private Health Insurance". Australian Government – Department of Health. https://www.health.gov.au/internet/main/publishing.nsf/content/4899F1657E19A6F4CA2583A50020140D/$File/Natural%20Therapies%20Overview%20Report%20Final%20with%20copyright%2011%20March.pdf. 
  11. Paola S (17 October 2017). "Homeopathy, naturopathy struck off private insurance list". Australian Journal of Pharmacy. https://ajp.com.au/news/homeopathy-naturopathy-struck-off-private-insurance-list/. 
  12. Robinson, Nicola; Lorenc, Ava; Liao, Xing (2011). "The evidence for Shiatsu: a systematic review of Shiatsu and acupressure". BMC Complementary and Alternative Medicine 11 (88): 88. doi:10.1186/1472-6882-11-88. PMID 21982157.  (cited by Ernst 2019, p. 194).
  13. E.g., Wada, Y.; Yanagihara, C.; Nishimura, Y. (2005). "Internal jugular vein thrombosis associated with shiatsu massage of the neck". Journal of Neurology, Neurosurgery, and Psychiatry 76 (1): 142–143. doi:10.1136/jnnp.2004.038521. PMID 15608019.  (cited by Ernst 2019, p. 194).
  14. 14.0 14.1 Jōya, Moku (1985). Mock Jōya's Things Japanese. pp. 55. 
  15. Fu ren da xue (Beijing, China). Ren lei xue bo wu guan; S.V.D. Research Institute; Society of the Divine Word (1962). Folklore studies. p. 235. https://books.google.com/books?id=3UwsAQAAIAAJ. Retrieved 11 May 2012. 
  16. Kaneko, DoAnn T (2006). Shiatsu Anma Therapy. Hmauchi. ISBN 9780977212804. 
  17. Louis Frédéric (2002). Japan Encyclopedia. Harvard University Press. pp. 28–29. ISBN 978-0-674-01753-5. https://books.google.com/books?id=p2QnPijAEmEC&pg=PA28. Retrieved 11 May 2012. 
  18. Young, Jacqueline (2007). Complementary Medicine For Dummies. John Wiley & Sons. pp. 99. ISBN 9780470519684. 
  19. Beresford-Cooke, Carola (2010). Shiatsu Theory and Practice. Elsevier Health Sciences. ISBN 9780080982472. 
  20. American Foundation for the Blind (1973). The New outlook for the blind. 67. pp. 178. 
  21. Carl Dubitsky (1 May 1997). Bodywork Shiatsu: Bringing the Art of Finger Pressure to the Massage Table. Inner Traditions * Bear & Company. pp. 7. ISBN 978-0-89281-526-5. https://books.google.com/books?id=zRB8DFWf1gQC&pg=PA7. Retrieved 11 May 2012. 
  22. Kiiko Matsumoto; Stephen Birch (1988). Hara Diagnosis: Reflections on the Sea. Paradigm Publications. pp. 315–. ISBN 978-0-912111-13-1. https://books.google.com/books?id=ktO5Atic5u4C&pg=PA315. Retrieved 11 May 2012. 
  23. Beresford-Cooke, Carola (2003). Shiatsu Theory and Practice: A Comprehensive Text for the Student and Professional. Elsevier Health Sciences. pp. 2. ISBN 9780443070594. 
  24. 24.0 24.1 24.2 Anderson, Sandra K. (2008). The Practice of Shiatsu. Mosby Elsevier. p. 12. ISBN 978-0-323-04580-3. 
  25. Stillerman, Elaine (2009). Modalities for Massage and Bodywork. Mosby. pp. 281–300. ISBN 978-0323052559. 
  26. Jarmey, Chris; Mojay, Gabriel (1991). Shiatsu: The Complete Guide. Thorsons. pp. 6. ISBN 9780722522431. 
  27. Hiron Shiatsu
  28. "Archived copy". http://www.herbig.net/uploads/tx_ttipcshop/media/eisele_wisdom.pdf. 

External links