Massage for "Better Circulation": What Is and Is Not Established

"Massage improves circulation" is one of the most repeated claims about massage. This page checks it against what we could read, and explains why the word "circulation" covers very different things. It is information only, not a diagnosis or treatment plan.

Urgent first: a possible blood clot

A blood clot in a deep leg vein (deep vein thrombosis, DVT) is serious. The NHS lists throbbing pain in one leg, usually in the calf or thigh, and swelling in one leg as symptoms. [1] If you have these symptoms plus shortness of breath or chest pain, the NHS says to call 999 or go to A&E, because clots can travel to the lungs. [1] In the US, call 911. Do not drive yourself. If you have one-sided leg pain or swelling and no breathing trouble, still get urgent medical advice instead of waiting, and do not have a leg massage until a clinician has looked at it.

The claim and what we found

Patient information sometimes says massage may improve blood flow. For example, a Kaiser Permanente encyclopedia says massage "may improve blood flow". [2] Evidence label: marketing claim in most spa descriptions; insufficient evidence or no good evidence of benefit for lasting circulation changes in the sources we read.

The idea behind the claim is a proposed mechanism: pressure on tissue might increase blood flow, for example by raising pressure in the smallest arteries, or warming the muscle through rubbing. [5] A proposed mechanism is not the same as a measured result, and the measurements above did not confirm it.

What helps blood flow, according to the NHS

For varicose veins, the NHS lists exercising regularly, such as running or walking, to improve blood flow, and putting your legs up when you can. [6] It also says to try not to injure your legs, to help prevent bleeding. [6] Compression stockings put pressure on the lower legs, which the NHS says improves blood flow and can help with swelling and pain. [6]

Varicose veins and swollen legs

Varicose veins are swollen, twisted veins under the skin, usually on the legs. [6] Symptoms can include aching, heaviness and swollen ankles or legs. [6] The NHS lists varicose veins among conditions that raise the chance of a DVT, along with cancer or heart failure. [1] So leg swelling is a reason to ask a clinician before booking, and to avoid pressing on bulging veins or painful areas. Details are on massage with varicose veins and circulation problems.

Specialist lymphatic care is a different thing

A 2020 review of 15 trials looked at lymphatic and compression treatments for swelling after orthopedic injury or surgery. [7] It concluded that when significant swelling persists after elective surgery, complex decongestive therapy and manual edema mobilization should be recommended in addition to conventional physical therapy. [7] That is clinical care from trained practitioners, not a relaxation massage. See lymphedema care and complete decongestive therapy.

What massage can still offer

Many people enjoy massage for relaxation and comfort, and some trials report less pain or stress. Those are feelings and comfort, which are real but different from changes in circulation. See massage evidence by goal.

Related pages

Massage and blood clots (DVT) warning signs, massage and the stress response and lymphatic massage at home and "lymph detox" claims.