For 15 years I lived in the Pacific Northwest where alternative/complementary medicine is used as commonly as conventional medicine.  Doctors there converse freely with acupuncturists, chiropractors, shiatsu specialists, etc. and are happy to coordinate care with such practitioners for the benefit of their patients.  They often referred their patients to me as part of their treatment plan.  Insurance companies on the West Coast and the Pacific Northwest cover the whole range of alternative therapies from bodywork to naturopathy to acupuncture and chiropractic.  When I moved back East and settled in the Mid-Atlantic, I was surprised to discover how rare it was to find that type of cooperation and coordination here.  I also found that a lot of people had never even heard of shiatsu, let alone used it.  In the time since I move here eight years ago, many more people in this town have heard about it but they still are not sure what shiatsu is and they often ask me how it differs from massage.   I thought it might be helpful to shed a little light on that question.  And, because people are often reluctant to try something new and unknown, I’ve added a little guidance on how to choose a bodyworker, regardless of the modality.

There are many different types of massage and bodywork.  Two of the most commonly practiced are Swedish massage and Shiatsu.  Massage is done with oils or lotions directly on the skin.  The practitioner uses palms, fingers and forearms in a horizontal plane along the main part of the muscles.  Massage is geared toward the skeletal muscles and the circulation of blood back to the heart.

Shiatsu is an acupressure technique that is often called “acupuncture without needles.”   The practitioner uses palms, fingers and thumbs in a vertical plane to stimulate the life force (qi) throughout the entire body. Shiatsu is geared at targeting your area of concern and harmonizing it with all your body’s functions and systems so that the effect is integrated and lasts longer.  It concentrates at the level of the nervous system to rejuvenate and enhance the:

  • Mobility, strength and flexibility of your joints
  • Circulation from your heart to all your cells, organs and muscles
  • Proper operation of your central nervous system  (brain, reflexes, etc.)
  • Harmonious coordination of your organ functions


  • Your pain will decrease;
  • Your joints will have better range of motion with less discomfort;
  • You will recover faster from injury or surgery;
  • Your stamina will increase;
  • You will sleep better,
  • You will digest better, and
  • Enjoy more peace of mind.

Many of the written descriptions of the various types of massage and bodywork sound so similar that it is hard to tell the difference between them.   How can you know which kind of bodywork will be the best for you?

There are several things to consider. Are you looking for relief from your neck and shoulder tension?  Do you want to calm your mind and sleep better?  Is your back pain beginning to get in the way of everyday activities?  Are you suffering from indigestion, allergies, headaches, menstrual discomfort?  Most types of bodywork address the muscle tension that results in tight neck and shoulders and/or back pain.  Depending on your individual response to treatment, you may favor lighter or deeper pressure.  Be sure to let your practitioner know if you have a preference.

You will also want to consider the training, skill, experience, and [most importantly] the goals of the practitioner who will perform the treatment.  Some practitioners are focused on the physical complaints.  Some are oriented toward the subtle energy of the body.  Still others like to address any suppressed emotions that tend to get jammed up in the various tissues (there should be additional training for this orientation).  There are practitioners who feel more comfortable concentrating on science and technique, while others prefer the art and flow, adjusting their technique according to intuition.  Most bodyworkers will practice some combination of art and science in various degrees and percentages.  Pressure can vary from a very light touch to medium to deep (or very deep) work, and a few practitioners have enough skill, talent, experience and intuition to use the whole range appropriately for the client’s needs and goals.

Referral by a healthcare provider or friend is always a good way to find the right person.  Even then, don’t be afraid to ask questions when you make your first contact, whether by phone or email.  In addition to the areas mentioned above, you might want to find out why most of their clients come to see them.  This may give you an idea of what they are used to treating in their practice.  You can also ask how much experience they have with your particular reason for seeking them out.  I know that if I were the one looking for a practitioner, I would not rely on an email for the first contact.  I would want to speak with them personally to get a sense of who they are.  I would want to feel confident about their professionalism and have the sense that we would “get along,” so to speak.  I would want to feel that the person understands me when I convey my needs and concerns.  Feeling comfortable, confident and compatible with your bodyworker can be the pivotal factor that turns a “good massage” into a great one.