Massage and the Nervous System

When you think about massage therapy, often you think about how your sore muscles will be provided with relief from the repetitive tasks that you take on in a day, whether it’s sitting at a desk, standing on your feet, or helping to manage other physical conditions. And as these benefits will leave you feeling pretty good post-massage, we often don’t think about the physiological reason for why we have a euphoric, ultra relaxed feeling for hours or days post massage. This euphoric state is due to massage impacting your nervous system positively by increasing your feel-good hormones and downregulating your stress hormones. Studies show that even after two weeks post-massage, cortisol and norepinephrine levels are significantly decreased (Lee, et. al, 2011).

The Value of Touch

Touch is an important aspect of human’s ability to thrive. It encourages positive social interactions and has been shown to help buffer stress and has calming effects (Eckstein, et. al, 2020). Post pandemic, work-from-home, mindful distance, and social media have created a world where we are experiencing fewer face-to-face interactions, and less opportunities for touch and connection. Less human connection and increased exposure to a world filled with chaos and uncertainty leads to increased stress.

Impact of Chronic Stress

Cortisol and norepinephrine are important hormones that are a part of your sympathetic nervous system (your fight-or flight response or your body’s alert system). It helps you wake in the morning, and it also helps you respond to danger. But when you have elevated levels over time (chronic stress), these hormones impact the gut-brain axis and are reported to cause systemic inflammation and gut dysbiosis and increases in proinflammatory cytokines, causing further dysregulation to the immune system (Perelli, et. al, 2024) which may leave you managing other conditions like cardiovascular diseases, diabetes, mental health disorders, and auto-immune conditions (Mariotti, 2015). Elevated stress hormones, over time, can cause symptoms of depression and other mood disorders, with additional correlation between major depression disorders and a 60% increased risk of developing Type 2 Diabetes. (Perelli, et. al, 2024)

The Feel-Good Hormones

Serotonin, oxytocin, endorphins, and dopamine are “feel good” hormones with serotonin being responsible for mood, sleep, digestion, and memory and your ability to learn. Oxytocin is the “love” hormone and aids in promoting trust, empathy and bonding, which can be increased through the means of physical touch, such as massage (Raypole, 2022). Endorphins help to alleviate pain, improve mood, and manage stress by regulating the release of cortisol. Lastly, dopamine is your “Reward center” and is released during pleasurable experiences like achieving goals, sex, eating, and touch.

How Does Massage Help Good/ Stress Hormones?

No, massage therapy alone cannot fix any of these chronic stress conditions, but it can aid in alleviating symptoms of many conditions, including anxiety, depression, and inflammatory responses by helping to decrease stress hormones and increasing happy hormones like serotonin, endorphins, dopamine, and oxytocin. In a study published by the International Journal of Neuroscience, recipients of massage realized an average of a 31% decrease in cortisol, and 28% increase in serotonin and a 31% increase in dopamine (Field, et. al, 2009)

If your body is stuck in sympathetic (fight or flight), massage can help you relax enough to shift back to a more natural and desired parasympathetic state of being (Meier, et. al, 2020). Ideally, the more frequently we can shift back into a relaxed state of being, the more we can balance our fight-or-flight response and better manage our stress.

Other Ways to Manage Stress

Massage is a great way to intentionally give yourself a dedicated hour (or more) to bring awareness back into your body, regulate your breathing, and become more centered while bringing attention to your muscle aches and pains, but there are many other ways to help regulate your stress response.

1. Meditation

2. Sunshine exposure

3. Exercise

4. Socializing with Friends

5. Sleep

6. Listen to and Dance to Music

7. Eating nutrient-dense food

Dopamine, 2025. Retrieved from: https://my.clevelandclinic.org/health/articles/22581-dopamine

Eckstein, M., Mamaev, I., Ditzen, B., & Sailer, U. (2020). Calming Effects of Touch in Human, Animal, and Robotic Interaction-Scientific State-of-the-Art and Technical Advances. Frontiers in psychiatry, 11, 555058. https://doi.org/10.3389/fpsyt.2020.555058

Field, T., Hernandez-Reif, M., Diego, M., Schanberg, S., & Kuhn, C. (2005). Cortisol decreases and serotonin and dopamine increase following massage therapy. The International journal of neuroscience, 115(10), 1397–1413. https://doi.org/10.1080/00207450590956459

Lee YH, Park BN, Kim SH. The effects of heat and massage application on autonomic nervous system. Yonsei Med J. 2011 Nov;52(6):982-9. doi: 10.3349/ymj.2011.52.6.982. PMID: 22028164; PMCID: PMC3220246.

Mariotti A. (2015). The effects of chronic stress on health: new insights into the molecular mechanisms of brain-body communication. Future science OA, 1(3), FSO23. https://doi.org/10.4155/fso.15.21

Maria Meier, Eva Unternaehrer, Stephanie J. Dimitroff, Annika B. E. Benz, Ulrike U. Bentele, Sabine M. Schorpp, Maya Wenzel, Jens C. Pruessner. Standardized massage interventions as protocols for the induction of psychophysiological relaxation in the laboratory: a block randomized, controlled trial. Scientific Reports, 2020; 10 (1) DOI: 10.1038/s41598-020-71173-w

Perrelli, M., Goparaju, P., Postolache, T. T., del Bosque-Plata, L., & Gragnoli, C. (2024). Stress and the CRH System, Norepinephrine, Depression, and Type 2 Diabetes. Biomedicines, 12(6), 1187. https://doi.org/10.3390/biomedicines12061187

Raypole, C. (2022). How to Hack your Hormones for a Better Mood. Healthline. Retrieved from https://www.healthline.com/health/happy-hormone#:~:text=Serotonin%3A%20This%20hormone%20and%20neurotransmitter,and%20strong%20parent%2Dchild%20bonding.

University of Konstanz. "Ten minutes of massage or rest will help your body fight stress." ScienceDaily. ScienceDaily, 18 September 2020. <www.sciencedaily.com/releases/2020/09/200918104305.htm>.

We live in the “Bold North”. The winters are long and sometimes we don’t see the sun for days. Many of us suffer from Seasonal Affective Disorder, which basically means that the winter and lack of sunshine literally depresses many of us.

Some of us are fortunate enough to be able to fly away for a vacation and the term “snowbird” is something we all understand, but what about those of us that are stuck in the frozen tundra until it thaws and gives way to longer days filled with sunshine?

What does Vitamin D do?

Vitamin is important for absorbing calcium and maintaining healthy bones and teeth Vitamin D supports a healthy immune system, brain and nervous systems as well as lung function and cardiovascular health.

It’s also reported to reduce the risk of multiple sclerosis, heart disease, and depression and aids those managing fibromyalgia.

Do I really need Vitamin D?

The fact of the matter is that there are only TWO ways to get vitamin D:

1. Sunshine

2. Supplements

You can, indeed, get vitamin in certain foods, but it’s pretty much impossible to consume the amount of vegetables required to gain your daily allowance of vitamin D.

What about sunscreen?

In order to gain the benefit of Vitamin D absorption, you should avoid using sunscreen. But don’t worry, D3 (cholecalciferol) is produced quickly and you can easily gain your daily D3 being in the sun for about half the time it would normally take your skin to burn. Sunshine is, without a doubt, the best way to get your Vitamin D. In the short time you spend in the sun’s rays, you can expect to gain about 10,000- 25,000 IU of Vitamin D!

Other factors to consider:

There are many factors that go into how your body absorbs Vitamin D. For example:

The darker your skin tone, the longer it takes your body to produce vitamin D. Additionally, your location matters- the closer to the equator you are and the amount of skin you expose, the faster your body is able to produce Vitamin D.

Can you overdose on Vitamin D supplements?

Yes! The recommended allowance of vitamin D is about 600 IU a day. Taking too much vitamin D can cause a rare, but potentially serious condition called hypervitaminosis D, which is a build up of calcium in your blood. Another reason that getting the real thing is the favored option, when available.

Happy Sunshine!

As with everything else, enjoy in moderation. If you know you will be in the sun all day, sunscreen is still recommended, but be sure to let the sun kiss you before applying!

1. American Association for Cancer Research (AACR). “Oral vitamin D supplements reduced levels of Ki67 in prostate cancer cells.” ScienceDaily, 31 Mar. 2012.

2. Cannell JJ, Vieth R, Willett W, Zasloff M, Hathcock J, White JH, Tanumihardjo SA, Larson-Meyer E, Bischoff-Ferrari HA, Lamberg-Allardt CJ, Lappe JM, Norman AW, Zittermann A, Whiting SJ, Grant WB, Hollis BW and Giovannucci E. Cod Liver Oil, Vitamin A Toxicity, Frequent Respiratory, Infections, and the Vitamin D Deficiency Epidemic. Annals of Otology, Rhinology & Laryngology Volume 117, No. 11. 2008.

3. Chen TC, Lu Z, and Holick MF. Photobiology of Vitamin D. In Vitamin D: Physiology, Molecular Biology and Clinical Applications by Holick MF. Humana Press, 2010.

4. Cusano NE, Thys-Jacobs S and Bilezikian JP. “Hypercalcemia Due to Vitamin D Toxicity.” In Vitamin D, Third Edition, by Feldman D, Pike JW and Adams JS. Elsevier Academic Press, 2011.

5. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM; Endocrine Society. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011 Jul;96(7):1911-30.

6. Holick MF. Photobiology of Vitamin D. In Vitamin D, Third Edition, by Feldman D, Pike JW and Adams JS. Elsevier Academic Press, 2011.

7. Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: National Academy Press, 2010.

8. Plum LA and Deluca HF. The Functional Metabolism and Molecular Biology of Vitamin D Action. In Vitamin D: Physiology, Molecular Biology and Clinical Applications by Holick MF. Humana Press, 2010.

9. Reichrath J and Reichrath S. Hope and challenge: the importance of ultraviolet radiation for cutaneous vitamin D synthesis and skin cancer. Scandinavian Journal of Clinical and Laboratory Investigation, 2012.

10. Smolders J, Hupperts R, Barkhof F, Grimaldi LM, Holmoy T, Killestein J, Rieckmann P, Schluep M, Vieth R, Hostalek U, Ghazi-Visser L, Beelke M. Efficacy of vitamin D(3) as add-on therapy in patients with relapsing-remitting multiple sclerosis receiving subcutaneous interferon beta-1a: a Phase II, multicenter, double-blind, randomized, placebo-controlled trial. J Neurol Sci. 2011 Dec 15;311(1-2):44-9. Epub 2011 May 28.

11. Tang, JY and Epstein Jr, EH. Vitamin D and Skin Cancer. In Vitamin D, Third Edition by Feldman D, Pike JW, and Adams JS. Elsevier Academic Press, 2011.

12. Terushkin V., Bender A., Psaty E.L., Engelsen O., Wang S.Q., Halpern A.C. Estimated equivalency of vitamin D production from natural sun exposure versus oral vitamin D supplementation across seasons at two US latitudes. J Am Acad Dermatol. 2010 June; 62 (6): 929.e1-9.

13. https://www.vitamindcouncil.org/about-vitamin-d/how-do-i-get-the-vitamin-d-my-body-needs/

Leveraging Massage for Nervous System Regulation

Vitamin D-ficiency