Can Remedial Massage
Support Pain Management?
Pain is more than just a physical sensation — it’s a complex signal shaped by biology, psychology, and context. Understanding what it is and why it persists is the first step towards managing it effectively.
Understanding Pain
Pain is a signal — not always a simple one
The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.”1 That distinction matters — pain is not a direct readout of physical damage. It is an interpretation made by the nervous system, influenced by tissue state, previous experience, stress, sleep, context, and many other factors.
It can be steady, throbbing, stabbing, aching, burning, pinching, or difficult to describe at all. Sometimes it’s localised to a specific area; other times it’s diffuse or referred to a region seemingly unconnected to its source. Sometimes it resolves quickly. Other times it persists long after the original tissue event has healed.
Untreated or poorly managed pain has significant consequences — physical, psychological, social, and economic. Research summarised in Australian acute pain guidelines notes that acute pain which is not adequately managed can contribute to neurological and immunological changes that increase the risk of pain becoming persistent.3
Acute vs Chronic
Two very different pain experiences
Short-term pain
Acute pain is recent, typically linked to a clear event — a strain, injury, or overload — and serves a protective function. It signals the nervous system to reduce activity in the affected area while tissue recovery occurs.
Duration: days to weeks. Generally settles as the underlying tissue heals.
- Muscle strain or tear
- Post-exercise soreness (DOMS)
- Joint sprain
- Acute postural overload
Persistent pain
Chronic pain is generally defined as pain persisting beyond three months — or beyond the expected healing time for the original injury. At this point, the nervous system itself may have undergone changes (central sensitisation) that maintain the pain signal independently of ongoing tissue damage.
Duration: months to years. Usually calls for a different, longer-term approach.
- Persistent lower back pain
- Chronic neck and shoulder tension
- Widespread pain presentations
- Long-standing myofascial pain patterns
Poorly managed acute pain can contribute to changes in the nervous and immune systems that increase the risk of pain persisting — which is why seeking appropriate care early is worthwhile.
— Summarised from ANZCA & FPM, Acute Pain Management: Scientific Evidence3
The Biopsychosocial Model
Why pain is never just physical
Contemporary pain science understands pain through a biopsychosocial lens — meaning the physical state of your tissue is only one part of the picture. Psychological and social factors also shape how pain is experienced, how it persists, and how well any given intervention is likely to work.
Biological
Tissue and nervous system
Muscle tension, tissue sensitivity, nerve sensitivity, inflammation, and the state of joints and soft tissues. This is the dimension manual therapy works with most directly.
Psychological
Thoughts, emotions, beliefs
Fear of movement, catastrophising, anxiety, low mood, and beliefs about pain can all amplify or maintain a pain experience — sometimes independently of tissue state. Sleep quality is closely linked here too.
Social
Context, work, relationships
Work demands, social support, occupational stress, and daily activity patterns all influence how pain is experienced and managed over time. A high-stress environment can help maintain a pain state that might otherwise settle.
How Remedial Massage May Help
What soft tissue work may contribute to pain management
Remedial massage is an evidence-informed manual therapy that works primarily with the biological dimension of pain — soft tissue state, nervous system tone, and movement restriction. It may also have indirect effects on the psychological and social dimensions. Responses vary between individuals.
Nervous system modulation
Touch and sustained pressure activate mechanoreceptors in the skin and underlying tissue that can modulate pain signal processing — a mechanism often described as “closing the gate” on pain transmission (gate control theory).4 This may contribute to reduced local sensitivity and the sense of comfort many clients report following treatment.
Easing muscle tension and guarding
Some models describe a cycle in which ongoing muscle guarding and pain sensitivity reinforce each other. Soft tissue work may help reduce guarding and perceived stiffness, which can make movement feel more comfortable and support the tissue settling towards a more relaxed resting state.
Local circulation and comfort
Manual therapy may temporarily influence blood flow and skin temperature in the treated area. Many clients describe a feeling of warmth and reduced stiffness afterwards, although individual responses vary.
Supporting movement range and quality
Restricted range of motion — whether from muscle guarding, stiffness, or protective movement patterns — is a common contributor to ongoing discomfort. Targeted soft tissue work, combined with appropriate movement, may support improved movement quality and reduce the load on compensating structures.
Stress, sleep, and the wider pain picture
Massage has been associated with short-term reductions in stress and nervous system arousal — a shift away from a “fight or flight” state towards rest and recovery. For people whose pain is influenced by ongoing stress and poor sleep, this may contribute to an improved overall pain experience over time.
The Clinical Approach
Acute and chronic pain call for different strategies
Working around the acute phase
In the immediate aftermath of an acute injury or strain, the priority is avoiding further irritation rather than working directly into the injured site. Assessment guides where to work — often the compensating structures and surrounding tissue rather than the acute area directly.
As the acute phase settles, treatment can progressively address the injured area more directly while monitoring the response at each stage.
A longer-term, layered approach
Persistent pain generally calls for a series of sessions rather than a single treatment. The aim is not to “fix” the pain in one session — it’s to work gradually with tissue state and nervous system sensitivity over time, while identifying the contributing factors that may be maintaining the pain.
Consistency, communication between sessions, and working alongside your other health providers where relevant are all part of this process.
Know the Limits
When to seek medical assessment first
Remedial massage is not appropriate as a primary intervention for all pain presentations. There are circumstances where pain requires medical assessment before any manual therapy is considered.
Seek medical assessment if you experience:
- Pain following a significant trauma, fall, or impact
- Sudden, severe, or rapidly worsening pain without a clear cause
- Pain accompanied by fever, unexplained weight loss, or night sweats
- Neurological symptoms: weakness, numbness, or loss of bowel or bladder control
- Chest pain or pain radiating into the arm or jaw
- New or unexplained pain with a history of cancer, without prior medical clearance
- Abdominal pain that may indicate a visceral rather than musculoskeletal origin
These are clinical red flags that indicate the pain may not be musculoskeletal in origin. Medical clearance should be sought before proceeding with massage. In an emergency, call 000.
Managing ongoing pain?
An assessment is a sensible first step.
Understanding what may be contributing to your pain — not just where it is — helps guide treatment that suits you. Book in and we’ll work through it together.
References
- Raja SN, et al. The revised International Association for the Study of Pain definition of pain. Pain. 2020;161(9):1976–1982.
- Painaustralia & Deloitte Access Economics. The cost of pain in Australia. 2019.
- Schug SA, et al. (eds). Acute Pain Management: Scientific Evidence, 5th ed. ANZCA & Faculty of Pain Medicine; 2020.
- Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965;150(3699):971–979.
Educational content only. Not medical advice. Individual results vary. This information should not replace consultation with a qualified healthcare professional. Remedial massage is not suitable for all pain conditions, and the potential benefits described vary between individuals. If you are experiencing pain that may require medical assessment — including any of the red flags described above — please consult your GP or an appropriate medical professional before seeking manual therapy. Hill Yang is an ESSA Accredited Exercise Scientist (AES #17005) and Remedial Massage Therapist (MMA #031045).
About the Author
Hill Yang
Hill has more than 20 years of clinical experience and over 25,000 hands-on sessions. He combines remedial massage with movement assessment, including force plate and motion-capture tools, to understand how load moves through the body. Hill was part of the medical team at the 2018 Commonwealth Games and is a finalist in the 2026 Australian Small Business Champion Awards (Health Improvement Services). He practises at Heal Young Massage in Varsity Lakes, Gold Coast, and offers sessions in English and Mandarin.
