Last Updated on February 11, 2026 by MASSAGE Magazine
Massage therapy does more than relax tight muscles. According to a review of more than 30 studies, massage can influence key hormones and neurotransmitters in the body, including lowering cortisol and increasing serotonin and dopamine.
For massage therapists, this matters. Clients often report feeling less stressed, lighter, or more balanced after a session. This body of research helps explain why that might be happening beneath the surface.
The review, titled “Cortisol decreases and serotonin and dopamine increase following massage therapy,” was conducted by researchers from the Touch Research Institutes at the University of Miami School of Medicine and collaborators from Duke University Medical School. It was originally published in the International Journal of Neuroscience (October 2005, Vol. 115, No. 10, pp. 1397–1413).
What Did Researchers Actually Review?
The authors examined more than 30 studies looking at the biochemical effects of massage therapy.
They focused specifically on:
- Decreases in cortisol, a stress hormone
- Increases in serotonin and dopamine, two neurotransmitters associated with mood and well-being
The studies covered a wide range of conditions and life stressors, including:
- Depression, including cases related to sex abuse and eating disorders
- Pain syndromes
- Autoimmune conditions such as asthma and chronic fatigue
- Immune-system diseases including HIV and breast cancer
- Job-related stress
- Age-related stress
- Pregnancy-related stress
Across these varied populations, researchers looked for consistent biochemical patterns following massage therapy.
What Happened to Cortisol Levels After Massage?
On average, cortisol levels decreased by 31 percent in studies where it was measured.
Cortisol is produced by the sympathetic nervous system during periods of stress. While it plays an important role in the body’s stress response, chronically elevated cortisol can negatively affect immune function and overall health.
For therapists, this finding supports what you may already observe in practice. Clients who arrive tense, overwhelmed, or exhausted often leave visibly calmer. A measurable reduction in cortisol provides a possible biochemical explanation for that shift.
What About Serotonin and Dopamine?
In studies measuring serotonin and dopamine levels in urine, researchers found:
- An average increase of 28 percent in serotonin
- An average increase of 31 percent in dopamine
Serotonin and dopamine are often referred to as “feel-good” neurotransmitters. They are associated with improved mood, reduced depression and decreased stress.
When these neurotransmitters increase following massage therapy, it suggests that the benefits of bodywork extend beyond muscles and into the nervous system.
What Did the Massage Sessions Look Like?
Across the studies reviewed, participants received massage sessions that were:
- At least 20 minutes long
- Administered at least twice per week during the study period
Hormone and neurotransmitter levels were measured through saliva or urine samples.
The consistency of results across different conditions and populations led the authors to suggest that massage therapy’s biochemical effects may be generalizable rather than condition-specific.
What Does This Mean for Massage Therapists?
This review suggests that massage therapy consistently produces positive biochemical changes, even though researchers do not yet fully understand the underlying mechanisms.
For practicing therapists, this reinforces several important points:
- Massage is not just mechanical.
- Massage influences the nervous system.
- Massage can support clients dealing with stress-related conditions.
When clients ask why they feel emotionally lighter or mentally clearer after a session, research like this gives you a grounded, evidence-informed explanation.
At the same time, it is important to avoid overstating claims. The authors themselves note that while positive effects are consistent, the exact mechanisms behind these changes are still being explored.
Why This Research Matters in Everyday Practice
As a massage therapist, you work at the intersection of touch and physiology. This review from the Touch Research Institutes suggests that your work may help regulate stress hormones and support mood-related neurotransmitters across a wide range of conditions.
That does not mean massage replaces medical treatment. It does mean that massage therapy appears to consistently influence stress chemistry in measurable ways.
For therapists serving clients with chronic stress, pain, autoimmune conditions or emotionally demanding life situations, understanding the biochemical effects of massage therapy adds depth to your practice. It connects what your hands feel to what the body is doing internally.
And sometimes, that connection is exactly what helps you communicate the real value of your work.