Many studies indicate that various spa therapies benefit the human body on a physiological level, far beyond the relaxation engendered by visiting a spa. By developing a deeper understanding of the health benefits and applications of spa therapies, a massage therapist can choose to offer spa-type services to clients in order to improve both outcomes and income.

A massage therapist does not need to work in a spa to provide clients a spa-like experience; however, in order to offer the spa add-ons described in this article, a massage therapist must obtain in-depth continuing education in spa techniques.

Spas do have the advantage of space, professional resources, equipment and personal instruction to provide guests services to help regain balance, change lifestyle habits and enhance their lives.

However, with education and adapted protocols, massage therapists can enhance sessions with such spa treatments and techniques as hydrotherapy, cold-mitt friction; salt, sugar or herbal scrubs; infrared light and sauna; and cold-sheet, mud, clay, seaweed and herbal wraps

Skin, Circulation & Lymph

The areas and functions of the human body most affected by both touch and various spa techniques are the skin, circulatory system and lymphatic system.

The skin is the largest organ of the human body, and comprises protein, water, lipids and various minerals and chemicals, according to the Cleveland Clinic.

The major functions of skin are protection, secretion, elimination, absorption, communication and temperature control. Skin harbors many vital parts, including capillaries; nerve endings; sweat glands; fat; collagen; connective-tissue cells; and thermal receptors, which measure temperature; mechanoreceptors, which measure touch and vibration; and nociceptors, which measure pain. Skin is so vital to our existence, it reproduces itself about every 27 days.

Together, the circulatory and lymphatic systems maintain equilibrium within the body at a cell-tissue level. The circulatory system consists of the heart and a closed system of blood vessels that transport oxygen, nutrients and waste from body system to body system.

The lymphatic system has a number of functions, including removal of interstitial fluid, the extracellular fluid that bathes most tissue.

It also acts as a sort of highway, transporting white blood cells to and from lymph nodes into bones; and antigen, presenting cells to lymph nodes. Lacteals, specialized lymphatic capillaries, carry fat from the digestive system to the bloodstream


The use of water, called hydrotherapy, has three physiological effects: mechanical, achieved through use of hydro-tubs, hoses and friction; chemical, achieved by consuming water, soaking or using water to irrigate; and thermal, achieved through application of water at temperatures above or below normal body temperature.

Although most massage session rooms are dry, meaning they don’t have access to such large water features as full-body tubs or hoses, hydrotherapy can be offered in a massage practice at a more basic level; hand or feet soaks, for example. Investing in a wet room and professional equipment is also an option.

One study showed 30 minutes of hydrotherapy consisting of Vichy shower and whirlpool bathing resulted in decreased self-perceived levels of fatigue after vigorous exercise.

The effects of contrasting hot-and-cold treatments include stimulation and increased local circulation. Generally, hot water immersion should last four minutes and cold water immersion should last less than a minute. A treatment combining heat and cold should last no more than 30 minutes.

Cold-Mitt Friction

Local friction massage using a cloth, mitt, towel or loofah that has been soaked in ice water promotes elimination of heat and reduces internal congestion at the site.

Friction increases circulation, bringing red and white blood cells to the skin’s surface, which aids in elimination of inflammatory byproducts. Cold-mitt friction can restore normal tone to tissues and muscles and raise energy and endurance levels

Salt, Sugar and Herbal Scrubs

The friction of salt, sugar and herbal products, with salt being most coarse, causes vasodilation and increased circulation with no increase in body temperature.

Mechanical effects of scrubs cause chemical irritation, which increases nerve and sebaceous activity, encouraging the removal of superficial skin. Further, a salt solution may cause osmosis of fluids toward superficial tissues, which softens skin.

Research by Japanese investigators, published in BioMed Research International, showed a dry-towel rubdown strengthened the immune system via the autonomic nervous system. Another study published in Medical Science Monitor showed a skin rubdown boosted natural killer cells.

Infrared Light and Far-Infrared Sauna

Offering clients infrared and far-infrared light or sauna is a safe way to increase circulation and cellular metabolism. This type of superficial heat penetrates connective tissue, as well as skeletal and smooth muscles in a relaxing way.

When used for up to 30 minutes, infrared and far-infrared light offer several benefits, including increased perspiration; calorie burning; excretion of lipophilic toxins; immune-system stimulation; and decreased sympathetic tone, which allows for vasodilation for at least 24 hours.

A review of sauna therapy published in Alternative Medicine Review concluded that regular use of either radiant heat or far-infrared units benefits people with chronic fatigue, chronic pain and other conditions.

Another research study, published in the journal Clinical Rheumatology, showed that people with rheumatoid arthritis and ankylosing spondylitis experienced decreased fatigue, pain and stiffness after a four-week sauna-treatment protocol, although those changes did not reach statistical significance

Cold, Wet Sheet Wrap

Massage therapists can offer the add-on of a full-body wrap in cold linens that have been soaked in water and ice and wrung out. A wet sheet is wrapped directly around the client and then covered by blankets. Although this procedure may sound uncomfortable, most clients feel so relaxed while receiving it, they fall asleep.

This is because cold on skin stimulates a heating response that continues as the water evaporates. The larger the area of skin stimulated by cold, the greater the heating response. Effects also include stimulation, sedation, hyperthermia and diaphoresis.

A prolonged cold application acts as a sedative, lessening vital activity as temperature falls. A cold application of 30 to 60 seconds is stimulating and reduces fatigue, as it causes contraction of the skin’s small blood vessels and internal organs, quickly followed by dilation.

Note that extreme temperature, below freezing and above 113 degrees, can injure human tissue

Mud, Clay and Seaweed Wraps

Mud, also called peat and peloids, is found in earth, lakes, moors and rivers, and on the ocean floor. Muds have antibacterial properties that help discourage infection; improve circulation to skin; promote tissue repair; and decrease inflammatory responses, such as effects from arthritis.

In one study, people aged 65 to 80 years old, all with knee osteoarthritis, received 11 consecutive sessions of mud-pack therapy, which resulted in significant improvements in both pain and functional capacity.

Another study examined the effects of mud packs combined with mineral bathing in people with osteoarthritis, and found a statistically significant reduction in spontaneous pain among subjects in the spatherapy group when compared to baseline numbers—an effect that lasted up to nine months for some participants.

Clay can be high in mineral content, and is used to absorb excess oils, toxins and dirt by causing fluid in tissue to move to the skin’s surface by the process of osmosis. Minerals in clay can reduce congestion and discomfort of backache, muscle spasm and inflammation.

There are thousands of types of seaweed classified as four types of marine algae and categorized by color: green; red, orange or yellow; or blue-green. Seaweed is packed with vital minerals and trace elements needed by every cell in the human body.

Full-Body Heat and Herbal Wraps

A full-body heat or herbal wrap elevates the client’s core temperature to create a mild to moderate fever. This protocol entails using dry blankets or hot, wet, soaked herbal linens.

As circulation increases, there is a rise in white blood cells in the bloodstream. This treatment stimulates production of antibodies, which in turn improves blood flow, as well as immune and cellular functioning.

A study published in the Archives of Physical Medicine and Rehabilitation indicated people with chronic low-back pain who wore a heat wrap for two hours experienced a reduction in non-normalized muscle activity and a positive short-term effect on self-reported disability, self-efficacy and pain-related anxiety.

Note that heat should not be applied during the first 72 hours of acute injury

Spa Science will Expand Your Practice

You do not need to work in a spa in order to offer a spa experience to your clients; however, you must obtain training to manage your clients’ spa-treatment plans. Then, you can create a therapeutic spa experience for your clientele, which will improve session outcomes and add to the sustainability of your career.

Consider incorporating the above-mentioned treatments as add-ons to complement massage sessions, depending on your clients’ health or relaxation needs, to provide better outcomes to clients while elevating your professional reputation as a health-and-wellness expert.

About the Author

Diane Trieste, L.M.T., is a spa consultant and director of massage and wellness at Bellus Academy in San Diego, California. Trieste held corporate management positions at Canyon Ranch health resorts for 13 years and was vice president of employer and alumni relations for Cortiva Institute. She is a frequent international guest lecturer and contributor of articles within massage, spa and hospitality publications.