by David L. Roylance

Thai Massage: More than Just a Spa Treatment, MASSAGE MagazineWhen traditional Thai massage first landed in the Western world, many people thought it was the next hot spa treatment that would run its course as a “fad” and quickly slip into the distant past, never to be heard from again.

Now, a couple of decades later, traditional Thai massage—or “nuat phaen boran”—is still here with no signs of slowing down in popularity. In actuality, clients are flocking to get treatments and, often times, seek out Thai massage from their therapists.

In 2005, the International Spa Association released research citing, “Asian modalities and Asian treatments as the next big trend for growth in the spa industry going forward.” The city of Los Angles, California, hosts a multitude of professional Thai massage centers, and spas all across the U.S. are adding Thai massage to their menus. Thai massage centers are sprouting up across the country as well.

What is spurring this growth? What’s behind it all? Where’s it coming from?

These are all valid questions. Those and many more will be answered in a series of articles I plan to publish.

This brief article will outline the traditional Thai medical system and help you to understand Thai massage’s place within this medical model. In short, traditional Thai massage is part of a unique medical model found only in Thailand. Not only is it part of a unique medical model, it represents an entire branch of medicine with practitioners, so highly trained and qualified they are considered “mo nuat,” or doctors of massage.

To understand Thai massage’s popularity, I interviewed a traditional Thai medicine doctor, or “mo boran”, named Dr. Supamas Kananurak. Kananurak is the director of therapeutics at Touch of Asia in Sterling, Virginia, and the Thai Institute of Healing Arts in Arlington, Virginia. He directs the operations of two separate Thai therapy centers specializing in traditional Thai medical massage and traditional Thai medicine treatments. He’s seen significant growth in his treatment centers’ popularity over the past several years.

Kananurak explained to me that, “Nuat phaen boran is part of a traditional medical system described in three specific branches: the body, the citta and the energy.”

Kananurak said traditional Thai medicine is practiced within these three branches, or framework. The body branch of medicine focuses on the treatment of a patient on a physical level using herbs and dietary regimens. A patient is often times diagnosed using the Thai 4 Element Theory of earth, air, fire and water. Other diagnosis methodologies are often employed before prescribing specific herbs to include in the patient’s diet and, perhaps, even herbs to exclude.

Thailand has an extensive herbal pharmacopeia spanning hundreds of plant species. It is the responsibility of a traditional Thai medicine doctor to understand their patients, herbal medicine theory and the associated herbal substances to provide treatment.

The citta branch of medicine addresses the spiritual self or development of the inner self. This branch of medicine addresses the mind, as it connects to the physical self.

Since Thailand is a devote Buddhist country, 95 percent of all Thais practice Theravada Buddhism. It is the master monk, or “phra ajahn,” that is sought when one needs a practitioner of this form of medicine. Buddhism teaches purification of one’s mind as a form of escaping suffering, which could be viewed as an illness. The theory of this branch of medicine holds that an impure mind can produce physical illness, and thus by purify one’s thoughts, the individual will be healthier.

Buddhism and medicine have a history of being intertwined, and it is still the case today in Thailand. During some portions of history, Buddhism and medicine were so intertwined one could not distinguish one from the other. Phra ajahn are not the only practitioners of the citta branch of medicine; in Thailand, there are countless varieties of shaman or spirit doctors (“mo phi”). Many of these practices predate the introduction of Buddhism into Thailand, which is thought to be between 200 BC and 200 AD.

Kananurak continued to explain that it is the philosophy of the energy branch of medicine that addresses an individual’s invisible life energy, or “lom.” Other cultures describe life energy as qi (China) or prana (India).

In Thai Medicine, the term lom cannot be easily translated into English or other culture languages; however, if relating to the Chinese or Indian meaning helps to start understanding the Thai concept of lom, then do so. Just keep in mind it is not the same as qi or prana, and we will explore the concept of lom in future articles to deepen our understanding of this term.

It is in this energy branch of medicine that we see Thai massage performed in order to maintain the health of a patient’s “sen.” Sen are pathways that carry lom throughout the body in order to maintain energetic health. Should a sen become blocked or broken, an individual would be more susceptible to illness or present symptoms of illness.

It’s the job of the Thai massage practitioner or doctor of Thai massage to ensure patients’ sen are free of blockages and without breaks. This ensures the patient is as close to optimal health as possible.

In order to fully understand Thai medicine or Thai massage, one must approach Thai knowledge and understand it based on its own merits. According to Kananurak, there are in-depth training programs in Thailand for each branch of medicine amounting to eight years of college level education.

“Traditional Thai massage is often times implemented as a spa treatment in the West, but its roots are in a detailed medical model from Thailand,” Kananurak said. “As such, to honor this ancient practice one should explore detailed training, keeping in mind Thai massage is much more than just a spa treatment and has an in-depth Thai medical theory as its foundation.”

In my next article, I will share the multiple influences that have come together to create Thai massage, as uncovered through exhaustive research into the history of medical practices in Thailand.

David L. Roylance is the successful executive director of Touch of Asia in Sterling, Virginia, and the Thai Institute of Healing Arts in Arlington, Virginia. He lives in Thailand for more than three months each year. He has been living and working among the Thais in the U.S. and in Thailand since 2001. Roylance currently provides in-depth training classes and seminars. For more information, visit