Where does Thai massage come from — tradition, energy lines and nuad

Jivaka Kumar Bhaccha — the doctor behind its origins

The history of Thai massage begins with a man few people have heard of outside South-East Asia. Jivaka Kumar Bhaccha — known as Shivago or the ‘father of Thai medicine’ — was a doctor who probably lived in India in the 5th or 6th century BC. Buddhist texts describe him as the court physician to King Bimbisara and a friend of Buddha himself. Whatever the balance of legend and historical fact, he is still symbolically honoured before every nuad session in schools of the Thai tradition.

Why him? It is believed that his medical knowledge — carried from India to Thailand alongside the spread of Buddhism — formed the foundation of a system developed by the Thai over subsequent centuries. Ayurveda, or classical Indian medicine, Buddhist philosophy of harmony and local knowledge of the body merged into something new. This is how nuad emerged — not as a recreational treatment, but as a healing practice performed by monks in temples.

Sen — energy lines you will not find in anatomy

To understand Thai massage, one key fact is needed: it is based on an entirely different map of the body from Western anatomy. Not on muscles, bones or nerves — at least not directly. It is based on a system of energy lines called sen (known as nadis in the Ayurvedic tradition).

Sen are invisible channels through which life energy — prana — is believed to flow through the body. Classical Thai tradition identifies ten main sen lines. They run through the whole body, from the feet to the head, via the abdomen, chest and arms. Each is linked to specific organs and body areas. Each is also linked to possible concerns when its flow is disrupted.

• Sen Sumana — runs through the centre of the body and is linked to the respiratory system and heart
• Sen Ittha and Pingkhala — two symmetrical lines running along either side of the spine, corresponding to the classical ida and pingala channels of Ayurveda
• Sen Kalathari — branches along the arms and legs, linked to the function of joints and limbs
• Sen Sahatsaranghsi and Thawari — leg lines running from the foot to the face, linked to vision and coordination
• Sen Lawusang and Ulangka — ear and face lines, linked to hearing and speech

A nuad therapist works along these lines. They apply pressure with their thumbs, hands and elbows, and sometimes knees or feet. The aim is to clear areas where energy ‘stops’ or becomes ‘blocked’. In Western terms, this could be described as working with fascia, connective tissue and trigger points. However, this is only an approximation. The philosophy behind these approaches is fundamentally different.

What is nuad — and why it is not relaxing in the Western sense

The full name for traditional Thai massage is nuad phaen boran — literally, ‘ancient healing touch’. The word nuad means touch or pressure, phaen means system or pattern, and boran means ancient or traditional. Together, they describe something Thai people understand not as relaxation, but as active work with the body to restore balance.

The difference is fundamental. Thai massage is not intended to relax a tense muscle through direct kneading. Its aim is to release blockages along energy lines and restore balance to the body. Yet many people experience deep relaxation as a side effect. It is simply achieved by a different route. Alongside relaxation, there is often increased mobility, lighter-feeling limbs and something difficult to put into words: the feeling that the body has ‘breathed out’ from within.

What a session feels like from within — a map of one hour

To understand Thai massage, it is worth looking at its structure. It is surprisingly logical and coherent, rather than random. A classic session always begins with the feet and legs. This is where all the main sen lines run. Working from the bottom upwards reflects the traditional understanding of energy flow in the body.

1. 01

   Feet and calves

   The therapist starts by applying pressure to the soles and rubbing points on the feet. They then work along the shin lines. This is the ‘opening’ stage — preparing the body for deeper work.

2. 02

   Thighs and hips

   Deeper pressure along the thigh lines, stretching of the iliotibial band and mobilisation of the hip joint. This is often where the first clear sense of relief appears — especially for people who sit for long periods.

3. 03

   Abdomen and chest

   Gentle circular work on the abdomen, following the direction of peristalsis, followed by chest stretching — opening the shoulders and allowing deeper breathing. This stage is understood as work with the centre of the body.

4. 04

   Arms, hands and neck

   Arm stretching, work on the fingers and wrists, and pressure on points around the nape and neck. It can often be surprisingly intense despite seemingly small movements.

5. 05

   Head and face

   Final work on the temples, jaw and brow bone. This is a calming stage — followed by several minutes of stillness.

6. 06

   Seated position — back stretching

   Classic nuad ends with work in a seated position. The therapist stretches your back, arms and neck — often with the famous ‘cross stretch’ or torso twists.

What happens in the body — and why it is difficult to measure

Western science has repeatedly tried to ‘decode’ Thai massage through physiology. It has found increasingly interesting insights. Yet not enough to fully describe the sen line system in terms of neurology or biomechanics. Nuad works on many levels at once, and not all are equally easy to study.

• Fascia and connective tissue. Sustained, slow pressure along the sen lines roughly corresponds to what Western physiotherapy calls fascial work — releasing dense networks of connective tissue surrounding the muscles. This may explain increased mobility after a session.
• The nervous system. Rhythmic, deep pressure activates the parasympathetic nervous system — the part responsible for rest, digestion and recovery. This may explain the characteristic feeling of ‘letting go’ after the session.
• Joints and mobility. Stretching in nuad has much in common with therapeutic yoga. Passive movements guided by the therapist allow your muscles and joints to reach a range of motion that may be inaccessible when practising alone.
• Lymph flow. Pressure along the limbs, especially from the periphery towards the centre, may support lymphatic circulation. This is often described as a feeling of lightness in the legs after a session.

At the same time, there are relatively few high-quality studies on this subject. Those that exist have a limited scope. The honest answer to ‘how exactly does it work?’ is therefore: we partly know, we partly make assumptions, and some aspects remain within the sphere of tradition and philosophy that Western methodology has not yet translated into its own language. And that is fine — because nuad’s effectiveness in easing tension, back pain or bodily fatigue is supported not only by texts dating back thousands of years, but also by the experience of many people who have simply tried it themselves.

Nuad today — a UNESCO-listed tradition

In 2019, traditional Thai nuad phaen boran massage was added to the UNESCO Intangible Cultural Heritage list. It is a symbolic but meaningful gesture. It recognises that this tradition is neither exotic nor a trend, but a living, multi-generational practice worthy of protection and preservation in its original form.

At the same time — and this is where a problem begins — Thai massage has become one of the most heavily franchised treatments in the world. On every continent, there are dozens, if not hundreds, of places calling themselves Thai massage salons while offering something only loosely connected to original nuad. A short session, no conversation, no work along the sen lines, no stretching or deeper philosophy — this is not Thai massage. It is massage with a Thai sign.

Thai massage and other massages — what makes it different

To place nuad on the map of available massage types, it helps to see where the line lies between it and traditions with which it is often confused or compared.

Both systems — nuad and shiatsu — are distinctly ‘deeper’ than classic relaxation massage in the Western sense. Both draw on an energetic philosophy of the body. But they have different maps, rhythms and session styles. Nuad is more dynamic and involves more whole-body movement. Shiatsu can be calmer and more meditative. Neither is better or worse — they are different, and each may suit someone different at a different time.