Emmanuel Bistas, the founder and director of Chicago’s New School for Massage, has been teaching massage students for more than a decade. A licensed massage therapist himself, he also treats clients at River North Massage Therapy Center, which he co-owns. Below, he answers some of the most common questions people have about massage (and tosses out some pretty sweet analogies in the process).

Why is massage good for you?

People think of massage as a treatment for the body, but its benefits actually start off in the brain. According to Bistas, bodywork signals to the brain and the nervous system that it’s okay to relax. These central bodily control systems pass the message along to the muscles and the rest of the body, creating trickle-down relaxation effects.

Bistas compares the process to typing. “You’re working with a computer, and the information gets processed in the hard drive, but you’re interacting with it through the keyboard.” (Except the computer is the body, the hard drive is the brain, and the keyboard is the muscles and skin.)

How is massage different from the medicine you get at a drugstore?

It’s collaborative. “The client plays a big role,” Bistas says. “It’s not the same as taking a chemical substance, a pill that will knock you out whether you believe it will or not.” To make a massage treatment successful, he says, clients need to do four things:

• Be receptive: If the patient doesn’t like to be touched, or doesn’t think massage will help them, the treatment will produce more tension than it releases.

• Participate: “If the pressure is not right, you need to say something.” Same goes if you’re overheating, too cold, or otherwise uncomfortable. 

• Commit: A regular regimen of massages is more effective than a smattering of emergency ones. If clients only get massages when they are in serious pain, they put the therapist in an impossible situation, since he or she then has “60 minutes to undo damage that has been done for years.”

• Know what it isn’t: Massage is a supplemental treatment—it won’t single-handedly make you healthy. Wellness also requires “proper nutrition, sufficient rest,exercise, and medical care,” Bistas says.

What’s the difference between Western and Eastern massage styles?

The difference lies in how therapists think about the body. In a Western framework, muscles and connective tissue—basically, the physical body—are the primary focus. But in an Eastern framework, “they’re not even thinking about the muscles. They’re thinking about the flow of energy and information through the body, and how to clear that up,” Bistas says.

The techniques that result from each framework are similar, in that they involve applying pressure strategically. But the schools of thought use “different maps,” as Bistas puts it, to arrive at their techniques. Bistas compares it to two people heading downtown. One is armed with a bike map, the other with a map of pedestrian pathways. “They’re seeing the same terrain,” he says, “but they follow different routes and notice different landmarks.”

What style of massage is best for my symptoms?

This is the wrong question, Bistas says. For one thing, every style of massage is so customizable, it can easily be tailored to the client’s needs. “We can change the stroke, the depth of the stroke, or the speed, or the temperature,” Bistas says—all without ever switching modalities.

Secondly, any symptom can mean a variety of things. For example, upper-back pain could indicate an actual upper-back problem, but it could also be rooted in a tightness in the chest that makes you hunch forward, or many other causes.

Symptoms, in other words, are an unreliable guide. According to Bistas, it’s more effective to choose a massage style based on what feels best to you. For help with that, see our massage decision tree.