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Thai Massage Therapy

The second, and most internationally famous type of Thai medical therapy is ráksãa thaang nûat (massage treatment).

The extensive and highly refined Thai massage system combines characteristics of massage (stroking and kneading the muscles), chiropractic (manipulating skeletal parts) and acupressure
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(applying deep, consistent pressure to specific nerves, tendons, or ligaments) in order to balance the functions of the four body elements (thâat tháng sìi).

These four elements are:
earth (din-solid parts of the body, including nerves, skeleton, muscles, blood vessels, tendons and ligaments); Water (náam-blood and bodily secretions); fire (fai-digestion and metabolism); and air (lom-respiration, and circulation).
 
Borrowing from India's Ayurvedic tradition, some practitioners employ Pali-Sanskrit terms for the four bodily elements: pathavidhatu, apodhatu, tecodhatu and vayodhatu.

From the Ayuthaya period until early this century, the Thai government's Department of Health included an official massage division (phanâek mãw nûat). Under the influence of international medicine and modern hospital development responsibility for the national propagation/maintenance of Thai massage was eventually transferred to Wat Phra Jetuphon (Wat Pho) in Bangkok, where it remains today. Traditional massage therapy has persisted most in the provinces however and has recently enjoyed a resurgence of popularity throughout the country.

Within the traditional Thai medical context, a massage therapist (mãw nûat, literally, 'massage doctor') usually applies Thai massage together with pharmacological and/or psycho-spiritual treatments as prescribed for a specific medical problem. Nowadays many Thais also use massage as a tool for relaxation and disease prevention, rather than for a specific medical problem.

Massage, associated with Bangkok's Turkish baths (àap òp nûat, or 'bathe-steam-massage' in Thai) is for the most part performed for recreational or entertainment purposes only (or as an adjunct to prostitution); the techniques used are loosely based on traditional Thai massage.

For problems affecting the nerves rather than the muscular or skeletal structures, many Thais resort to nûat jàp sên (nerve-touch massage), a Chinese-style massage technique that works with the body's nerve meridians much like acupuncture.