Can Chiropractic Care, Massage and Manual Therapy Help with Depression? What the Latest Research Reveals

Written by Dr Julian Simpson — Chiropractor with 15+ years of experience, Board Member of the Chiropractic Australia Research Foundation, and author/reviewer of 800+ health articles.

Can Chiropractic Care, Massage, and Manual Therapy Help with Depression? What the Latest Research Reveals

New Research Highlights the Powerful Connection Between Physical Health, Pain, and Mental Wellbeing

When most people think about depression, they think about emotional symptoms such as sadness, low mood, or loss of motivation.

What many people don't realise is that depression often has significant physical symptoms as well.

Fatigue, headaches, neck pain, back pain, muscle tension, poor posture, digestive complaints and persistent aches are all commonly associated with depression. In fact, research suggests that physical symptoms may sometimes appear before emotional symptoms become obvious.

A major 2025 systematic review examined 97 studies investigating whether manual therapies—including massage therapy, chiropractic care, osteopathic treatment, craniosacral therapy and other hands-on approaches—can help reduce symptoms of depression.

The findings were fascinating.

At Health Wise Chiropractic, we know the body and mind are closely connected. Here's what the latest evidence tells us.

Depression Is More Common Than Many People Realise

According to the research:

• Approximately 21 million adults experience a major depressive episode each year

• Young adults aged 18–25 experience the highest rates

• Depression is one of the leading causes of disability worldwide

• Physical symptoms are extremely common alongside emotional symptoms

Researchers noted that depression often presents with:

✔ Chronic pain

✔ Neck and back pain

✔ Headaches

✔ Muscle tension

✔ Fatigue

✔ Digestive complaints

✔ Sleep disturbances

✔ Reduced physical activity

The Surprising Link Between Posture and Depression

One of the most interesting findings highlighted in the review involved posture.

Studies have found that people experiencing depressive episodes often demonstrate noticeable postural changes including:

• Forward head posture

• Increased thoracic kyphosis (rounded upper back)

• Rounded shoulders

• Altered pelvic positioning

These changes can create increased muscle tension, joint stress and physical discomfort.

Researchers suggest this may partly explain why many people experiencing depression also report:

• Neck pain

• Shoulder tension

• Headaches

• Back pain

• Generalised muscular discomfort

This highlights the importance of addressing both the psychological and physical aspects of wellbeing.

What Did the Researchers Investigate?

The review analysed 97 peer-reviewed studies published between 1990 and 2025.

Researchers examined a wide range of hands-on therapies including:

• Massage therapy

• Chiropractic care

• Spinal manipulation

• Osteopathic treatment

• Craniosacral therapy

• Acupressure

• Reflexology

• Soft tissue therapy

• Manual therapy

The goal was to determine whether these therapies could help reduce depression symptoms.

The Results: Many Manual Therapies Showed Positive Effects

Across the 97 studies reviewed, researchers found many manual therapy approaches were associated with improvements in depression symptoms.

Importantly, these therapies were used as complementary approaches alongside traditional medical and psychological care—not replacements.

Massage Therapy Produced the Largest Body of Evidence

Massage therapy had the strongest research base.

Researchers identified:

• 45 separate massage therapy studies

• 32 studies (71%) reported significant improvements in depression symptoms

• Multiple studies involved participants formally diagnosed with depression

One study involving adults with depression found massage therapy produced significantly greater improvements than light-touch therapy.

Another study involving adolescents with depression found:

• Improvements occurred after the very first massage session

• Benefits remained present after five consecutive days of treatment

The review concluded that massage therapy appears to be a safe and potentially effective complementary approach for people experiencing depression, particularly when pain and muscle tension are also present.

What About Chiropractic Care?

The review also examined chiropractic spinal manipulation and manual therapies.

Key Findings

Researchers found:

• 5 out of 6 chiropractic studies reported improvements in depression-related symptoms

• Several studies involved patients with chronic neck pain and back pain

• Improvements often occurred alongside reductions in pain and disability

One high-quality study involving chronic low back pain patients found both spinal manipulation and placebo treatments improved depression scores, highlighting the complex relationship between pain, expectations and recovery.

While researchers concluded more studies are needed specifically in people diagnosed with depression, the findings suggest chiropractic care may have an important role when depression coexists with musculoskeletal pain.

Chronic Pain and Depression Often Go Together

One of the strongest themes throughout the review was the connection between pain and mental health.

Many participants studied had conditions such as:

• Chronic low back pain

• Neck pain

• Fibromyalgia

• Headaches

• Arthritis

• Chronic fatigue

• Migraines

Researchers repeatedly observed that when pain improved, depression symptoms often improved as well.

This is particularly important because:

World Health Organization Research Found:

• Two-thirds of people with depression initially presented with physical symptoms alone

• More than half reported multiple medically unexplained physical complaints

This highlights why addressing physical health can play an important role in overall wellbeing.

Why Might Manual Therapy Help?

Researchers proposed several possible explanations.

1. Reduced Pain

Pain and depression share common neurological pathways.

Reducing physical pain may help reduce emotional distress.

2. Improved Movement

When people move better, they often become more physically active.

Exercise and movement are well-established strategies for improving mental wellbeing.

3. Reduced Muscle Tension

Depression is frequently associated with increased muscular tension.

Hands-on therapies may help relieve tension and discomfort.

4. Improved Body Awareness

Manual therapy may help patients reconnect with their bodies, particularly during periods of stress, anxiety or depression.

5. Enhanced Relaxation

Massage and manual therapies may activate the parasympathetic nervous system, helping the body enter a more restorative state.

What This Means for Australians

The research does not suggest chiropractic care or massage therapy should replace:

• Psychological treatment

• Counselling

• Medication when required

• GP management

However, the evidence does suggest they may be valuable complementary therapies.

This may be particularly relevant for people experiencing:

✔ Chronic pain and low mood

✔ Persistent muscle tension

✔ Headaches

✔ Neck and back pain

✔ Stress-related physical symptoms

✔ Reduced mobility and activity levels

Practical Strategies We Recommend at Health Wise Chiropractic

For patients experiencing stress, persistent pain or reduced wellbeing, we commonly recommend a holistic approach that may include:

Daily Walking

Research consistently shows walking can improve both physical and mental health.

Aim for:

20–30 minutes daily

Posture Breaks

If you sit for long periods:

• Stand every 30–60 minutes

• Stretch regularly

• Change positions frequently

Gentle Mobility Exercises

Focus on:

• Neck mobility

• Thoracic spine mobility

• Hip mobility

• Breathing exercises

Strength Training

Resistance exercise has been shown to improve both physical function and mood.

Aim for:

2–3 sessions per week

Quality Sleep

Sleep disruption and depression are closely linked.

Aim for:

7–9 hours per night

Seek Professional Support

Persistent symptoms should always be discussed with:

• Your GP

• A psychologist

• Other qualified healthcare professionals

How Chiropractic Care May Help

At Health Wise Chiropractic, we take a comprehensive approach to posture-related care.

Treatment may include:

• Chiropractic adjustments

• Postural assessment

• Soft tissue therapy

• Corrective exercises

• Ergonomic advice

• Laser therapy

• Shockwave therapy

• Spinal decompression therapy

We focus on addressing both the symptoms and the underlying biomechanical stress contributing to neck dysfunction.

About the Author

Dr Julian Simpson is an Australian chiropractor with over 15 years of experience in musculoskeletal healthcare and rehabilitation.

He is a Board Member of the Chiropractic Australia Research Foundation and has reviewed and written more than 800 evidence-based health articles focused on spinal health, rehabilitation, sports injuries and conservative care approaches.

His treatment focus includes:

• Chiropractic adjustments

• Sports chiropractic

• Massage therapy

• Shockwave therapy

• Laser therapy

• Non-surgical spinal decompression

Dr Simpson provides patient care through Healthwise Chiropractic, serving communities including Sunbury, Melton, Diggers Rest and surrounding regions.

reference

Schulz P, Huzij T. Manual therapy modalities and depression: a systematic review. J Osteopath Med. 2026 Apr 27. doi: 10.1515/jom-2025-0214. Epub ahead of print. PMID: 42046169.