Can Manual Therapy Help Reduce Stress Hormones? What Research Says About Cortisol, Oxytocin & Pain Relief

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 Manual Therapy Help Reduce Stress Hormones? What Research Says About Cortisol, Oxytocin & Pain Relief

When people book a massage, chiropractic adjustment, or spinal mobilisation session, they often say the same thing afterwards:“I feel calmer, looser, and less stressed.”

But is there an actual physiological reason behind that feeling?

A recent scoping review titled “Physiological Changes of Cortisol and Oxytocin Following Manual Therapy” examined whether hands-on therapies like massage, chiropractic care, spinal manipulation, mobilisation, and myofascial techniques can influence the body’s stress and relaxation hormones.

What Are Cortisol and Oxytocin?

Cortisol: The Stress Hormone

Cortisol is commonly known as the body’s “stress hormone.” It is released by the adrenal glands as part of the body’s stress-response system.

While cortisol is essential for survival, chronically elevated levels are linked with:

• Increased muscle tension

• Poor sleep

• Fatigue

• Heightened pain sensitivity

• Increased inflammation

• Anxiety and stress overload

Research has shown that chronic pain and stress often go hand-in-hand because the nervous system and hormonal system are closely connected.

Oxytocin: The Relaxation & Connection Hormone

Oxytocin is often referred to as the “bonding” or “feel-good” hormone.

It plays a role in:

• Relaxation

• Pain modulation

• Nervous system calming

• Social bonding

• Stress reduction

• Emotional regulation

Interestingly, oxytocin can also help regulate the stress response and may reduce excessive cortisol activity.

Because manual therapy involves therapeutic touch, researchers have long suspected that chiropractic care and massage may influence oxytocin release.

Key Findings From The Research

1. Massage Therapy Frequently Reduced Cortisol

One of the strongest patterns in the review was that many massage-based therapies were associated with reductions in cortisol.

Out of 35 massage-focused cortisol studies, approximately 20 studies showed significant cortisol reductions after treatment.

Reported benefits included reductions in cortisol among people with:

• Migraine

• Fibromyalgia

• Anxiety

• Depression

• Cancer-related stress

• High blood pressure

• Chronic pain

• Post-operative stress

Some studies used only a single 15–60 minute session, while others involved multiple treatments over several weeks.

2. Chiropractic & Spinal Manipulation Showed Mixed But Interesting Results

Research on chiropractic spinal manipulation produced more varied findings.

Some studies showed:

• Short-term increases in cortisol immediately after manipulation

• Followed by later reductions

• Increased oxytocin levels after treatment

Researchers suggested these changes may reflect nervous system activation and regulation rather than a purely “relaxation-only” response.

3. Oxytocin Research Is Still Emerging

Compared with cortisol, far fewer studies examined oxytocin.

Still, several studies reported promising results.

Key findings included:

• A study of 95 adults found Swedish massage significantly increased oxytocin levels.

• Hand-delivered massage produced stronger oxytocin responses than machine massage.

• Spinal manipulation studies also showed increases in oxytocin following treatment.

Researchers noted that oxytocin may help explain why many patients report:

• Feeling calmer after treatment

• Reduced tension

• Better mood

• Less pain sensitivity

• Improved relaxation

Why This Matters For Pain & Recovery

Pain is not purely mechanical.

Modern pain science shows that stress, sleep, inflammation, nervous system sensitivity, and emotional stress can all influence how pain is experienced.

When stress remains elevated:

• Muscles tend to tighten

• Recovery slows

• Sleep quality worsens

• Inflammation may increase

• Pain sensitivity can rise

• 
  

This review suggests that manual therapy may help influence some of these physiological pathways through the nervous system and hormonal responses.

That does not mean manual therapy “fixes hormones” directly. However, it may help support healthier nervous system regulation in some individuals.

What This Means Clinically

At Health Wise Chiropractic, we regularly see patients report improvements not only in pain and mobility, but also:

• Reduced tension

• Better sleep

• Lower stress

• Feeling more relaxed after treatment

  
  

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

Cao AT, Alanazi MS, Billings R, Reed WR. Physiological changes of cortisol and oxytocin following manual therapy: a scoping review. Front Rehabil Sci. 2026 Mar 5;7:1719735. doi: 10.3389/fresc.2026.1719735. PMID: 41868962; PMCID: PMC13000766.