# Stone massage

A stone massage is a form of alternative medicine massage involving the placement of either heated or cooled stones on the body for the purpose of pain relief and relaxation. There are multiple variations in the usage of the stones, its placement and positioning, derived from a variety of ancient and traditional practices. Stone massages are primarily used to alleviate physical pain and promote emotional and spiritual well-being.

## Origin and history

Stone massages and similar practices involving the placement of objects of different temperatures have been dated back to ancient civilizations as a form of healing and therapy. Cultures including Native American, Hawaiian, and many South Pacific nations have practiced similar methods to provide physical and spiritual ease. The traditional Hawaiian healing massage ‘lomilomi’ involves the use of warmed Lomi stones to increase areas of blood flow in the body and provide a healing effect. Similar practices in China that date back 2,000 years involved the use of heated stones to stimulate improved internal organ function. Such traditional practices have evolved and influenced the application of modern stone massage practices.
In 1993, stone massage techniques re-emerged when Mary D. Nelson developed a form of massage utilizing hot and cold stones referred to as ‘LaStone Therapy’. This form quickly rose to popularity, becoming a multi-million dollar industry, and has a strong focus on spiritual healing centering around chakras and energy channeling. Many modern forms of stone massage combine techniques utilized in Swedish massage and deep tissue massage.

## Technique

Volcanic stones, such as basalt, are placed in hot water, typically at temperatures between 40 and 60 degrees Celsius (100 to 140 degrees Fahrenheit). Stones can also be placed in chilled water to achieve a temperature between -5 to 25 degrees Celsius (25 to 75 degrees Fahrenheit). The use of a calibrated thermometer is common and recommended to reach ideal temperatures. To maintain adequate external skin hydration, massage oils or lotions are commonly applied to the client's skin. Sufficient internal hydration is also essential for the treatment, due to an increase in body temperature. A sheet or towel is placed on the client's skin to provide a barrier between the hot or cold stones and their bare skin, preventing potential burns or discomfort. The stones are then placed on the client according to areas of concern or needing treatment, such as the back, legs, arms, or feet. During the massage, the stones are held by the therapist and massaged into the muscles, acting as an extension of their hands.
Stones are consistently monitored to ensure they remain at a safe and comfortable temperature, to produce the most effective results and enjoyable experience for the client.
Some therapists may also perform a Swedish massage with the application of stones to warm and relax the muscles. The duration of stone massages typically ranges from 60 to 90 minutes, depending on the technique used and the needs of the client.

## Training

Due to the potential dangers and harms, massage therapists wanting to use stone massage should undergo extensive and appropriate training. It's important to know the correct adaption of the practice to the needs and current condition of a client, and methods to incorporate stone massages into other massage practices. Certification from professionally recognized massage associations is mandatory to conduct a stone massage in a professional setting. Internationally, to maintain professional standards, stone massage therapists can obtain Continuing Professional Education (CPE) points which can be achieved through training programs and courses. With the potential dangers and risks associated with the practice, a manifold of liability insurance options are available for therapists conducting stone massages. It is highly recommended to obtain background knowledge and training in the principles of hydrotherapy to safely carry out stone massage therapy.
Mary Nelson, creator of modern stone massage through LaStone Therapy, argued for the need for extensive training and instruction in the field. Nelson developed a group of trained therapists to teach and train the practice internationally and produced informational videos to highlight effective methods of stone massage.

## Effectiveness
### Benefits

A primary benefit associated with the practice is that of stimulating blood flow in the circulatory system through the heat and movement of the stones. Stone massages also ease muscle pain and, often, the presence of muscle tension and spasms, by reducing inflammation and relaxing muscles, through a combination of both the heat and movement experienced during the practice to access deeper tissues.
Many also engage in the practice for the purpose of mental benefits through relaxation, whose induction can be assisted by the environment and physical effects experienced. Studies have shown that stone massages and related therapies have assisted in improving sleep quality for individuals. A study conducted at the Urmia University of Medical Science found that basalt hot stone massage therapy “…can successfully contribute in reducing sleep disturbances, improving quality of sleep and enhancing comfort level…”. The study applied five specialized stones to the areas of the first, second, third, fourth, and fifth chakras to stimulate an enhancement of sleep quality.
The use of stones can reduce physical stress on a massage therapist. As the stones carry out the majority of the contact and work with the client, the incidence of stress and strain in the therapist's hands, wrists, and upper body can be reduced. The occurrence of stress injuries caused by repetitive activity in the fingers and hand is commonly diminished for the therapist.

### Risks

There are a number of dangers and risks associated with stone massage therapy. A major issue is high temperature objects being placed on the skin. Improper heating, leading to unsafe or uneven temperatures, can raise the potential for burns.
Certain medical conditions can increase the risks involved in receiving a stone massage. Medical conditions including diabetes, epilepsy, skin conditions, heart disease, and neuropathy are contraindications for stone massage. Clients with recent skin or shallow abrasions such as cuts, burns, bruising and varicose veins are advised to avoid stone massages as this therapy has the potential to increase further injury or greater concerns such as tissue damage. Such conditions or minor injuries also pose a risk for higher chances of infection from bacterial exposure from the stones, massage oils or the masseuse.
Being under the influence of drugs and/or alcohol largely impedes on the safety and effectiveness of stone massage therapy. The impairment of such substances often limits an individual's judgment and impulse control, which are necessary to actively engage in a stone massage. Participation and contribution from the client are essential due to the risk and uncertainty of reaction to the temperature of the stones, a reaction that could be largely desensitized due to the effects of alcohol or drugs.

### Pseudoscience

Scientifically unsupportable claims are sometimes made for medical benefits, by massage therapists. While stone massages may be pleasant and relatively harmless, they produce no significant therapeutic effect for any important health problem — hot stone massage would be a good example of this; which is why most people go to a doctor or physiotherapist when they have an obvious injury.

## Misconceptions

Media misrepresentations of stone massage can lead to misconceptions concerning the practice. Mainstream representation of the massage often involves the stones being directly placed on the clients skin, whilst the real life application of the practice rarely involves this method, instead using a cloth or towel to prevent stones making direct contact with the skin. Many individuals avoid the practice due to fear of burns or pain from this widespread misconception. It is often wrongly thought that the massage is a set, standard practice and routine that is applied to every client. Professional treatments vary depending on the needs of the client and skills acquired by the therapist. Depictions of the practice commonly show the stones arranged in an orderly pattern down the center of the client's back, tracing the spine. The specialist stones are placed all around the body, commonly avoiding the crevice of the spine, focusing on the areas of concern for the client.

## Supply Companies and Industries

As stone massages utilize equipment and techniques that were new to the massage industry, a number of stone supply companies were developed to fulfill specialized demands. Firms such as Desert Stone People, RubRocks and Nature’s Stones Inc became prominent suppliers and distributors of the stones to spas and parlors predominantly across the United States. The development of equipment suited towards heating and cooling the stones was also essential is establishing adequate and safe applications of this process, with products such as the ‘Spa-Pro Massage Stone Heater’ being designed and distributed.