What to Know About Hot Stone Massage

Medically Reviewed by Jabeen Begum, MD on November 25, 2022
5 min read

If you're seeking relief or relaxation, a massage might be just the thing. One especially therapeutic type of massage that has become increasingly popular is hot stone massage, which incorporates hot stones into traditional massage techniques.

A hot stone massage is a type of massage in which the masseuse places smooth, hot stones on your back. These stones provide heat therapy to the muscles, which can help reduce tension and pain. The stones used in hot stone massage are typically basalt, volcanic rock that is usually high in iron, which allows them to absorb heat.

Hot stone massage placement. The placement of the stones during a hot stone massage will depend on the muscles and tissues that are being worked on. For example, if you have lower back pain, the masseuse may place the hot stones along your spine. Other common spots for hot stone placement include the abdomen, chest, face, feet, forehead, and palms.

Hot stone massage techniques. Like stone placement, the techniques that your masseuse uses with the hot stones will depend on your specific needs. Therapists often use circular movements, kneading, long strokes, and vibrations. The hot stones can be used alone or incorporated into other types of massage, like Swedish massage.  

Hot stone massage temperature. Stones that are too hot may cause burns, while stones that aren’t hot enough may not have the desired effect. The American Massage Therapy Association recommends that the only way you should heat hot stones is in water. The water should be between 110° F and 130° F, and the water should completely cover the stones.

One of the best ways to do this is with a professional massage stone heater. This device looks a little like a slow cooker and allows you to control the temperature of the water. Despite this, also use a calibrated thermometer to test the temperature of the water.

You should be able to hold the stones comfortably in your hands. If you can’t, they’re too hot to use. Never warm them with heating pads or frying pans. These only heat the surface and won’t heat the inside of the stone like water does.

The practice of using hot stones for therapeutic purposes has been around for centuries. It’s thought to have originated thousands of years ago from Ayurveda, the ancient Indian medical system that takes a natural and holistic approach to health. River stones were heated for healing and massage.

Hot stones were popular throughout ancient Asia. About 4,000 years ago, the Japanese used hot stones to warm the abdomen and improve digestion, while about 2,000 years ago, Chinese medicine used hot stones to improve the function of internal organs.

In North America, indigenous Americans used hot stones in sweat lodges, to heal ailments, and to relieve cramps. Hawaiians have used hot stones to increase circulation.

Hot stones were introduced into modern methods of massage in 1993 by way of a technique called LaStone Therapy. From there, hot stone massages have grown in mainstream popularity.

Using hot stones in massage introduces the element of heat, which leads to many benefits.

Relieves muscle pain and tension. Hot stone massage can relieve pain and tension in your muscles due to the combination of massage therapy and heat. Heat is often recommended as a way to treat achy muscles. Applying heat to an area of the body helps increase blood flow to that spot, which improves healing. Using heat on muscle knots before massaging the area can make those knots easier to soothe.

Reduces inflammation.Inflammation happens when your body activates your immune system for tasks like attacking bacteria or healing damaged tissue. Sometimes, your body sends out these cells when it doesn’t need to, which can lead to chronic inflammation and autoimmune conditions. Both heat and massage can help manage inflammation.

Improves flexibility. Stiff joints and muscles limit your flexibility and make it hard to move. Heat and massage help loosen and relax these muscles, which can reduce pain and make it easier to move.

Improves circulation. Both heat and massage improve blood flow and increase circulation. This reduces pain and inflammation and promotes healing.

Reduces stress and anxiety. Both heat and massage help you relax, but massage takes it a step further. Pressure, like from a massage or a good hug, releases endorphins, which relax muscles, help you manage pain, and put you in a better mood.

Boosts your immune system. Stress can lower your body’s ability to fight disease. The stress relief that massage therapy and heat offer can lower stress, letting your body build up your immune system again.

Improves sleep. Whether it’s the stress relief, the pain relief, or the endorphins, studies have shown that hot stone massage can improve sleep quality.

Who Can Benefit From a Hot Stone Massage? 

Physicians believe that hot stone massage can help manage several conditions, including:

  • Anxiety
  • Autoimmune diseases (may need special considerations based on the disease)
  • Chronic headaches
  • Depression
  • Digestive problems
  • Exercise-related injuries
  • Fatigue
  • Fibromyalgia
  • Insomnia
  • Lymphedema
  • Low back pain
  • Muscle spasms
  • Multiple sclerosis
  • Osteoarthritis
  • Post-surgery pain (massages should not be done within six weeks after surgery unless okayed by a doctor)
  • Repetitive stress injuries
  • Sciatica
  • Sports injuries

Who Should Not Get a Hot Stone Massage? 

Some people should avoid hot stone massages or may need extra considerations when getting a massage. Conditions may include:

  • Cancer
  • Clotting disorders
  • Diabetes
  • Epilepsy
  • Heart disease
  • Neuropathy
  • Osteoporosis
  • Pregnancy
  • Recent surgeries
  • Skin conditions

Do you need to wear anything special for a massage? How do you prepare? Luckily, it’s not hard to dress for a massage of any kind. The most important thing is that you dress in clothes that are comfortable and that you can relax in. If you prefer to stay fully clothed during your massage, wear as few layers as possible so your masseuse can work on deep tissues.

If you’re planning to strip down to your underwear, choose something comfortable that isn’t too bulky or ornate. For back massages, if you normally wear a bra, a sports bra may be easier for your massage therapist to work around rather than a standard bra with a hook and eye clasp.

If you wear any jewelry or accessories in the area that you’re having massaged, remove those things if possible.