There’s rarely any justification for extremely painful massage, unless it clearly produces a better result than gentler treatment — which is rarely clear!1 It is possible that a few “brutal” deep tissue massages could do the trick where gentler treatment would fail — but there is no way to know this in advance, and massage is expensive stuff. If you’re going to gamble on a treatment, gamble on cheaper and less painful ones.

One theory is that muscle knots may be caused by something that goes wrong at the “motor end plate” — where a nerve ending attaches to a muscle cell.9 We don’t know why this happens, or what exactly goes wrong, but there is circumstantial evidence that motor end plates are the “point” in trigger point. That evidence is too complex and controversial to review properly here. It is explored in detail in my book. Some research has suggested that it may actually be possible to physically destroy the motor end plate with strong massage, thereby inactivating the trigger point.10 When it regrows — these are microscopic structures, it doesn’t take them long to heal — the trigger point may be gone.
Thank you for explaining the difference between a deep tissue massage and a firm pressure massage. The place I go to offers different techniques and I have been wondering what the difference was between those two. Good to know that a deep tissue massage uses very little to no lubricant so the muscles can be hooked and grabbed. That one sounds like a really great option.

A deep tissue full body massage is a form of healing bodywork. At your first massage, your massage therapist will do a brief intake. They will ask you questions about the type of pressure you’d like to receive during your deep tissue massage, any previous massage experience you’ve had, and any injuries or sensitivities you have. You can remain clothed, or the massage therapist will provide draping so that even if you’re not wearing clothes you are always fully covered. Deep tissue massage may be a good option for people with chronic pain or muscle tension. The systematic deep tissue strokes will work to break down any scar tissue or stiff tissues and create ease in your body again. Massage therapists use their hands, forearms, fists and knuckles to knead and stroke your muscles and loosen adhesions. Although deep tissue massage work is intense, it should not be painful, so communicate clearly with your massage therapist so they know if you’re having any discomfort. The national average cost of a deep tissue massage is between $70 and $90.

A person receiving a deep tissue massage usually lays on the stomach or back in one position, while deep pressure is applied to targeted areas of the body by a trained massage therapist. The massage is beneficial mostly because it helps stimulate blood flow and relieve muscle tension, while at the same time lowering psychological stress and releasing “happy hormones” like serotonin and oxytocin.
A study in the Journal of Alternative and Complementary Medicine found that people's blood pressure fell after a single 45 to 60 minute deep tissue massage. Additionally, a 2010 meta-analysis in the Journal of Clinical Psychiatry found that massage modalities like deep tissue reduce stress hormone levels and heart rate while boosting mood and relaxation by triggering the release of oxytocin and serotonin.

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