Osteopathy and the Autonomic Nervous System: How Does Therapeutic Touch Regulate Your System?

Our body’s ability to maintain balance — whether that means digesting food, recovering from stress, or healing from injury — depends on more than just muscles and bones. Beneath every movement lies a constant conversation between the body and brain, managed by one of our most important regulatory networks: the autonomic nervous system (ANS).

What Is the Autonomic Nervous System?

The ANS governs the automatic processes that keep us alive — heart rate, breathing, blood pressure, digestion, glandular secretion, and more (Gibbins, 2014; Aydin et al., 2021). It operates largely below conscious control and has two major branches that work in balance: The sympathetic nervous system (SNS), which mobilises the body’s resources for activity — often referred to as the “fight or flight” system. The parasympathetic nervous system (PNS), which restores calm and supports recovery — the “rest and digest” response. Healthy functioning requires continuous interplay between these systems. When stress, pain, or emotional load dominate, the SNS can become overactive, leading to issues such as tension, fatigue, digestive disturbance, and impaired healing (Thayer & Lane, 2009; Breit et al., 2018).

How Osteopathy Interacts with the ANS

Osteopathy is not limited to structural mechanics; it also influences how the body regulates itself internally. Through gentle manual contact, an osteopath can affect sensory and neural pathways that project into the central autonomic network — the interconnected brain regions that integrate information from the heart, viscera, and fascia to modulate autonomic output (Thayer & Lane, 2009; Henley et al., 2024). Studies have shown that manual and myofascial techniques can lead to measurable shifts in heart rate variability (HRV) — an established biomarker of autonomic balance and parasympathetic activation (Shaffer & Ginsberg, 2017; Giles et al., 2014). Increases in HRV generally indicate enhanced adaptability and resilience of the nervous system. This interaction is supported by systematic reviews showing that osteopathic and manual therapies can promote parasympathetic activity, improve circulation, and reduce physiological stress responses (Posadzki et al., 2021; Henley et al., 2024).

The Neurobiological Basis of Therapeutic Touch

Touch is more than a mechanical input — it’s a form of communication with the nervous system. Research in affective neuroscience demonstrates that slow, sustained, and attentive touch activates C-tactile afferent fibres, which project to limbic brain regions involved in emotion, body awareness, and social regulation (Walker & McGlone, 2013). This type of sensory input is believed to help calm the stress response and facilitate a state of safety within the body, aligning with the parasympathetic branch of the ANS. Moreover, studies in massage therapy have shown reductions in cortisol levels and increases in serotonin and dopamine following tactile intervention, further illustrating how physical contact can influence neurochemical and autonomic states (Field et al., 2005).

Fascia, Mechanotransduction, and Systemic Communication

Fascial tissues — the continuous network of connective tissue enveloping and linking every structure — are densely innervated with sensory and autonomic fibres (Findley, Schleip, & Chaitow, 2012; Schleip et al., 2012).
Through mechanotransduction, gentle manual forces can influence local circulation, interstitial fluid dynamics, and neural signalling. These effects may help modulate not only musculoskeletal tension but also visceral motility and vascular tone — key components of autonomic regulation (Kandel et al., 2021; Aydin et al., 2021).

The Role of Context and Perception

Beyond physical touch, the context of treatment — the atmosphere, the patient–practitioner relationship, and the individual’s sense of safety — significantly influences outcomes. Research has shown that contextual and placebo mechanisms can modulate physiological responses such as pain thresholds, proprioception, and cervical mobility, even in the absence of direct mechanical effects (Safran & Kaya, 2025). A supportive therapeutic environment, therefore, isn’t “extra” — it’s part of how the nervous system interprets safety and down-regulates defensive states.

Bringing It Together: Regulation as a Therapeutic Goal

When osteopathic treatment helps restore autonomic balance, the effects ripple across multiple systems: improved digestion, calmer breathing, enhanced circulation, better sleep, and reduced pain perception. These are not simply signs of “relaxation,” but indicators of re-integration — the body regaining its capacity for adaptability and self-regulation. Osteopathy, by working with both structure and the nervous system, offers a way to support this dynamic balance — encouraging the body’s innate intelligence to find its way back to homeostasis.

References

Aydin, M., et al. (2021). The autonomic nervous system and homeostasis. Archives of Gastroenterology, 28(3), 45–56. https://doi.org/10.14744/agri.2021.43078

Breit, S., Kupferberg, A., Rogler, G., & Hasler, G. (2018). Vagus nerve as modulator of the brain–gut axis in psychiatric and inflammatory disorders. Frontiers in Psychiatry, 9, 44. https://doi.org/10.3389/fpsyt.2018.00044

Field, T., Hernandez-Reif, M., Diego, M., et al. (2005). Cortisol decreases and serotonin and dopamine increase following massage therapy. International Journal of Neuroscience, 115(10), 1397–1413. https://doi.org/10.1080/00207450590897943

Findley, T., Schleip, R., & Chaitow, L. (2012). Fascia Research II. Elsevier.

Gibbins, I. (2014). Autonomic nervous system: Organization and function. In Fundamental Neuroscience.

Giles, P., Maher, C., & Schofield, D. (2014). Effects of manual therapy on autonomic function: A systematic review. Journal of Bodywork and Movement Therapies, 18(4), 520–528. https://doi.org/10.1016/j.jbmt.2014.03.001

Henley, C., et al. (2024). Effect of manual osteopathic techniques on the autonomic nervous system: A systematic review. Frontiers in Medicine, 11, 1358529. https://doi.org/10.3389/fmed.2024.1358529

Kandel, E., Schwartz, J., Jessell, T., et al. (2021). Principles of Neural Science (6th ed.). McGraw-Hill.

Posadzki, P., Ernst, E., & Lee, M. (2021). Do manual therapies have a specific autonomic effect? An overview of systematic reviews. PMC, 8638932. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8638932/

Safran, E., & Kaya, Y. (2025). Contextual and placebo effects of suboccipital myofascial release: Evaluating its influence on pain threshold, cervical range of motion, and proprioception. BMC Musculoskeletal Disorders, 26(1), Article 502. https://doi.org/10.1186/s12891-025-08741-6

Schleip, R., Findley, T., Chaitow, L., & Huijing, P. (2012). Fascia: The tensional network of the human body. Elsevier.

Shaffer, F., & Ginsberg, J. (2017). An overview of heart rate variability metrics and norms. Frontiers in Public Health, 5, 258. https://doi.org/10.3389/fpubh.2017.00258

Thayer, J. F., & Lane, R. D. (2009). Claude Bernard and the heart–brain connection: Further elaboration of a model of neurovisceral integration. Neuroscience & Biobehavioral Reviews, 33(2), 81–88. https://doi.org/10.1016/j.neubiorev.2008.08.004

Walker, S. C., & McGlone, F. P. (2013). The social brain: Neurobiological basis of affiliative behaviours and psychological well-being. Neuroscience & Biobehavioral Reviews, 37(9 Pt 2), 2007–2023. https://doi.org/10.1016/j.neubiorev.2013.05.017