Following the discussion of massage and the detox myth, another common question arises: why do some people need to urinate after a massage? This observation is often linked to the same ‘flushing toxins’ idea, yet current research offers a different explanation. The urge to urinate after massage is not a sign that toxins have been […]
Following the discussion of massage and the detox myth, another common question arises: why do some people need to urinate after a massage?
This observation is often linked to the same ‘flushing toxins’ idea, yet current research offers a different explanation. The urge to urinate after massage is not a sign that toxins have been released or fluids forced through the body. Instead, it reflects how touch may influence the autonomic nervous system (ANS), the part of the brain–body network that regulates internal balance.
The ANS maintains balance between two complementary modes: the sympathetic system, which supports alertness and defence, and the parasympathetic system, which supports rest, digestion and recovery.
During states of stress or heightened vigilance, sympathetic activity increases and can disrupt normal bladder filling. Excessive sympathetic tone reduces the bladder’s ability to relax fully, leading to smaller, more frequent voids and a sense of incomplete emptying (Xu et al., 2024). When the body feels calm and safe, parasympathetic pathways regain influence, allowing the detrusor muscle to relax during filling and contract effectively when voiding is appropriate. This coordination supports both comfortable filling and complete emptying of the bladder (Li et al., 2024; Andersson and Arner, 2021).
Massage and other supportive touch therapies may encourage this return to parasympathetic balance. Evidence from an overview of systematic reviews suggests that manual therapies can modulate markers of autonomic activity, such as heart-rate variability and skin conductance, although findings are inconsistent and of variable quality (Roura et al., 2021). More recent research also suggests that gentle touch may stimulate mechanoreceptors and vagal pathways linked with interoception and relaxation (McGlone et al., 2024; Stępnik et al., 2024). These findings show promise of how touch therapies can help buffer autonomic regulation.
f a client feels the need to urinate after massage, it is more accurate to view this as a sign of autonomic regulation rather than detoxification. The kidneys and bladder are working as they always do, only now without the subtle tension that accompanies sympathetic dominance.
Massage does not make the body eliminate waste faster, but by calming the nervous system it may help the body’s normal functions operate with greater efficiency. In this way, urination after treatment can be seen as a reflection of restored balance rather than the removal of toxins.
Importantly, no single massage technique has been shown to produce superior effects on the autonomic nervous system. Reviews continue to highlight wide variability in study quality and results (Roura et al., 2021; Stępnik et al., 2024).
What appears to matter most is the meaning and context of touch. How safe, comfortable and supported a person feels during treatment influences the body’s regulatory responses as much as the physical technique itself. Relational and emotional factors such as trust and perceived safety are increasingly recognised as central to how the nervous system responds (Bialosky et al., 2018).
In simple terms, the body relaxes not just because of pressure or movement, but because the touch feels safe.
Rather than describing post-massage urination as the body ‘flushing toxins’, it is more accurate to see it as evidence of the nervous system returning to equilibrium. Touch therapies help the body transition from defence to regulation, supporting normal organ function and overall balance.
When clients mention needing the toilet after a massage, it is a good opportunity to educate them about the body’s regulatory systems and the difference between detoxification and restoration. This explanation strengthens professional credibility and aligns with evidence-informed practice.
Massage therefore does not detoxify the body, it helps it regulate, and regulation is the foundation of health.
Andersson, K.E. and Arner, A. (2021) ‘Urinary bladder contraction and relaxation: Physiology and pathophysiology’, Physiological Reviews, 101(3), pp. 1369–1422.
Bialosky, J.E., Beneciuk, J.M., Bishop, M.D. et al. (2018) ‘Unravelling the mechanisms of manual therapy: Modelling an approach’, Journal of Orthopaedic and Sports Physical Therapy, 48(1), pp. 8–18.
Li, H. et al. (2024) ‘Brainstem control of coordinated bladder and urethral function’, eLife, 13, RP103224.
McGlone, F., Cerritelli, F. and Schütz-Bosbach, S. (2024) ‘Touch medicine: Bridging the gap between recent insights and clinical practice’, Frontiers in Psychiatry, 13, 1390673.
Roura, S., Álvarez, G., Solà, I. and Cerritelli, F. (2021) ‘Do manual therapies have a specific autonomic effect? An overview of systematic reviews’, PLOS ONE, 16(12), e0260642.
Stępnik, J. et al. (2024) ‘Effect of manual osteopathic techniques on the autonomic nervous system and related physiology: A systematic review’, Frontiers in Medicine, 11, 1358529.
Xu, Y. et al. (2024) ‘Neurophysiology of micturition: A narrative review on preventing lower urinary tract dysfunction’, Frontiers in Physiology, 15, 1399276.
Established in 1992 and officially recognised by the Scottish Government, the Scottish Manual Therapists Organisation (SMTO) is the foremost and longest-standing association for soft tissue, massage, and manual therapy practitioners in Scotland.
