Effleurage is the most common stroke in Swedish massage. It is a free-flowing and gliding movement towards the heart, tracing the contours of the body using the palm of one or both hands. Oil is applied with this stroke to begin the first stage of massage. The therapist applies a light or medium constant pressure. This stroke is used to warm up the muscles, relax the body, calm the nerves, improve blood circulation and heart function, and improve lymphatic drainage.

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In massage therapy, so much can be achieved while inflicting only good pain on patients that bad pain must be justified by vivid, quick, and somewhat lasting benefits — which is a high bar to clear. All health care practices must be justified by benefits. As risk and pain and expense increase, the benefits must also. There is simply no point in tolerating — and paying for — painful treatment without an obvious return on the investment.
In all cases, such massage techniques are employed in collaboration with other appropriate medical care. For example, encouraging circulation around a bruise, but not directly on it, through the use of compression, cross-fiber techniques or even long, deep strokes is only used after appropriate medical referral and diagnostics indicate that there are no clots formed in the area which may embolize.

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A 2004 systematic review found single applications of massage therapy "reduced state anxiety, blood pressure, and heart rate but not negative mood, immediate assessment of pain, and cortisol level", while "multiple applications reduced delayed assessment of pain", and found improvements in anxiety and depression similar to effects of psychotherapy.[54] A subsequent systematic review published in 2008 found that there is little evidence supporting the use of massage therapy for depression in high quality studies from randomized controlled trials.[55]

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