While the practice of Nuad Thai can now be found in spas throughout the world, the soul of the humble therapy hasn’t changed much in the place where it was born.

Among the towering spires and ceramic inlaid stupas of Bangkok’s Wat Pho temple are a group of inscriptions from the 19th Century. Shaded by the wooden eaves, these large marble plaques, known as the Epigraphic Archives of Wat Pho, divulge the secrets of the Thai way of life and are one of the earliest recordings of the techniques of one of Thailand’s most revered therapies: Nuad Thai (Thai massage).

Thai massage helps close this gap, cure ailments and make a connection

Added to Unesco’s Intangible Culture Heritage of Humanity list in 2019, this ancient healing method practised by Buddhist monks at the temple uses a blend of stretching, yoga and acupressure techniques to relax the body. Unlike Swedish massage or Hawaiian lomi lomi massage, where the patient is a passive participant, in Thai massage, the patient – who remains fully clothed – bends, stretches and moves their limbs with the help of the therapist to boost flexibility. Some therapists in Thailand will even step on the patient’s back to more deeply massage the muscles, although it’s not a technique used by all.

Chiselled into the marble on the Wat Pho plaques are representations of sen lines – crisscrossing energy paths on the body that therapists follow when placing their hands, feet or elbows on a person – which are believed to be conduits of “life force”. Each plaque features the outline of a human figure with features such as a rib cage or spine, and the network of thin black lines is intersected with dots, depicting acupressure points. Each acupressure point is annotated with a label noting which ailment it corresponds to. In Nuad Thai, it’s thought that the body comprises four elements (earth, water, wind and fire), which the therapist rebalances by manipulating the acupressure points to remove any energy blockages from the sen lines.

In the mid-19th Century, before the introduction of modern medicine in Thailand, the 16th-Century temple served as a centre for medical education, which included Nuad Thai as part of its curriculum. And so, when King Bhumibol wanted to open a Thai massage school in 1955, it was no surprise that he chose the grounds of Wat Pho. Today, students from all over the world come here to study the practice; and while Nuad Thai can now be found in spas across the globe, the soul of the therapy hasn’t changed much from its humble beginnings.

You may also be interested in:
Taiwan’s 2,000-year-old knife massage
Asia’s centuries-old healing technique
The berry that keeps Asia looking young

While Wat Pho is conventionally known as “the birthplace of traditional Thai massage”, the earliest adopters of this ancient Thai therapy lie far beyond the temple doors and can be found deep in the countryside within Thailand’s farming communities. Each village has traditionally had its own massage healer who the villagers visit to help cure their aches and pains from hard days of labour. The designated healer, often an elder, performs the back-cracking, body-folding therapy that has been handed down through the generations, and won’t charge for his or her services as the practice follows the Buddhist tenets of caring for others in the community.

Wat Pho Massage School teacher Krairath Chantrasri, who is from the farming area of Phetchabun in northern Thailand, knows first-hand what an important part these healers play in village life. “My grandfather is one of the massage healers who used to treat people in my community,” he said. “I wasn’t very old, but I remember people visiting my grandfather at the house, and I would go and see what they were doing.”

Nuad Thai is practised in nearly every rural household. Children are often taught the techniques so they can ease the aching muscles of their parents and grandparents after they have spent the day toiling in the rice paddies. While they might not understand the acupressure point theory behind it, they know how to pull and push limbs and how to step on the back to soothe the muscles of their hardworking relatives. The therapy’s humble roots can be seen in the way it is performed, usually on a mattress on the floor (similar to the ones seen in traditional Thai homes).

While Chantrasri was encouraged by his mother to perfect his skill at the Wat Pho Massage School, he had been practising massage from an early age. “My mother would ask me to step on her legs or on her back to give her a massage. I was being taught massage techniques, but as a child I didn’t realise it,” he said. Although now, as a therapist at Wat Pho, he no longer practises these particular techniques as they are not part of the school’s philosophy and curriculum.

The tablets at Wat Pho may be the most public record of Thai massage, but the earliest documentation of the therapy is a royal decree from 1455, which makes reference to the court’s massage department. But how Nuad Thai came to exist originally in communities is due to a synthesis of various healing traditions says Jan Chaithavuthi, co-author of Ancient Thai Massage Healing with Prana. “The idea of life force in Thai massage practise may be influenced by Chinese and Indian cultures. However, the practical techniques that make Thai massage unique have been invented by the Thai people and handed down through the generations,” she said.

We give thanks and ask for them to help us heal the client

Thai massage takes two forms: folk Thai massage and royal Thai massage. Folk Thai massage is practised in the countryside, and the practitioner uses his or her hands, elbows, knees and feet to help ease the muscle aches of the villager. It is the most practised form in Thailand and around the world. Royal Thai massage is a more reserved method that was created in the palaces, where the healer only uses his or her hands and fingertips to apply the treatment, remaining at arm’s length. This is the method that the Ministry of Public Health advises massage clinics at community health centres and hospitals to follow.

No matter what, each Nuad Thai treatment begins as it has for centuries – with the therapist saying a wai khru (prayer) to thank his or her teachers and ask for help in healing the client. “We will think of our teacher and Chiwaka Komparaphat (Buddha’s physician) who is respected as the first teacher of Thai traditional medicine,” said Serat Tangtrongchitr, general manager at the Wat Pho Massage School. “We give thanks and ask for them to help us heal the client.”

After the image of Nuad Thai was tarnished by US military personnel seeking more than a massage during the Vietnam War, in 1985, the Thai government launched the Thai Massage Revival Project, a programme that would reclaim the practice as a spiritual therapy and help shed its tawdry image. Experts from the fields of public health, Thai traditional medicine and therapeutic massage worked together to create a series of curricula that would define the principles and techniques of Thai massage. The project took three years to complete and focused on safety, efficacy and etiquette. Today, Thai massage therapists must achieve 800 hours of study before they can become licensed practitioners.

The therapy that has helped to get Thai farmers get back onto their feet has also become part of mainstream medical care, as Thai hospitals now use Nuad Thai to rehabilitate stroke patients and diabetes sufferers, among others. It has also grown into a multimillion-dollar industry that provides livelihoods for many Thais, including those who might have previously been on the fringes of society. There are now massage schools for the blind in Bangkok and Chiang Mai, and the Chiang Mai Women’s Correctional Institution has a massage college for inmates.

Nuad Thai has also proven to be a big attraction for tourists – either in the form of experiencing massage or learning the techniques themselves. Thai massage schools such as Wat Pho Thai Massage School and the Thai Massage School of Thailand in Chiang Mai (TMC), which was co-founded by Chaithavuthi, attract international students from as far away as Peru and North America. “Training is demanding,” said UK therapist Ashleigh Guthrie who travelled to Wat Pho Thai Massage School to learn the discipline. “The techniques require you to have a strong core as it’s quite an active method. Agility and flexibility are also required to master the art of the stretches.”

Canadian Paul Buffel, a former marketing professional, chose to study at TMC in Chiang Mai. He believes that the 30-hour flight was more than worth it. “Thai massage is best understood, integrated and expressed through the lens of Thai culture,” he said. “The people, land and culture of Thailand are intricately embodied within the practice of Thai massage.”

Even though all Thais now have access to free government health care, village healers still influence Thai culture to this day. “We still use Thai herbal medicine, and Thai massage is part of our daily lives,” said Chaithavuthi.

Tangtrongchitr believes that this ancient therapy is relevant now more than ever. “We may be surrounded by people, but the modern world can be a lonely place. Thai massage helps close this gap, cure ailments and make a connection.” 

BBC Travel’s Well World is a global take on wellness that explores different ways that cultures the world over strive for a healthy lifestyle.

Join more than three million BBC Travel fans by liking us on Facebook, or follow us on Twitter and Instagram.

If you liked this story, sign up for the weekly bbc.com features newsletter called "The Essential List". A handpicked selection of stories from BBC Future, Culture, Worklife and Travel, delivered to your inbox every Friday.