Key Points

• Ancient Thai medicinal herbs can be used to create hot compresses and integrated into massage and bodywork sessions.

• Specific recipes of Thai herbal therapies are effective in loosening tight muscles, increasing blood circulation, and relieving stress.

• Thai herbal compresses have a myriad of uses, including sinus steams, soaking baths, and analgesic balms.

Medicinal herbs in one form or another have been used for millennia in major civilizations around the world, including in ancient Thailand (Siam). When combined with heat, the healing properties inherent in herbs can have a profound impact on those who receive massage and bodywork. As medicated heat penetrates the pores of the skin and descends through the layers, blood vessels are dilated and blood flow is stimulated. As muscles and tendons relax, range of motion is improved, and techniques based on stretching, compression, and acupressure may be better received. Most Thai herbal blends are anti-inflammatory and offer benefits to the sinuses, respiratory system, skin, heart, and other organs. Blood circulation and digestive functions may also be improved through hot herbal compresses, and the inhalation of vapors helps relieve stress, improve general health, calm the mind, stimulate free flow of wind (energy) in the body, and encourage self-healing. 

Although herbal compress therapy is mostly known through its association with traditional Thai massage performed on a floor mat, it may also be used with great success in Western table work, physical therapy, acupressure, and other practices. This article is offered as a basic introduction to Thai herbal healing traditions with the hope of inspiring more therapists to study and use them in professional practice.

Herbs, Compresses, and Materials

In Thailand, foreign students of traditional Thai massage are taught to use fresh ingredients to make herbal compresses, but many of these fresh Thai herbs and rhizomes aren’t available when they return to their native countries. As a result, they import premade dry mixes or “herbal balls” made for spas and tourists. These are made with cumbersome handles, and because they’re expensive, they are often used on several clients and mistakenly left out to dry and accumulate mold. Outside of Thailand, the most reasonable option is to source basic dried ingredients in one’s own region, mix the dry herbs and store them appropriately, and then add fresh ingredients to each compress on the day it is used. Companies that sell bulk dried herbs exist on all continents, enabling therapists to cut costs and integrate herbs more readily into therapeutic practice.

Ginger is the most important and most available fresh ingredient. The rhizome has strong antiseptic properties, and the smashed fibers retain heat when they are steamed, which helps maintain an even temperature inside the compress. Other irregularly sized materials, such as rock salt and small pieces of roots and rhizomes, help keep the compress firm and evenly distribute the dry herbs as they are steamed.

Cotton Outer Cloths and Muslin Bags

Typically, dried and fresh herbs, leaves, and rhizomes are cut and crushed and then wrapped and tied in a cloth bundle. Cotton and muslin cloth is used. The most convenient outer wrappers are light cotton washcloths, the type used to clean the hands of factory workers and automobile mechanics.

Place the herbs directly in the center of the cotton cloth, fold up the corners (Image 1), and squeeze the neck of the compress to make the bundle as firm and hard as possible (Image 2). Tie it with a thick rubber band or a string, fold down the flaps to make a knobby handle (Image 3), and you’re ready to go (Image 4). If you make a compress in this way, be prepared to throw it away after use because the herbs will get stuck in the fibers and the cloth will be very difficult to wash and clean afterward. To avoid these limitations, therapists should consider using cotton drawstring bags for herbal compresses. Muslin bags provide options for using a compress more than once and for adjusting the percentage of herbs. They also allow you to convert recently used herbal compresses into bath infusions or shower loofahs to give to clients after treatment.

The Steamer

It’s best to use an electric steamer with a thermostat that gives you extra temperature control. Make sure to use a true vegetable steamer and not a rice cooker or slow cooker. Avoid using a machine that has a ticking timer or a bell or digital sound, or one that shuts off automatically. The lid should always remain closed, except when you move the compress in and out of the steamer. If you live in a region where electric steamers are not available, you can use a hot plate. Insert a round metal steaming rack inside a pot with water, place your compress on the rack, cover the pot, and turn on the heat. After the compress is thoroughly steamed, lower the temperature, and refresh the pot with a little water whenever necessary.

Herbal Blends

The dry ingredients mentioned below are available around the world from herbal wholesalers and online companies, often described as “cut and sifted.” Dry materials should be mixed outside whenever possible; this way, the powders and fine particles in the herbs escape to the open air instead of settling on your floor and furniture or penetrating your nose and lungs. When stored in large plastic ziplock bags or airtight glass or plastic containers at room temperature in a dark place, dried herbs can retain their medicinal properties for up to one year.

A good general dry blend includes two parts each of lemongrass, eucalyptus, and dried ginger pieces, one part each of ginger powder and peppermint, and a half part each of galangal and rock salt. For each compress, add freshly cut and smashed ginger and a pinch of camphor crystals to several handfuls of dry mix.

When you learn the basic medicinal properties of the herbs you use, you’ll be able to customize compresses for clients with special conditions. Some recipes are specifically designed to clear congestion in the lungs and sinuses; to aid in relaxation for someone who is tense or going through a difficult time; or to treat skin disorders, insect bites, and other topical conditions. In addition, cold or iced compresses may be used to treat strained muscles, ligament or tendon sprains; hematomas; headaches and neck pain; and contusions, burns, and swelling.

Techniques and Guidelines for Using Hot Compresses

Chopping

Rapid percussion with a very hot compress is suitable for dense areas of the body, such as the back, shoulders, gluteal muscles, and lateral legs. Move constantly all around the area as you “chop” percussively with the compress.

Rolling

Using a medium-hot compress, the rolling technique starts at one side of the compress and ends at the other side. Flex your wrist outward, so a bottom corner of the compress makes contact with the body, and then apply a rolling movement by rotating your wrist. Generally, try to roll in one direction, whether outward (for shoulders and arms) or upward (for back and legs).

Pressure-Sliding

This technique is best for the back, with the receiver in either prone, side-lying, or child’s pose position. Use a hot compress directly on the skin and slide quickly upward with medium-firm pressure. Release the compress at the top, return to the bottom, and repeat several times.

Pressing

A common way to use a compress is to apply it to the body with incremental pressure. Use a medium-hot compress, and apply it over clothing, or on bare skin whenever possible. Position yourself so you use your body weight and not your arm muscles. Keep your arm as straight as possible, and lean in as you apply pressure, then rock backward to release.

Moving the Body Around a Compress                                                                                                        

Using a warm to medium-hot compress, you can take advantage of the receiver’s own body weight to apply medicinal heat. Place a compress under a certain area of the client's body, and then roll or move the body around the static compress. When you remove the body from contact with the compress, move the compress quickly to a new position a few inches away, and roll the body over it again. This technique works very well with clients in supine position as you work the shoulders, neck, and head.

Contraindications, Precautions, and Energy Concerns

Extra care should be taken for clients with diabetes, paralysis, varicose veins, and with children and older people, since their skin is often tender. Don’t use hot compresses on clients within 24 hours after swelling, inflammation, or bleeding, or for people with acute dermatitis or open wounds, since heat may worsen the condition.

It’s usually best to prepare compresses on the same morning you plan to use them. This way, the ingredients are freshly mixed and specifically made for the clients you will treat that day. Traditional Thai healers and herbalists often recite prayers and invocations when they choose fresh herbs for medicinal purposes. Experienced therapists often “charge” compresses with prayers, blessings, and good energy before they are applied to a client.

Whenever possible, don’t use compresses with multiple clients for more than one day, and try to change the outer cotton wrapper for each person. This is a hygienic concern, but it’s also important to minimize energy transference from one person to the next. If a compress has been used in a session where there was a strong reaction of some kind, especially an emotional release in which a person cried or recalled past trauma, it is always best to discard the compress and never use it again. If you feel that any type of outside energy has been transferred to a compress, be safe, and immediately dispose of it. Don’t use it on another person or give it away as a bath infusion, and don’t use it on yourself. Instead, empty the contents of the compress onto the soil outside or into a compost heap.

Thai Herbal Steam, Soaking Baths, and Skin Treatments

Since early times, Thai healers and herbalists have prescribed therapeutic herbal steam for a wide range of conditions. Traditionally, saunas were built around a charcoal burner or a slow-burning fire partially covered with stones. Fresh herbs and oils were placed on the stones, and water was sprayed to create medicated vapor. Today, Thai herbal healing centers known as samunphrai feature steam rooms and steaming tents.

Thai steam baths and soaks treat both the body and mind. The soothing aromas relax the mind and provide an enjoyable therapeutic environment. Medicinal properties in the plants relieve skin conditions, reduce inflammation, and penetrate and detoxify the inner body through inhalation and absorption.

Herbal Sinus Steam

Not everyone has access to a traditional Thai steam room, but herbal vapors may be inhaled at home to treat colds and congestion and to loosen mucous. It’s easy to do in your own kitchen using fresh ingredients and/or essential oils. Boil freshly crushed ginger in 5 cups of water for about 10 minutes and then add essential oils of eucalyptus, peppermint, and camphor. A few drops of lemongrass essential oil add a nice fragrance. Make it as strong as you wish. Mix the essential oils into the water as soon as you remove the pot from the heat. Sit in a comfortable position, cover your head and the back of your neck with a towel, and hold your head at a comfortable height above the steam for as long as possible as you breathe slowly and deeply through your nose and mouth. If the sensation is too intense, come out of your “tent” for a few seconds, and then return for more steam inhalation. Continue this process for 3–5 minutes or until the vapors subside.

Herbal Bath Infusions

Soaking in a Thai herbal bath is one of life’s simple pleasures. Herbal bath infusions can be prepared in muslin bags immediately before bathing, or you can modify and refresh a compress that was previously used during a bodywork session. Once it’s used as a bath infusion, the herbs lose most of their medicinal properties, but the sachet may still be used again as a shower loofah. Before the bath, take a quick shower with soap and warm water to clean your body and remove lingering body oils and odors. Don’t use soap in your herbal bath; the herbs will do all the cleaning.

Place the sachet directly under the faucet and run hot water over it. Use the hottest water you have available and allow it to run slowly over the sachet until the tub is filled to approximately 40 percent of its volume. Close the bathroom door so the fragrance of the herbs and vapors remains in the room. Return in a few minutes to see how things are going. Stir the water in the tub to evenly distribute the herbal properties, and squeeze the herbal sachet a few times to release more herbal properties into the water. Prepare the bathroom with other things you may desire, such as a candle, a glass of water, or a cup of herbal tea. Continue to fill the tub with hot water, and then temper it with some cold water, so the bath will be at the right temperature. Try to tolerate the hottest water temperature possible. Remain in the bath for at least 10 minutes, then use the herbal sachet to scrub your skin and distribute the herbal water all over your body. When you leave the bath, lightly dry yourself. Don’t rinse or wash your body again in the shower, and avoid using creams, lotions, or perfumes after your bath.

Basic Herbal Bath 

Use the basic dry compress blend described previously, which contains dried lemongrass, dried eucalyptus, dried ginger pieces and powder, dried peppermint, salt, and freshly crushed ginger, but do not add camphor crystals. As with a compress, place the dry mix and crushed ginger in a muslin bag and tie it tightly with a shoelace knot.

Stimulating Bath  

To aid in awareness and mental acuity, and to boost energy, use freshly crushed ginger, dried lemongrass, peppermint, eucalyptus, cloves, rose or other dried flower petals (or a few drops of natural flower essential oil), and salt.  

Cleansing Bath  

To help skin conditions, some recipes include galangal, lemongrass, ginger, ginger powder, kaffir lime leaves or kaffir essential oil, and honey.

Relaxing and Fragrant Bath  

For pure relaxation after a long day, try blending dried lemongrass, rose or other fragrant flower petals, fresh ginger, salt, citrus rind, honey, and essential oil of frangipani or jasmine.

Herbal Balms and Poultices

In Thailand, traditional herbal recipes are popular, and healers and herbalists make their own medicines, balms, and oils from herbs, roots, rhizomes, flowers, plant leaves, tree bark, and distillations purchased from herbal apothecaries. Outside of Thailand, it’s usually best to buy commercial Thai balms from import stores and online companies.

For areas of tightness, soreness, physical restriction, and pains in the back, chest, and shoulders, analgesic balms are often very effective. When applied to the chest and throat, they can alleviate discomfort due to colds, congestion, and sinusitis. In Thailand, balms are sometimes applied in three coats using medium pressure while rubbing in a circular motion. Some balms and creams may be used on the feet and at the end of the session while working on the shoulders, neck, and face. Lightly scented herbal balm is excellent for finishing touches on the neck, face, and forehead, when the client is in final supine position. A small dab on the third eye area of the forehead can help to work the entire face.

Herbal poultices made from fresh and dried ingredients and powders are used to treat a variety of conditions. Salt plasters treat infections and abscesses, macerated cloves or clove essential oil is used for upper body skin tags, garlic is used for warts and bumps on the skin, a crushed ginger poultice treats inflammation, and blends of bulbs and rhizomes treat foot fungus. Other Thai herbal traditions include nasal inhalers, teas for nausea and sore throat, Thai curry paste, and Thai herbal water for spiritual cleansing and deodorizing.    

Diligent Study and Practice

Some therapists and teachers have a general lack of understanding about ways to effectively use herbal compresses, balms, and poultices, and how to prepare, use, and store herbs before integrating them into manual therapy treatments. All too often, information isn’t provided to students about the properties of medicinal herbs or about how to modify compresses to suit the specific needs of clients. In addition, hygienic and energetic concerns are often not stressed in basic trainings. All these issues are important for those who wish to use herbal compresses, balms, and poultices in therapeutic practice.

No matter how you integrate Thai medicinal herbs into a bodywork treatment, your clients will love you for it. After some serious study with qualified teachers, and after a long period of practice on friends and family members, you’ll be able to begin working with herbs in your professional bodywork practice. Choose your teachers wisely, study diligently, suppress the ego, and work with love always.