In today’s fast-paced world, stress is a common companion. But beneath the surface of mental and emotional strain is a key hormone that orchestrates much of how our body responds: cortisol. Often called the “stress hormone,” cortisol plays a crucial role in regulating energy, blood pressure, sleep-wake cycles, and immune function. Yet when cortisol levels remain elevated due to chronic stress, it can wreak havoc, contributing to pain, poor sleep, digestive issues, anxiety, and even weight gain.
So, how can we better manage cortisol? One emerging answer is manual therapy, particularly osteopathic manipulative treatment (OMT).
Cortisol is produced by the adrenal glands in response to stress. In the short term, it helps us cope by mobilizing energy, increasing alertness, and reducing non-essential functions like digestion or inflammation. But when stress becomes chronic, persistently high cortisol can disrupt sleep patterns, cause muscle tension and pain, weaken immunity, and increase risk for cardiovascular and cognitive issues.
Lifestyle factors that influence cortisol include:
A recent systematic review and meta-analysis by Thibaut et al. (2023) looked at the impact of manipulative therapy on cortisol levels. The analysis pooled data from four studies with 135 participants. The results? OMT led to a measurable decrease in salivary cortisol levels compared to sham treatments, with an average reduction of 0.10 μg/dl. While this drop may seem small, the consistency across studies (with 0% heterogeneity) suggests a real physiological effect.
Importantly, the authors emphasize that while a single session may yield modest results, repeated sessions could have a cumulative and more impactful effect. This opens the door to using manual therapy as a regular tool for long-term stress management and nervous system regulation.
If you’re feeling overwhelmed, fatigued, or stuck in a stress cycle, OMT or other forms of manual therapy (like chiropractic care) may help modulate your stress response. These treatments stimulate the parasympathetic nervous system (the “rest and digest” mode), support vagal tone, and may help lower sympathetic overdrive, where cortisol often plays a starring role.
For best results, pair manual therapy with daily habits that naturally regulate cortisol:
Not everyone knows where to start when tackling chronic stress. When life feels out of control, scheduling a manual therapy session can be a powerful first step. You don’t need to have a diagnosis or injury—sometimes, it’s just about calming the nervous system and reconnecting with your body. Adding it as a regular part of your wellness routine may create a foundation for better sleep, less tension, and lower overall stress load.
Book your appointment with us by clicking here, or chat with our team on WhatsApp. Take care of your body and mind!
Thibaut, D., Santarlas, V., Hoppes, J., Vásquez-Castillo, A., Morrow, A., Oviedo, E., & Toldi, J. (2023). Osteopathic Manipulation as a Method of Cortisol Modification: A Systematic Review. Cureus, 15(3), e36854. https://doi.org/10.7759/cureus.36854
