The Vagus Nerve and Its Relevance to Manual Therapy

How Understanding the Vagus Nerve Can Enhance Your Clinical Practice

The vagus nerve has emerged as a point of fascination in both neuroscience and clinical bodywork. For manual therapy practitioners, understanding the role of the vagus nerve can open new pathways for supporting client wellbeing—particularly for those experiencing chronic stress, pain, or dysregulated nervous system responses.

An illustration of a woman featuring a detailed diagram of the vagus nerve, highlighting the link between the nervous system and manual therapy, set against a soothing green and beige background.

The vagus nerve is the tenth cranial nerve and plays a central role in the parasympathetic nervous system—the part responsible for ‘rest and digest’. It influences heart rate, digestion, respiratory rate, and even emotional regulation. In manual therapy, many of our clients present with conditions that involve nervous system imbalance: tension headaches, jaw pain, digestive complaints, or persistent muscle tightness. This is where the vagus nerve becomes highly relevant.

Why the Vagus Nerve Matters in Manual Therapy

Stimulation of the vagus nerve—whether directly or indirectly—can promote parasympathetic activation. This is particularly relevant for manual therapy practitioners who are already engaging in therapeutic touch that may calm the nervous system. Techniques such as diaphragmatic breathing cues, gentle neck or suboccipital work, and craniosacral-inspired holds have been associated with vagal activation.

Research continues to explore how manual interventions may influence vagal tone, but we already know that a relaxed, safe, and present therapeutic environment can support this system. A calm client, breathing deeply and slowly during a treatment, is more likely to experience the benefits of parasympathetic dominance—reduced muscle tension, improved digestion, and enhanced mood.

Practical Considerations for Manual Therapy Practitioners

Manual therapy practitioners don’t need to ‘treat’ the vagus nerve directly to support it. Awareness is the key. Encouraging slower breathing, allowing time for stillness in a session, and working gently around the neck and thoracic inlet can all support vagal pathways.

It’s also important to remember that not every client will be ready to shift into a parasympathetic state immediately. For clients with chronic stress or trauma backgrounds, a gentle, trauma-informed approach is essential.

Final Thoughts

The vagus nerve provides a useful lens through which we can view our work as manual therapy practitioners. By understanding how our touch, presence, and environment may influence nervous system regulation, we can more effectively support our clients’ healing processes—especially those with complex or chronic conditions.