Lomi Lomi

Contexts in Hawaiian life

A 2024 reprint of Nā Moʻolelo Lomilomi, edited by Makana Risser Chai and published by Bishop Museum Press, gathers accounts by Native Hawaiian historians including David Malo, Samuel Kamakau and John Papa ʻĪʻī, together with oral histories from more than 60 Hawaiian healers spanning the 1830s to 2004. The publisher describes lomilomi as connected to childbirth, to the martial art lua, to heat therapies, bone-setting and hoʻoponopono (a process of making things right within a family), and says historical records trace the practice to at least 1779.

A 2021 article by a Hawaiʻi massage therapist describes two classes of traditional practitioner: kāhuna lāʻau lapaʻau, specialists in plant medicine, and kāhuna hāhā, diagnosticians skilled in touch. The same article says that before the late twentieth-century revival the practice continued quietly within families as a response to colic, indigestion, injuries and muscle soreness. In interviews with ten Native Hawaiian elders, four described using lomilomi for aches and stomach ailments, in one case with warmed oil.

Decline and revival

A 2001 interview study of 25 Hawaiian health practitioners on Oʻahu reports that Hawaiian medical practice became fragmented after the arrival of Western civilization and that, by the 1990s, three modalities remained in use: hoʻolomilomi (massage), lāʻau lapaʻau (herbal medicine) and hoʻoponopono (conflict resolution). All 25 reported apprenticeship under a master healer or recognized elder, often a family member. The Ke Ola article dates the resurgence of lomilomi to the cultural pride that followed the 1976 voyage of the canoe Hōkūleʻa.

In the Papakolea Hawaiian homestead community in Honolulu, a community nonprofit formed in 1992 began a training program, Nā Lomilomi O Papakolea, which a 2014 case report describes as the first self-sustaining program for training lomilomi practitioners there. The report is a community account written by the participants, not an independent evaluation.

The word and its spellings

In Hawaiian orthography the term is written lomilomi, a reduplication of lomi. The Ke Ola article gives one translation of lomilomi as breaking up into small pieces, a reference to food preparation, and stresses that the practice extends beyond physical massage. A 2014 case report glosses it as traditional Native Hawaiian therapeutic massage, and the 2001 practitioner study uses the causative form hoʻolomilomi. English-language trade and research writing often uses lomi lomi, Lomi Lomi or Hawaiian massage; one 2009 review used Lomi Lomi for a style of massage combined with passive movements.

Neighboring terms

Lāʻau lapaʻau refers to Hawaiian herbal medicine and healing practice, and hoʻoponopono to the family process of resolving conflict; the practitioner study treats the three as distinct modalities that the same person may practice. Lomi-lomi salmon, a Hawaiian dish, shares the name and appears in food-safety case reports about raw fish, unrelated to bodywork.

Techniques and tools

The Ke Ola article lists compressions, stretches, kneading, percussion, squeezing and soothing strokes, sometimes combined with plants, herbs, salt, heat, ʻiliʻili stones, lomi sticks and saltwater. A 2024 trade-magazine article by a licensed massage therapist describes long sweeping forearm strokes likened to ocean waves, range-of-motion work, deep pressure for chronic tension, abdominal massage and spinal mobilization. These are descriptions of how teachers present the work, and techniques vary by family, teacher and island.

Prayer, teaching and apprenticeship

In the 2001 practitioner study, all 25 practitioners gave a spiritual blessing before and after any healing modality, and 56 percent were training students. Ke Ola describes lomilomi as involving pule (prayer) and hoʻoponopono, and practitioners cultivating awareness through breath and intention. The Papakolea program described in 2014 combines lomilomi with lāʻau lapaʻau and hoʻoponopono and, in the report, a seven-week initial course followed by a five-year apprenticeship. No single national or international training standard for lomilomi was found in the sources reviewed.

Community and clinic settings

The Papakolea report says practitioners worked in community centers, hospitals and home visits, and that healers began to recognize clients who also needed medical care, leading to partnerships with physicians. A 1997 report describes nurse practitioner clinics on Oʻahu's North Shore that offered lomilomi alongside primary care for uninsured Native Hawaiians, with referral to physicians as needed.

Traditional uses

Within Hawaiian families and healing lineages, sources describe lomilomi being used for colic, indigestion, injuries, muscle soreness, aches and stomach upset, and in the context of childbirth and bone-setting. Practitioners and teachers also describe it as addressing spiritual and emotional dimensions, for example the idea reported in Ke Ola that memory is stored in the bones. These are beliefs and uses attributed to the traditions, not findings from trials.

Contemporary patterns of use

Use data come mainly from Hawaiʻi. A 2006 survey of 309 of 482 intercollegiate athletes at a university in Hawaiʻi found that 14 percent had used lomilomi in the previous 12 months, and that Hawaiian, Samoan and Tongan athletes were more likely to use Hawaiian-originated forms. A survey of 1,321 Hawaiʻi high school students in 1993 to 1994 found that community access and healer preference predicted participation in healing practices such as hoʻoponopono and lomilomi. In an interview study of 18 Native Hawaiian caregivers of children with asthma, lomilomi was seldom, if ever, used.

What has been studied

A PubMed title-and-abstract search for lomilomi, lomi-lomi and Hawaiian massage, run for this entry on 6 October 2026, returned 13 records. None was a randomized or controlled trial of lomilomi massage; most were qualitative studies, program descriptions or unrelated items. A 2009 narrative review of massage and passive movement drew on lomilomi principles to propose a combined technique and said it required empirical testing. Systematic reviews specific to lomilomi were not found.

The Uliʻeo Koa program, reported in 2001, combined exercise including lua, a traditional Hawaiian diet, lomilomi and health education for active Native Hawaiian adults, and compared baseline and post-intervention measures. The abstract does not describe a control group, and because lomilomi was one component among several, its separate contribution cannot be inferred.

Related evidence on massage

The National Center for Complementary and Integrative Health states that several reviews found weak evidence that massage may help low-back pain, that neck pain evidence is uncertain, and that evidence for pain and anxiety relief in cancer is not strong. It also says much research on massage is preliminary or conflicting. These conclusions concern massage in general, usually other styles, and should not be transferred to lomilomi, to its spiritual components, or to its use for a particular condition.

Reports of satisfaction, such as the 1997 clinic report, and community case reports describe acceptability and integration with medical services; they are not measures of clinical effect.

Lineage practice and commercial variants

The Ke Ola article states that contemporary lomilomi taught in Hawaiian lineages differs from spa massage through its integration of prayer, hoʻoponopono and attention to the person as a whole. A 2024 trade-magazine article reports that Hawaiian elders have expressed concern that some Western adaptations are more New Age than Hawaiian, and that spa versions often omit prayer and intention-setting. These accounts come from practitioners, not from a survey of how lomilomi is taught or sold, so the proportion of variants cannot be stated.

Community-led teaching and respect for practice

The Papakolea program was founded and led by community members, and its report quotes a Hawaiian proverb that all knowledge is not taught in the same school, a reminder that teachers and families hold different approaches. In a qualitative study, the ten Native Hawaiian elders interviewed said they valued health care providers who got to know them and respected Hawaiian cultural practices, whatever the provider's ethnicity.

Massage precautions

The National Center for Complementary and Integrative Health states that massage appears to have few risks when performed by a trained practitioner, but that rare serious effects such as blood clot, nerve injury or bone fracture have been reported. It advises that therapists take precautions with certain health conditions and that people talk with their health care providers about whether massage is suitable for them. No source reviewed reported adverse-event data specific to lomilomi, so the frequency of harm from its deep forearm pressure, heat or herbal and oil applications is not established.

Care boundaries

The Papakolea report notes that traditional healers recommended follow-up with a physician for some medical conditions, and the 1997 clinic report describes referral between nurse practitioners and lomilomi practitioners. Lomilomi is described in these sources as complementary to, not a replacement for, medical assessment. A person with new, severe or worsening symptoms needs conventional evaluation and should not delay it for any bodywork.