Traditional Thai massage is a rich synthesis of three ancient health traditions stretching back more than 1000 years. By combining ayurvedic (classical Indian) medical theory and the postural dynamics of hatha yoga with their own health beliefs and ingenuity, the Thai's developed a very relaxing, therapeutic and graceful system of massage. Traditional Thai massage can be applied as a full-body treatment or as a specific therapy to treat a broad range of physical discomforts and stress-related disorders.

TTM is particularly effective in treating headaches, menstrual irregularities, back and hip pain, shoulder and neck tension, joint and soft tissue injury, digestive upsets, insomnia and anxiety. Traditional Thai massage employs the hands, elbows, knees and feet in unique and innovative ways, and these techniques are often associated with stretching manoeuvres, many directly related to yoga postures.

All styles of TTM encourage the movement of energy (Lom) in the body, via a network of channels known as Sen. This stimulates an integrative principle within the body that promotes and stabilises health and structural poise. Some important physiological benefits of TTM are improvements to the immune, lymphatic and circulatory systems, relaxation and strengthening for the muscles, increased suppleness of the joints and a deep sense of relaxation for the mind and body.

Thai massage is a type of massage in Thai style that involves stretching and deep massage. This form of bodywork is usually performed on the floor, and the client wears comfortable clothes that allow for movement. No oils are used in Thai massage. It is known in Thailand as "nuat phaen boran" (Thaiนวดแผนโบราณ, IPA: [nûət pʰɛ̌ːn boːraːn]), literally, the ancient-manner massage. Most Thai people simply refer to Thai massage as นวดแผนไทย "nuad phaen thai".

The massage recipient changes into loose, comfortable clothes and lies on a mat or firm mattress on the floor. It can be done solo or in a group of a dozen or so patients in the same large room. The receiver may be positioned in a variety of yoga-like positions during the course of the massage, but deep static and rhythmic pressures form the core of the massage.

The massage practitioner leans on the recipient's body using hands and usually straight forearms locked at the elbow to apply firm rhythmic pressure. The massage generally follows the Sen lines on the body—somewhat analogous to meridians or channels and Indian nadis. Legs and feet of the giver can be used to fixate the body or limbs of the recipient. In other positions, hands fixate the body, while the feet do the massaging action. A full Thai massage session typically lasts two hours or more, and includes rhythmic pressing and stretching of the entire body; this may include pulling fingers, toes, ears, cracking the knuckles, walking on the recipient's back, and arching the recipient into bhujangasana (or cobra position). There is a standard procedure and rhythm to the massage, which the practitioner will adjust to fit each individual client.

The true practice of the art of healing in traditional nuad boran (thai massage) is the compassionate intent of the healer. The Buddhist spiritual practices associated with thai massage cultivate humility, awareness, and concentration in the healer designed to bring the practitioner to a deeper level of awareness of herself and the client. This compassionate state of being is termed "metta", which usually translates as "loving kindness".

The founder of Thai massage and medicine is said to have been Shivago Komarpaj (ชีวกโกมารภัจจ์ Jīvaka Komarabhācca), who is said in the Pāli Buddhist Canon to have been the Buddha's physician over 2,500 years ago. In fact, the history of Thai massage is more complex than this legend of a single founder would suggest. Thai massage, like TTM more generally, is a combination of influences from Indian, Chinese, Southeast Asian cultural spheres and traditions of medicine. The art as it is practiced today is likely to be the product of a 19th century synthesis of various healing traditions from all over the kingdom. Even today, there is considerable variation from region to region across Thailand, and no single routine or theoretical framework that is universally accepted among healers.