Shiatsu is a very old form of therapy, the basics of which pre-date its first mention in print Japan in 1915. When the practice was exported to the West, word of mouth spread quickly. This word of mouth was not all good. People complained that the treatment was painful. I am curious as to whether practitioners adapted the technique to be more appealing to Americans to a point where it is actually less effective than it is in Japan.
Shiatsu is recognized as a medical therapy in Japan and it is not even called massage. Here is an official government definition of Shiatsu from Japan:
Shiatsu technique refers to the use of fingers and palm of one’s hand to apply pressure to particular sections on the surface of the body for the purpose of correcting the imbalances of the body, and for maintaining and promoting health. It is also a method contributing to the healing of specific illnesses.
That last sentence is something you will not see in reference to Shiatsu in the West. The therapy has gained wide acceptance as a complimentary treatment since its interstitial surge in the 70s, but there is no evidence that it cures disease.