The purpose of this study was to investigate the therapeutic effects of traditional Thai massage (TTM) on pain intensity, pressure pain threshold (PPT), muscle tension and anxiety associated with scapulocostal syndrome (SCS). Twenty patients were randomly allocated to receive a 30-min session of either TTM or physical therapy modalities (PT: ultrasound therapy and hot pack) for 9 sessions over a period of 3 weeks. Pain intensity, PPT, muscle tension and anxiety were measured before and immediately after the first treatment session, 1 day after the last treatment session and 2 weeks after the last treatment session. Results indicated that the TTM group showed a significant improvement in all parameters after the first treatment session and at 1 day and 2 weeks after the last treatment session (p < 0.05). For all outcomes, similar changes were observed in the PT group except for PPT (p < 0.05). The adjusted post-test mean values of each assessment time point for pain intensity and muscle tension were significantly lower in the TTM group than those of the PT group (p < 0.01). In addition, the values for PPT were significantly higher in the TTM group (p > 0.05). We therefore suggest that TTM could be an alternative treatment for the patient with SCS.