Lomi lomi has traditionally been passed down in families from one generation to another. The practitioner of this ancient treatment is often the "tutu" (grandmother) or another revered family member. Though the style of massage can vary, traditionally one lies on a woven mat on the ground while the massage is carried out with a combination of thumbs, knuckles, palms, arms and elbow motions, though another form of Lomi lomi can involve the practitioner walking on the body. Oils obtained from native products such as palm or kukui or macadamia nuts are used as massage lotions and to nourish and moisturize the skin.

Lomi lomi is part of a broader Hawaiian belief system that embraces the body, spirit and healing. Therefore it traditionally includes the elements of prayer, breath and energy, rooted in the ancient Hawaiian philosophy known as Huna. Some knolwedge of Huna helps in understanding how Lomi lomi relates to healing of the whole person. Huna teaches that all things seek harmony and love - in fact, another name of lomi lomi is the "loving hands" massage, involving deep but gentle strokes that nurture the body and allow the receiver to relax and simply be.

Although today Lomi lomi massage is used to knead the tissues, it is, as we have pointed out, much more than simply a spa treatment. Deeply rooted in ancient traditional Hawaiian medicine, Lomi lomi has been used from time immemorial to promote and maintain wellness, decongest the body, relieve pain and treat various ailments including fractures, dislocations, and internal conditions such as stomach upsets, as well as to aid in childbirth.