Physical health issues that can be treated range from minor cuts or common cold, to chronic illnesses, burns, and serious injuries. In general, the aim is to direct the treatment to one or more specific areas where there is a build up of byosen (toxins). During a reiki session, the focus can be on the specific area where you have clear symptoms or pain (boysen build up). The hands are also used to sense areas in the body where there are accumulations of toxins (often these areas feel painful, stiff, uncomfortable, and are out of balance). These areas with byosen can be treated by placing the hands on them. In doing so, the reiki energy is used to break down and eliminate such toxins more effectively.  Once toxins have been eliminated, the reiki energy helps to balance the body's hormones and systems. The body will then move more easily into a state of balance and health.

Most reiki treatments are hands-on conducted by the practitioner by laying their hands on the clothed body of the recipient, allowing the reiki energy to flow through the body. The warmth of the hands (physical warmth and reiki warmth) helps the recipient to relax or feel calm and at peace, optimizing their physical and emotional state. If reiki is performed frequently, it will also help calm the mind