Only a few years ago, to many people the phrase "massage profession" conjured up images of scantily clad women working in dimly lit back offices, providing massages and other unmentionable "services" to their clients. Now, getting a massage or spending a weekend at a spa is de rigueur - the "in" thing among busy professionals, celebrities, athletes and ordinary Americans alike.

What has caused this sea change in the public's opinion of massage? While no single issue is responsible, several smaller issues percolating separately over the past few years have bubbled up to the surface, coalescing into a new understanding and appreciation of massage therapy as a whole. Educational standards have increased. Research shows massage is effective in treating a wide range of conditions. Massage therapists are being portrayed in a positive light in the mainstream media.

Insurance companies are providing coverage for massage and related treatments. And consumers are seeing massage no longer as a luxury item or fringe element of health care, but an accepted, vital ingredient to one's overall health and well-being.

As the practice of massage continues to increase in size and popularity, it becomes more difficult to obtain accurate information on the profession. To facilitate matters, the American Massage Therapy Association recently published the 2005 Overview of the Massage Therapy Industry and Massage Therapy Industry Fact Sheet. The reports are compiled from various sources, including government statistics, clinical studies, and surveys conducted by the AMTA, the International Spa Association, and other agencies. Combined, the reports paint a vivid picture of the massage profession in the U.S., with particular attention given to those who practice massage therapy, those who use massage therapy and the benefits massage can offer.

The Massage Therapist of the 21^st Century

As more consumers seek out massage as a way of maintaining or improving their health, the number of people entering the massage profession also has increased. According to the Industry Fact Sheet:

• Eighty-three percent of massage therapists are female; most are in their mid-40s, and have been working in the industry an average of 7.8 years.
• Most massage therapists (72 percent) are sole practitioners or partners in their own business.
• Not counting time spent on business tasks such as billing, bookkeeping and scheduling appointments, the typical massage therapist works an average of 15 hours per week providing massage, and delivers an average of 38 massages per month.
• Massage therapists charge an average of $58 for one hour of massage, and earn an average wage of $39 per hour (including tips) for all massage-related work. Including tips, the average annual salary for a massage therapist who provides 15 hours of massage per week is $29,250 - approximately $1,100 more than a full-time physician officer worker, and over $3,000 a year more than a full-time physical therapist.
• Swedish massage appears to be the therapy of choice among providers. Seventy-eight percent of therapists offer Swedish massage, followed by deep tissue massage (70 percent) and trigger point therapy (41 percent).
• Employment opportunities for massage therapists are predicted to increase from 21 percent to 35 percent by 2012 - much faster than the growth rates of similar occupations.

To enhance its reputation among the public and ensure that consumers can find qualified providers, the massage therapy profession has made great strides in introducing accreditation programs and increasing educational standards for practitioners. Among these accomplishments are the recognition of the Commission on Massage Therapy Accreditation by the U.S. Department of Education and the establishment of the National Certification Board for Therapeutic Massage and Bodywork. Together, these organizations have accredited more than 70 massage therapy institutions and programs in the U.S., and certified over 80,000 massage therapy professionals.

While improving the public's perception of massage, increased education and training also appear important to massage therapists already in practice. Ninety-two percent of massage therapists strongly or somewhat agree that there should be minimum education standards for massage therapists. Eighty-nine percent of massage therapists have taken continuing education classes after their initial training, with therapists taking an average of 27 CE hours per year. Advanced training for specific modalities rates as one of the most popular choices for continuing education, along with training for new modalities or techniques, and massage for specific populations, such as pregnant women and the elderly.

The number of people who seek out the services of a massage therapist continues to increase. Figures from the reports also indicate people are receiving massages at a variety of locales for a variety of reasons. Thirty-four percent of all adult Americans have received a massage within the past five years, while seventy-three percent of people who have had a massage would recommend it to someone else. When asked why they chose to receive a massage, 32 percent of the respondents cited a medical reason, such as muscle soreness, rehabilitation of an injury or pain relief. Twenty-six percent reported getting a massage for relaxation and stress relief. The most common location at which Americans received their last massage was a spa (20 percent). Almost every spa in the U.S., according to the International Spa Association, has at least one massage therapist on staff.

The impact massage has had on the general population has not been lost on the medical community. More than ever, health care providers are discussing the use of massage with their patients, and in some instances, even referring patients to massage therapists for care. Twenty-one percent of American adults discussed massage therapy with their doctor or health care provider, an increase of 150 percent from 2002. Seventy percent of massage therapists questioned in the AMTA 2005 Industry Survey stated that they received referrals from health care professionals, with an average of two referrals per month. Of hospitals offering complementary and alternative medicine services in the U.S., 82 percent offered massage therapy. Seventy percent of those hospitals utilized massage therapy for pain management and pain relief.

Several studies examining the benefits of massage therapy have been sponsored by the National Center for Complementary and Alternative Medicine. Results of these and other studies have shown that massage is effective in: treating chronic back pain better than other forms of CAM; strengthening the body's immune system; lessening the symptoms of carpal tunnel syndrome; reducing anxiety and blood pressure levels in stroke patients; reducing postoperative pain; lowering the frequency of headaches; and decreasing pain and anxiety in hospitalized cancer patients.

The Future Looks Bright for Massage

All health care professions experience growing pains on the path to acceptance by the general public. In this regard, massage therapy is no different from acupuncture, chiropractic, or any number of forms of healing not considered "traditional." That said, the massage profession has much to be proud of for what it has accomplished in the past decade, with massage regulations in 36 states, dozens of scientific studies that have shown the effectiveness of massage for a variety of conditions, and a growing acknowledgement by legislators, health care providers and insurers. As the authors of the Overview state in their conclusion: "The future will likely see more people entering the massage therapy profession, the public integrating massage therapy into their regular health routine, and more evidence of the efficacy of massage in clinical trials and research. Consequently, there should be even more support for massage by the health care community. Massage is expected to be seen as a beneficial option for people suffering from pain, stress or illness, and become an integral part of good health for all. The public is likely to view professional massage as an important contribution toward wellness and more than ever will receive massage on a regular basis."