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  Massage Therapy Fact Sheet Press Releases Massage Makes Strides in Public Acceptance — Consumer Research
OverviewPositive Awareness Why Americans Seek Massage Regional Variations Where Services Are Delivered Consumer Spending Patterns Building Consumer Loyalty Deterrents to Consumer Use of Massage Massage Therapy Supply and Demand Massage Therapy Research and Medicine Complementary and Alternative Medicine Perspective Insurance Reimbursement Rapid Growth in Types of Massage Therapy and Bodywork Explosive Growth Rate for Massage Training Begins to Flatten ABMP Practitioner Characteristics and Professional Membership Patterns Influence of National Retailing Trends on Massage Glossary of More Than
250 Entries on Massage Treatments Searchable Archive
of More Than 800 Articles, from Acupressure to ZenMassage Makes Strides in Public Acceptance — Consumer Research Overview Although there remains some lingering public confusion that hampers the trained, respectable practitioners of massage therapy and bodywork, the massage profession in the United States has largely shed the clouded image from having its name pirated by unsavory and illegal “massage parlors.” Massage therapy (a term used throughout this site to describe the whole of massage, bodywork and somatic therapies), rapidly gains converts and social acceptance each year, with near-universal favor among first-time customers. Massage is now a therapeutic leader in the burgeoning field of complementary and alternative medicine. As an August 2005 issue of Consumer Reports declares, “Alternative medicine has come of age.” Consumer Reports cites deep-tissue massage as one of the remedies most effective as voted by readers for back pain, arthritis, osteoarthritis and fibromyalgia. In addition to being enthusiastic users of alternative medicine, subscribers of Consumer Reports are older, wealthier and well educated. In February of 2007, Associated Bodywork & Massage Professionals (ABMP) unveiled the results of a national consumer survey on the use of massage. ABMP’s study was conducted by the independent, national public opinion research firm of Harstad Strategic Research, Inc., based in Boulder, Colo. The poll included a national telephone survey of a representative sample of 1,008 adults aged 21 and older, conducted Jan. 4–11, 2007. Positive Awareness Among the positive wave of response was the information that 16 percent of U.S. adults visited a massage therapist in 2006 and 38 percent have received a professional massage sometime in their life. Americans report overwhelmingly positive feelings about their massage experiences. Ninety-four percent express favorable feelings toward massage therapists, with 69 percent expressing very favorable feelings. Among 2006 massage clients, fully 85 percent voiced very favorable feelings about their most recent massage, with 37 percent rating it a perfect ten-out-of-ten. For the adults who visited a massage therapist in 2006, the average number of visits was seven. This use level puts massage on par with consumer use of chiropractic and physical-therapy services. Why Americans Seek Massage There are three primary reasons people seek massage, each representing about a third of all massages delivered. Most seek relaxation and restoration (30 percent), need relief from pain or muscle soreness (29 percent), or have a massage because they received it as a gift (28 percent). Recommendations by medical professionals and receiving gift certificates are primary factors in consumers choosing to get a massage. Regional Variations Consumers in the West and Midwest are most likely to have received a massage in 2006 — 20 percent and 19 percent respectively in a recent survey, compared with 14 percent in the Northeast and 12 percent in the South. Each of these percentages is up from 2004 levels, with the six-percentage point gain in the Midwest the most dramatic. Where Services are Delivered With massage weaving its way into the U.S. lifestyle, it’s useful to note where individuals experienced their most recent massage sessions. A 30 percent plurality said they went to a therapist’s office while 31 percent experienced theirs in a spa setting. A fortunate six percent had a therapist come to their homes, and four percent saw practitioners in the offices of another healthcare professional. Just two percent had a massage at an athletic club, and four percent experienced massage in a hotel, a hospital (three percent), at work (two percent) or at a hair salon (two percent). The 18th annual list of the 100 Best Companies for Working Mothers, published by Working Mother magazine in September 2003, notes that 77 of the top 100 companies offered work site massage. Consumer Spending Patterns The median and average prices for a one-hour massage have held steady in recent years at $60.  Of the 32 percent of respondents not included above, 15 percent received massage as a gift or otherwise got it for free, four percent received services in a hospital or had insurance pay for it in another setting. Fourteen percent didn't remember the cost of their massage, or declined to say. In earlier research (2004), consumers predominantly experienced one-hour massages (65 percent), followed by 12 percent that were 30-minute sessions, 9 percent that lasted 40-50 minutes, 7 percent that were 90 minutes, and 3 percent that were 75-minute sessions. Building Consumer Loyalty In 2006, 8 percent of consumers who had a massage went 21 times or more to a therapist. Similar to prior studies, 33 percent had just one massage in 2006 and 9 percent had 11–20 sessions. So 26 percent of all clients had 11 or more massages last year (2006). Nine percent received 6–10 sessions; 21 percent had 3–5 sessions; and 19 percent had just two sessions. Deterrents to Consumer Use of Massage In 2006, 84 percent of respondents did not see a massage therapist. Fully 24 percent of them said they simply didn’t perceive a value or feel a massage was necessary. Contrast that with the overwhelming positive response by consumers — fully 85 percent voiced very favorable feelings about their most recent massage — with 37 rating it a perfect ten-out-of ten. Clearly more education needs to be done on the benefits of massage. These results echo other national press reports of increased spa traffic, numbers of men seeking bodywork and baby boomers looking for ways to ward off aging. Thirty percent cited cost as a deterrent, but with 90 percent of massage sessions paid out of pocket, a prevailing cost of $1 per minute is outside the means of some budgets. Thirty-one percent said they just didn’t have time for a massage. A potential new issue inhibiting further use of massage therapy may be years of an accelerated growth rate of massage school enrollment with an uneven quality of graduate preparedness, resulting in higher therapist turnover and an increased risk of pedestrian quality massage work. Consumers should be encouraged to explore the styles of several massage practitioners until they find a comfortable match. Other residual issues inhibiting broader use of massage therapy include discomfort by many over a perception that massage requires nudity (it doesn’t necessarily require removal of all clothes and is conducted in the United States with careful attention to draping). This misperception coincides with a surprisingly prevalent American cultural phobia about being touched. Earlier Harstad research (2004) found such concerns arose most often among males aged 55-plus. Massage Therapy Supply and Demand ABMP estimates indicate that 241,058 trained therapists now provide massage and bodywork in the United States. (A January 2006 analysis was based on state licensing lists, totals from primary membership organizations [ABMP and AMTA], National Certification Board for Therapeutic Massage and Bodywork certificants and state populations. General receptivity toward massage in particular regions was also factored in.) Consumers receive approximately 120 million to 135 million massage sessions annually, for which they pay $6.5 billion to $8.8 billion. Of these sums, massage therapists receive $5.5 billion to $7.5 billion, the remainder going to spa owners, landlords or medical professionals providing space and customer flow. In totality — including expenditures for training, equipment, services and marketing — massage therapy is a $7 billion to $10 billion industry. There is no definitive answer on the number of sessions conducted and their dollar value. A calculation using the 2005 average ABMP member-client contact hours per week (15.4), at an average rate of $60 per hour, yields an annual 182 million sessions and $9.3 billion. As the 15.4 hours are drawn from massage therapists reporting client contact hours during the week prior to the survey, they are more likely to be accurate than annual estimates made by therapists and consumers. Even so, some therapists have either overreported income or have given some sessions gratis or at concessionary rates. Thus, the more conservative dollar ranges are shown. ABMP membership growth also reflects the increasing professionalism and advancement of the field:  Click on image for larger view. Growth in massage use is just one manifestation of consumer determination to access massage therapy and other complementary healthcare services, despite the fact that formal research is incomplete and the reality of paying for most such services out of their own pockets. Massage Therapy Research and Medicine While the last decade has been a boon to massage-therapy research, there is still much to be done. One barrier to further gains in public and medical community acceptance is the relatively modest base of research on the efficacy of massage therapy. Intuitively, many users find massage helpful, but nonusers continue to wait for proof of scientific effectiveness. According to Dr. Janet Kahn, a massage therapist and executive director of the Integrated Healthcare Policy Consortium, “Very few people were thinking or speaking about research on therapeutic massage and bodywork 10 years ago. Three institutions emerged … to change that picture. The first was Touch Research Institute (TRI), founded in 1992 … at the University of Miami. Researchers at TRI have conducted more than 100 studies on a wide variety of potential massage applications. Most of these investigations are relatively small pilot studies. While not establishing definitive effects of massage, they have identified many areas in which massage shows potential and should be further investigated.” She notes that the 1999 convening of the Massage Research Agenda Workgroup provided a way for massage therapists and bodyworkers who may not have the training or the inclination to conduct research to nevertheless influence the types of research being done. Kahn also notes the contributions of the National Center for Complementary and Alternative Medicine at the National Institutes for Health. For Kahn’s complete article on massage profession research, click here. In September of 2006 Associated Bodywork & Massage Professionals pledged $15,000 to help gain medical recognition of massage therapy as a treatment for low-back pain, which afflicts millions of Americans. ABMP made the lead grant to the initiative and the funds pledged represent one fourth of those needed to advance a review under the auspices of the National Institutes for Health, Office of Medical Applications of Research. Click here for more. Complementary and Alternative Medicine Perspective Established in 1999, the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes for Health has a 2006 budget of $122.7 million. It reported in 2004 that 62 percent of respondents to a National Center for Health Statistics survey (31,044 adults) used complementary or alternative medicine, or both, in 2002. In conjunction with the Centers for Disease Control and Prevention, NCCAM is conducting a follow-up survey throughout 2007 and expects to release the findings in late 2008 or early 2009.
Insurance Reimbursement When it comes to receiving third-party insurance reimbursement, only 18 percent of ABMP massage and bodywork practitioners do. For most of these practitioners, insurance reimbursement comes for only a portion of their massage work. Almost all such work is related to workers’ compensation disability or accident rehabilitation. Most chiropractic and physical-therapy treatments are reimbursed by health insurance while more than 90 percent of massage therapy sessions are paid out of the client’s pocket. The services of a massage-therapy or bodywork professional may be covered by health insurance when prescribed by a chiropractor or osteopath. Therapies provided as part of a prescribed treatment by a physician or registered physical therapist are often covered. A number of health insurance plans now recognize massage by assembling networks of approved massage-therapist providers. While few of these plans reimburse therapists for massage work, therapists provide their services to eligible clients for a 20 percent or 25 percent discount from their normal charge rates in return for the plans funneling clients their way. As CAM therapies gain research validation as treatments, they move closer to the realm of conventional medicine, according to NCCAM. While this may pave the way for improved insurance coverage of such treatments, there is some resistance to this movement. Insurance companies take a harder line on funding less well-established practices and criticism of their rate setting and paperwork requirements are legion. ABMP studies and anecdotal information reveal some practitioners enjoy their status and freedom outside mainstream medicine and wish to avoid the additional administrative work associated with insurance reimbursement. They seek to ensure that the “art and heart” of massage maintain important places alongside scientific and clinical research. Consumer demand for these services, and their recognition as legitimate medical expenses, seems likely to drive practitioners and insurers closer together, along with competitive pressure on employers to attract and retain staff. Many therapists have strong feelings about how the profession is viewed and compensated by the insurance industry. To learn more, click here. Rapid Growth in Types of Massage Therapy and Bodywork New massage modalities or techniques seem to be emerging every year — a mixture of truly original approaches and close cousins of established techniques. The field is highly segmented and differentiated. Although this trend fits the individualistic nature of the field, it may be a source of confusion to consumers. There are as many as 250 types of massage and bodywork; various techniques use different strokes, including basic rubbing strokes, rocking movement, posture and movement reeducation, application of pressure to specific points and more. ABMP’s glossary of some 250 modalities has emerged over our 20 years in this rapidly evolving field. The 20 most common modalities used by ABMP members (listed here in order from most practiced to least) are: Swedish Massage Integrative Massage Deep-Tissue Massage Reflexology Reiki Sports Massage Craniosacral Therapy Stone/La Stone/Hot Stone/Hot Rock Neuromuscular Therapy Myofascial Release Shiatsu Prenatal/Pregnancy Massage Therapeutic Massage Trigger Point Therapy Acupressure Chair Massage Lymph Drainage Deep-Tissue Integration Polarity Therapy Thai Massage/Thai Yoga Massage The top two modalities — Swedish Massage and Integrative Massage — account for the majority of work in two-thirds of all massage sessions conducted by ABMP members responding to the survey. Glossary of More Than 250 Entries on Massage Treatments Searchable Archive of More Than 800 Articles, from Acupressure to Zen | |
 
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