There are approximately 123,000 massage therapists in the United States; of these, over half are self-employed. Job-growth statistics indicate this occupation is likely to grow by 19 percent over the next ten years.
Massage therapists manipulate clients’ muscles to bring them relief from pain, to prevent or minimize sports or other injuries, to reduce stress, or to improve overall health. There are many massage modalities. Reflexology, deep-tissue massage, Swedish massage, sports massage, and neuromuscular massage are the types most familiar to Americans. Each modality uses different techniques or combinations. Long, deep pressure, percussive jabs, light strokes, or working muscles with knuckles, a cupped hand, an elbow, or even by walking on the client’s back are all legitimate massage techniques.

Massage therapists are attentive to their clients’ physical and emotional needs, and adapt the massage appropriately. For example, the deep massage a therapist might use for a sports injury is very different than much more delicate techniques that would be appropriate for elderly clients and small children.

When the massage therapist meets a client for the first time, there is generally a brief, informal interview for the therapist to learn the client’s reasons for massage and to determine medical history. While the massage is under way, the therapist will notice areas of tightly bunched muscles and concentrate on those areas. Some massage modalities are done with lotion or oil to allow the therapist’s hands to glide without resistance.
Massage therapists do their work with clients using a specially designed massage table or chair that is draped with clean linens. The client might remain dressed, if the clothing is loose enough to allow the massage therapist to work. If the client is comfortable being undressed, the therapist drapes the body and exposes each area being worked on in turn.

Many massage therapists are self-employed. Others work for health clubs, chiropractors, wellness centers, hospitals, doctor’s clinics, or sports facilities. Some massage therapists make house calls. Many work in a number of different settings throughout the week. The work environment is tranquil and soothing. Many therapists play soft music or use a water garden feature to minimize noise from outside. Massages are done in a room that is very dimly lit, either by lamp or candlelight. Some therapists scent the air with fragrance candles or incense. There should be very little conversation during the massage, unless the client initiates it. Massage therapists depend on clients who return regularly; this means the therapist must make the experience enjoyable. Therapists need to be sensitive to a client’s unspoken needs and respond to body signals.
Massage therapists spend their workday repeating the same movements over and over. Unless they tend to their own bodies as they do to their clients’ bodies, they may injure themselves or develop carpel tunnel syndrome. They must have considerable stamina, as they will be on their feet for the entire session, which can last up to two hours. When sessions are booked back to back, there is very little time for the therapist to rest. Therapists may spend a lot of time traveling from client to client or office to office, carrying a massage table and other equipment.
Most full-time massage therapists limit their work to 30 hours per week. Nearly half of all massage therapists work part time.
Most states and the District of Columbia regulate massage therapy, although the specific qualifications differ from state to state. In general, a massage therapist is required to pass an examination following graduation from an accredited program. In states where massage is not regulated at the state level, many local governments require certification or licensing. Training is offered in many colleges and learning centers; some programs require 500 hours of study. In addition to learning a variety of modalities, massage therapy coursework includes body mechanics, anatomy, kinesiology, medical ethics, physiology, and business management. Full- and part-time programs are options.
Most states have their own accreditation standards designed by a state board. In addition, many therapists get accredited through an independent agency. In some states, therapists must participate in continuing education to keep their licenses active. Some states accept a national massage therapy certification exam given by the National Certification Examination for Therapeutic Massage and Bodywork (NCETMB) or the Massage and Bodywork Licensing Examination (MBLEx) instead of a state exam.
Career advancement most commonly occurs naturally as a massage therapist develops skill and builds a client base. Many open their own businesses. Others specialize in a particular type of massage or become instructors.
The median hourly pay for massage therapists who are not self-employed is around $17. Those in the midrange earn between $12 and $25 an hour. Those in the highest 10 percent in pay make just under $35 per hour. These figures take into account not only the period of time the massage takes, but also documentation, travel, preparation, and billing. Self-employed massage therapists earn more, but must provide their own equipment and supplies.