In the UK there are no national governmental regulations related to the practice of massage therapy or commercial massage. There are a number of licensing requirements in certain jurisdictions for businesses where massage is performed.
In the provinces that are regulated, professional massage therapists are referred to as Registered Massage Therapists. Only four provinces in Canada regulate professional massage therapists: British Columbia, Newfoundland and Labrador, New Brunswick, and Ontario. Since 2012 the regulated provinces have had inter-jurisdiction standards of competency, which are spelled out in “Inter-Jurisdiction Competency Standards” dated 2012-06-10.
The province of Quebec is not at this time provincially regulated. Instead massage therapists in Quebec can get a certification with one of perhaps dozens of different associations currently operating. Some of the better-known ones are the Professional Association Of Specialized Massage Therapists of Quebec, which also goes by the name of Mon Réseau Plus, representing 6,300 professional massage therapists, which include naturotherapists, orthotherapists and others. Another association is the "Alliance Québécoise des Thérapeutes Naturels" and the Quebec Federation of Massage Therapists (FMQ), but none of these are regulated by law.
Professional massage is regulated in Germany by the federal government. Someone must complete 3,200 of practical and theoretical training before they can be called a professional “Medizinischer Bademeister und Masseur,” which means Spa Therapist and Medical Masseur. The training consists of Classical and Myofascial Massage, Movement Therapy and Exercise. They can extend their training another 12 to 18 months to become a Physiotherapist.
During training their study includes classes on: Dermiatry and Orthopedics, which are the most important, as well as Anatomy, Electrotherapy, Gynecology, Psychiatry, Surgery, Podiatry and Psychology. They also receive training in Hydrotherapy, which includes: Underwater Massage, Kneipp, Therapeutic Washing, Steambath and Sauna.
Depending on the local collage they will also receive special types of massage, for example: Reflex zone massage for the feet and Thai Massage, etc. Once a trainee graduates they can treat patients, but only under the supervision of a doctor, who is regulated by the body regulating professional Physiotherapists. There are always legal restrictions on advertising and the taking of an oath of confidentiality to protect the privacy of clients.
The Ministry of Health & Family Welfare’s Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha & Homeopathy (AYUSH) license professional massage therapists in India as of March 1995. In India massage therapy is derived from the practice of Ayurveda, which is an ancient medicinal system, popular around 600 BC.
In Ayurveda, massage is practiced as an aspect of a whole range of holistic medicine, as opposed to the various independent types of massage systems that are popular today. Siddha massage is derived from Tamil, the practice of traditional types of medicine practiced in south India, where massage is called “Thokkanam” and is divided up into nine different types, one each for a specific disease.
Massage therapists in Mexico are called “sobadores.” They use lotion or oil and practice a form of acupuncture mixed with faith. Sobadores help relieve problems of the digestive tract as well as pain in the back and knees. Many sobadores literally work out of the bed of a truck, using only a curtain for privacy. They can become what is called a curandero by acquiring additional skills in holistic healing.
Prostitution is legal in many areas of Mexico and prostitutes are legally able to promote a sexual massage. These types of businesses are mostly confined to certain areas of a city, like the Zona Norte in the border town of Tijuana.
Massage is not regulated in New Zealand, although there are two different levels that are registered with Massage New Zealand. This is a professional body dedicated to massage therapy within the country, although these levels receive no governmental recognition. Someone designated as a Registered Certified Massage Therapist is supposed to be competent in practicing relaxation massage. A Remedial Massage Therapist is designated for having achieved competency in practicing orthopedic or remedial massage. Both these levels have agreed upon minimum competencies with a minimum number of hours of training.
Thai massage is recognized as well as regulated by the Thai government as an aspect of traditional Thai medicine. Thai massage is actually considered a respected type of medical treatment in Thailand and is commonly used in the treatment of a broad range of medical conditions and illnesses. Massage therapists, centers, schools and practitioners are more and more being regulated in Thailand by the country’s Ministries of Public Health and Education.
As of 2012 there were 280,000 to 320,000 massage therapists as well as students attending massage schools in the United States. This statistic is according to the American Massage Therapy Association. In terms of the number of accredited massage programs and schools, in 2011 there were 300 in the U.S. Most states in the U.S. do have requirements that have to be met in for a practitioner to call himself or herself a “massage therapist.” In certain states and cities a license must be obtained to practice any type of massage. But if there are no laws in a given state, a massage practitioner does not need to have a license. But a practitioner should check the laws of any county or local municipality to see if they have any laws that apply to massage therapists.
Training programs for professional massage therapists are usually 500 to 1000 hours in the U.S. Upon graduation the student will be awarded a diploma, certificate or degree, all depending on which school they attended. There are approximately 1,300 massage programs in the U.S. and courses usually include kinesiology, massage techniques, anatomy and physiology, CPR, first aid, ethical and legal issues, and business practices. The coursework always provides for hands-on practice, usually with other students, along with requirements for continuing education if the school is regulated. The organization that is most prominent in working to get massage schools in the U.S. accredited is the Commission on Massage Therapy Accreditation (COMTA). As of August 2012 they said there were about 300 massage schools that had been accredited by this organization.
In the United States, forty-three states plus the District of Columbia are currently offering some form of credential to massage professionals and those who do bodywork. This usually comes in the form of a license, certificate or registration. In thirty-eight states plus the District of Columbia a license is required to practice massage therapy. Being certified by the National Certification Board for Therapeutic Massage & Bodyworks (NCTMB) will get you a license to practice massage therapy in thirty-nine states plus the District of Columbia. This is done by rule or statute.
The Board gives you the designation “Nationally Certified in Therapeutic Massage & Bodywork.” There are two different tests that can be taken and you can also become certified via a portfolio process where you document that you have had the equivalent amount of training and experience. Only 10% to 20% of cities or counties actually regulate the massage profession. Being certified by the NCBTMB does not give you the automatic right to practice massage therapy in any state in the country. There could easily be local regulations ranging from prohibiting someone from giving a massage to a person of the opposite sex, requirements to be fingerprinted, checked for venereal diseases by a doctor, to a prohibition on making house calls. These are stem from the concern that someone could be selling sexual services, not merely a massage.
Having a license to practice massage therapy is the highest level of governmental regulation in the U.S. This keeps anyone who does not have a license from practicing the profession or calling himself or herself a massage therapist. Being certified means that person has met certain educational requirements and being registered means the massage therapist has applied and met the required training and education. A massage therapist may very well be certified, but not have a license because the licensing requirements change state-by-state. Often there are additional requirements that must be met besides just attending and graduating from an accredited school of massage therapy and the passing of a state exam.
Most certifications are local in the U.S, but as of March 2014 there were still some states that do not have requirements to be certified or licensed. But, this should change over time as more regulatory agencies are popping up to govern the massage profession. At the moment, some states do allow reciprocity so if a massage therapist who is licensed moves to another state, they can fairly easily get a license to practice massage in their new state. The Federation of State Massage Therapy Boards came out in 2007 with a new certification exam they call the MGLEx. At the current time, 40 states plus the District of Columbia have decided to accept this exam, as well as the U.S. Virgin Islands and Puerto Rico.
In 1997, almost twenty years ago, it was estimated that there were 114 million visits for massage therapy in the U.S. This has become one of the most popular forms of alternative medicine used in hospitals throughout the country. In a one- year period, from July 2010 to July 2011 approximately 38 million American adults, (18% of the adult population) had at least one massage. People say they have massage sessions because they’re seeking pain relief from various injuries and other causes, for stress-reduction, to help them relax, to rehabilitate from sports injuries, to help with anxiety and depression and to enhance their overall health and well being.
In a survey taken of young adults from 25 to 35 years old, 79% said they wanted massage therapy to be covered by health insurance. Many American companies offer their employees massage, and these companies include Allstate Insurance, Best Buy, Cisco, FedEx, Gannett Publishing, GE, Google, HP, Home Depot, Kimberly-Clark, Texas Instruments as well as Yahoo! Duke University Health system in 2006 opened a central where medical disciplines were integrated with CAM disciplines like acupuncture and massage therapy. In 2007 there were a total of 15,500 spas throughout the United States, and 33.3% of visitors happen to be men. The number of visits to spas was 91 million in 1999 and that rose to 136 million in 2003. This generated $11 billion in revenue. So it’s not surprising that the job prospects for massage therapists are expected to grow by 20% from 2010 to 2020 according to the Bureau of Labor Statistics, which is above average growth.