It’s 9pm, the last client left two hours ago, and you’re reading a “top 10 massage trends” article on your phone. Cupping is back. Wearables are coming. AI will personalise every treatment. None of it has a source, and none of it tells you whether to hire another therapist next spring.
Most trend content for this industry is written to fill a calendar. So this piece sticks to what the employment data, the consumer surveys and the published research actually show, with the year on every number. Then it gets into what a small clinic can reasonably do with it.
The job numbers are strong on both sides of the border
In the US, the Bureau of Labor Statistics counted about 155,400 massage therapist jobs in 2025 and projects 15% growth from 2025 to 2035. The average for all occupations over that period is 3%. BLS expects around 20,400 openings a year, and it puts self-employment at 36%, the largest single group.
Canada tells a similar story with smaller numbers. The federal Canadian Occupational Projection System estimated 45,000 massage therapists employed in 2023, with employment growing about 2.5% a year against a national average of 1.2%. It rates the occupation at moderate risk of a labour shortage through 2033. Job openings (21,500) and job seekers (22,200) are projected to run almost neck and neck.
The Ontario picture is worth a look if you run a clinic there. Job Bank rates the 2025 to 2027 outlook for RMTs in Ontario as good, and very good in the Toronto region. It also reports that 86% of massage therapists in the province are self-employed and 47% work part-time. Its stated demand drivers are a growing and aging population and wider use of massage for chronic and acute pain.
What this means in practice: demand isn’t the hard part. Finding and keeping therapists is. If you have tried to hire recently, you already knew that, and the projections say it won’t loosen up soon.
Clients are booking for health reasons
The biggest shift in the consumer data is why people book. In AMTA’s 2025 consumer survey of 1,000 US adults, 71% of massage consumers had used massage for a health or medical reason in the previous 12 months. 86% agreed massage should be considered a form of health care. Only 29% saw it as pampering. Consumers averaged 2.7 massages in that year.
AMTA’s 2026 Massage Profession Research Report fact sheet breaks the reasons down. Soreness, stiffness or spasm came in at 49%, relaxation and stress reduction at 43%, chronic pain at 42% and injury recovery at 36%. Mental health reasons were cited by 26%.
Relaxation hasn’t gone away, but it now sits inside a bigger health picture. A client booking for a sore lower back has different expectations than one booking a birthday treat. They want to be asked about their history and given a plan that carries over to the next visit. Many also want a receipt their benefits provider will accept.
Who’s booking, and who isn’t yet
The same 2026 fact sheet found that 23% of men and 19% of women had a massage in the past year. Income splits the market sharply: 34% of people in households earning $100,000 or more got a massage, against 14% of those earning $50,000 or less.
That income gap matters for pricing and for how you talk about coverage. In Canada, extended health benefits often decide whether a client books monthly or twice a year. Clear direct billing or a clean, insurance-ready receipt can do more for retention than a promotion. Our guide to how medical massage billing works covers the paperwork side.
Referrals from other health professionals are a real channel
AMTA’s 2026 fact sheet lists where massage therapists get referrals: 74% from other massage therapists, 64% from other health care professionals and 60% from chiropractic offices.
When almost two thirds of therapists get work from other health care providers, a physio or family doctor who trusts your notes is one of your best growth channels. That trust is built on documentation. If a referring practitioner asks what you found and what you did, you should be able to answer from a proper SOAP note. We wrote about turning that into a habit in building a referral system.
Hivemanager.io keeps intake forms, SOAP notes and visit history on one client record, so a referral update takes minutes instead of a search through paper files.
The research is growing, and it’s honest about its limits
Clients and referring clinicians will ask whether massage works. The most useful recent answer is a 2024 review of systematic reviews in JAMA Network Open. The authors found 129 systematic reviews of massage for adult pain published between 2018 and 2023. Of the conclusions they mapped, none reached high certainty. Seven reached moderate certainty, and all seven found a benefit. Those covered low back pain, fibromyalgia, labour pain, myofascial pain and pain after breast cancer surgery.
So the honest position is that the evidence is encouraging for some conditions and thin for others. The authors asked for better trials that compare massage with other active treatments. For a clinic, that is a reason to avoid overclaiming in your marketing, and to describe what you work on in plain terms.
What to do with all this
Trends are only useful if they change a decision. Here are the moves we’d make.
Set your intake up for health-focused clients. If most people now book for pain or recovery, your intake forms should capture history, medications and goals before the first visit, not on a clipboard in the waiting room.
Pick two referral partners and send them something useful. A physio clinic or chiropractor nearby, plus one family practice. A short note after a shared client’s visit does more than a stack of business cards.
Plan hiring around the shortage. With openings and job seekers running close in both countries, retention of the therapists you have is worth more than another ad. Our piece on why massage therapists leave covers the common reasons.
Watch your own numbers. National data describes averages. Your rebooking rate, your therapist utilization and the share of clients who come back a second time are the trends that pay your rent. Check them monthly in your reporting.
The national data says more people are booking massage, more of them for health reasons, while therapists stay hard to find. None of that requires a new modality or a gadget. It mostly rewards clinics that take good notes and keep their therapists around.