Demand for Massage Therapy Is Increasing, While Client Retention Is Dropping to Unacceptable Levels

From the Author

As always, today’s overview is open to discussion, agreement, and disagreement and questions. Some colleagues may say, “I disagree. I continue to succeed and do not see or feel any major changes.” My answer would be: I believe you, and I am happy for you. However, that was not my experience.

To assess the current condition of the massage therapy industry, the best place to look is at large massage corporations, since they employ significant numbers of massage therapists and reflect broader industry trends.

Today, agreements and disagreements must be based on data.

Scale of the Problem

• According to the Centers for Disease Control and Prevention (CDC), approximately 6–7% of U.S. adults — roughly 17–20 million people — were living with Long COVID–related symptoms in 2024.
• The National Center for Health Statistics reports that more than 50% of U.S. adults have multiple chronic conditions, a figure that has steadily increased in recent years.
• The World Health Organization (WHO) recognizes post-COVID condition as a multisystem disorder involving fatigue, cognitive impairment, sleep disturbances, and pain, often persisting for months.

I passionately love practicing medical and sports massage. Every day, I used to go to work as if I were entering an art studio, because every case demanded clinical thinking, activated my own energy and creativity, and provided the excitement of a new challenge — all accomplished through my hands.

And, of course, the greatest reward of all was hearing clients thank me for helping them avoid surgery, regain their quality of life, or, in some cases, feel as though they had their life back.

Then, approximately five years ago, my beautiful professional world suddenly collapsed.

I did not expect it. I was absolutely unprepared for it.

Cases of tension headaches, upper and lower back pain, anxiety, clinical depression, and stress-related disorders — conditions in which I had previously achieved sustainable results within a relatively short course of treatment — suddenly began responding differently. My treatments often caused aggravation or only temporary relief, with symptoms quickly returning.

I became frightened and deeply stressed. I could not understand what was happening. For some time, I could barely sleep. As someone who believes every person is born with a mission, I even began wondering whether it was time for me to stop practicing.

The most painful part was that, for the first time in my 46-year career, I became afraid to provide treatment. I was afraid to touch my clients, fearing that my treatment might worsen their condition. I genuinely prayed for God’s mercy and guidance.

Fortunately, as I explained in one of my articles, I experienced a moment of realization. I remembered my earlier work with burned-out Olympic athletes who demonstrated reactions and symptoms very similar to those now seen in many of my patients.

Immediately, I shifted to massage protocols designed to restore brain function. Thank God, my ability to consistently achieve positive outcomes returned — even in some of the most difficult cases I have ever treated.

Today, I understand that professional burnout is not simply emotional exhaustion. It is a real physiological disorder, complex and serious in nature. I sincerely feel very sorry for the thousands of my colleagues who have experienced professional burnout. I know what it is, and I know how it feels.

Today’s writing should be viewed as a summary and overview of all my articles regarding medical massage in cases of chronic stress-related disorders.

Let Us Review the Massage Therapy Field

Before the COVID pandemic, many spas and massage corporations sustained successful businesses employing thousands of massage therapists by offering pleasant full-body massages that often prioritized comfort over therapeutic outcomes.

Even when massage did not significantly help headaches, musculoskeletal disorders, or stress management, in most cases it did not aggravate the condition. Clients left feeling relaxed and satisfied, returned for additional sessions, and enrolled in memberships.

The same was true for many so-called “deep tissue” massages, where vigorous pressure was applied. Although these treatments often failed to resolve chronic problems, they generally did not create long-term aggravation.

Let’s understand something very important: any form of touch can become destructive therapy.

Yes, I intentionally use the word “therapy.”

Even destructive therapy may temporarily help people feel better. As I described previously, massage corporations and spas succeeded by providing massage therapy — but in some cases also by unintentionally providing destructive therapy through massage.

Today, that model no longer works the same way.

Post-pandemic stress physiology has changed dramatically.

As I described in my articles, the multisystem biological mechanisms involved in chronic stress disorders differ significantly from those associated with acute stress. Prior to the pandemic, many people were suffering from stress-related symptoms, yet most practitioners could still achieve relatively stable outcomes in cases such as:

• tension headaches,
• sleep disorders,
• musculoskeletal pain,
• stress-related muscular tension.

Now we are facing something much more complex.

Again — Scale of the Problem

• According to the CDC, approximately 6–7% of U.S. adults — roughly 17–20 million people — were living with Long COVID–related symptoms in 2024.
• The National Center for Health Statistics reports that over 50% of U.S. adults have multiple chronic conditions.
• The WHO recognizes post-COVID condition as a multisystem disorder involving fatigue, cognitive impairment, sleep disturbances, and pain.

We are discussing approximately 130 million people who, according to 2020–2025 statistics, are traveling from one medical specialist to another while continuing to suffer from chronic symptoms. Inevitably, many of these individuals eventually arrive on our massage tables searching for relief.

This explains the significant increase in demand for massage therapy.

During the last five years, my primary clinical focus has been chronic stress and Long COVID disorders. Every day, I see people suffering from multiple simultaneous symptoms:

• cognitive decline,
• sleep disorders,
• headaches,
• inability to focus,
• chronic fatigue,
• anxiety,
• widespread muscular pain.

Many are truly miserable.

What is even more concerning is the dramatic increase in the prescription of medications that often fail to produce meaningful improvement. I discuss this issue extensively in my articles.

https://www.medicalmassage-edu.com/blog/multisystem-biological-mechanisms-in-long-covid-and-chronic-stressrelated-disorders.htm

Before disagreeing with me, I ask only one thing: please carefully read my articles and directly challenge the specific claims or conclusions with which you disagree.

These articles are the result of extensive personal research conducted to assess the condition of modern healthcare and the growing need for more integrative approaches.

I would also encourage you to review information about my webinar. I am sincerely looking forward to recruiting massage therapists who genuinely want to make a difference in the lives of millions of Americans.

In my master classes, I teach details — what some people refer to as “secrets” — that make it possible to achieve reproducible, outcome-oriented results.

https://www.medicalmassage-edu.com/blog/medical-massage-master-class.htm

Unfortunately, I do not believe the statistics I have discussed will improve anytime soon.

I have argued that massage therapy must play a significant — if not major — role within integrative medicine in addressing chronic stress-related disorders.

https://www.medicalmassage-edu.com/blog/primary-care-physical-therapy-chiropractic-massage-healthcare-changed.htm

Below is a link to my recent article, where I briefly explain why certain treatments are not only ineffective, but in some cases may actually aggravate patients’ conditions.

https://www.medicalmassage-edu.com/blog/limited-durability-of-massage-procedure-facet-joint-focused-chiropractic-corrections-physical-therapy-procedures.htm

For curious minds only .

Between 2020 and 2025, healthcare systems across the United States and globally experienced a dramatic rise in patients presenting with persistent multisystem symptoms — including fatigue, brain fog, headaches, sleep disturbances, autonomic dysfunction, chronic pain, dizziness, and concentration difficulties. Multiple institutions reported that many of these patients cycled through neurologists, cardiologists, rheumatologists, endocrinologists, psychiatrists, sleep specialists, and primary care physicians without receiving definitive diagnoses or effective treatment, often despite normal laboratory and imaging findings. (Cleveland Clinic)

Researchers and clinicians at major medical centers, including the Cleveland Clinic, documented extremely high rates of fatigue, insomnia, non-restorative sleep, and cognitive dysfunction among post-COVID and chronic multisystem patients. In Cleveland Clinic’s reCOVer Clinic cohort, more than 67% of patients reported moderate to severe fatigue, while approximately 41% experienced moderate to severe sleep disturbances, commonly accompanied by “brain fog,” insomnia, and impaired concentration. (Cleveland Clinic)

Mayo Clinic’s multidisciplinary COVID-19 rehabilitation program reported that many patients experienced debilitating fatigue, cognitive impairment, neurologic complaints, and sleep dysfunction despite normal or nondiagnostic laboratory and imaging studies. The Mayo cohort further demonstrated that these symptoms significantly impaired patients’ ability to return to work and perform activities of daily living. (Reddit)

Collectively, these findings contributed to growing recognition that healthcare systems were facing a substantial population of patients suffering from chronic post-viral and stress-related multisystem disorders that challenged traditional diagnostic models and fragmented specialty-based care approaches. (Cleveland Clinic)

Summary

Some of you may agree with my views, while others may disagree. Please do not hesitate to post your opinions, thoughts, and educational perspectives. Equally important, do not hesitate to ask questions.

In any case, please remember that I am, first and foremost, a clinician, and only then an educator, because what I teach comes directly from real treatment-room experience.

As I mentioned in one of my previous commentaries, I have no intention of apologizing for my knowledge or for the depth of my clinical experience. Whenever I make a claim, I am prepared to defend it based on both scientific principles and decades of hands-on clinical application of massage therapy in the treatment room.