Muscling in on massage for the masses: One of Britain's 'little industries' is trying to shake off its sex-and-sleaze image, reports Elizabeth Heathcote

The massage industry has an image problem: to many it means either sex or being slapped around on a slab of marble in a Turkish bath. 'People just don't take it seriously,' complained Alexandra Mavolwane, one of a growing breed of modern practitioners who are very earnest indeed about their profession.

The popular image is accurate only in part. Some form of massage is still available in a few local authority steam rooms, although many of their clients have been enticed away by the more luxurious private health clubs and the likes of Ms Mavolwane.

For 14 years, Pat Rodgers has given 30 bodyscrubs a day, a pared-down version of the full treatment, at the Ironmonger Row Turkish baths in London. She has watched costs escalate and custom decline steadily. 'No baths could do full massage any more,' she said. 'It wouldn't pay.'

Sexual massage is alive and kicking, as anyone who has used a telephone box in central London and glanced at the stickers will know, but it is unlikely to do much for your rheumatism. But massage therapy may, and this branch of the industry, including all 'serious' muscular massage, is the fastest-growing sector.

Ms Mavolwane is typical of the new-generation masseuse. She was struggling to make a living as a dancer, became intrigued by massage but could not afford it and so enrolled on a short course. A hobby led to a career and she has been practising a form of Swedish massage - the gentle variety that uses oils - for four years.

Like most massage therapists, Ms Mavolwane is self-employed. She has a part- time residency at a health club, teaches at the London College of Massage, is hired by businesses to relax their stress-ridden employees, and devotes the balance of her week to individual bookings and regular clients. She charges pounds 20 to pounds 30 per hour.

It is not a bad return on investment. A weekend course at the London College of Massage costs pounds 90 and professional training starts at pounds 900. The college estimates that its turnover has trebled over the past 18 months, with people from such diverse backgrounds as architecture and stockbroking signing up for a change of career.

But the business is still in its infancy. Estimates of the number of legitimate masseurs average 5,000 but range wildly. There is no system of central registration, no generally recognised qualification and nothing to stop the complete amateur from setting up shop. 'There are a lot of charlatans about,' Ms Rodgers warned.

An assortment of colleges produce practitioners with vastly different levels and types of skill. This lack of clarity adds to the confusion of shy but willing consumers.

'Massage is still a word used by prostitutes and this is a problem,' Ms Mavolwane said. 'It puts people off because they are not really sure where to find the bona fide thing.' She has received bookings from male clients who decline to leave their surname or a contact number and turn tail as soon as they realise their mistake. However the industry is gradually becoming more structured.

The two most important umbrella bodies, which also cover professions such as hypnotherapy, aromatherapy and reflexology, are the Institute of Complementary Medicine and the British Complementary Medicine Association.

They are battling it out to be first with an accepted professional qualification, but disagree fundamentally about the level at which this should be fixed and the way massage should develop. The medically-orientated BCMA wants masseurs operating under the jurisdiction of GPs who have, since the end of last year, been allowed to refer patients; the broader membership of the ICM insists on retaining control over diagnosis.

Conventional medical recognition of the remedial benefits of massage will inevitably hasten a clearer distinction between legitimate and back-street businesses. But there are anxieties that if the profession migrates too far towards the National Health Service controls could become so rigid that a GP's referral might be a prerequisite for a simple lunchtime session of stress relief.

'Practitioners could lose the right to independent practice,' Michael Endacott, deputy director at the ICM, said. 'We want a continuation of the system where complementary medicine is allowed to offer its services to the public.'

Juliet Lowe practises massage and acupuncture, and her services are available on the NHS; she operates as a health promotion worker for a GP. She has no anxieties about the structural changes but sees the rapid growth of the profession as the biggest problem, adding a cautionary note for anyone contemplating throwing up his or her day job.

'A lot of people are training but not practising,' she said. 'So many people want to study now. It will not be long before London at least will be saturated.'