During the 1930s and 1940s massage's influence decreased as a result of medical advancements of the time, while in the 1970s massage's influence grew once again with a notable rise among athletes.[12] Until the 1970s, nurses used massage to reduce pain and aid sleep.[21] The massage therapy industry is continuously increasing, with a projected 19% increase between 2008 and 2009. U.S. consumers spend between $4 and $6 billion on visits to massage therapists, as of 2009