A massage sounds like the perfect way to relax. Get one at a spa, though, and itmay turn out to be a royal pain.

1. "You wanna relax? Take a number."
Americans spend $2.6 billion a year on Prozac, but apparently pills aren't enough. In search of bliss and a good rubdown, they're also flocking to spas: People make 95 million spa visits each year.

And while spa brochures promise such benefits as "finding yourself and nurturing your soul," what you're more likely to find is a whole bunch of strangers -- all vying for the same services you want.

Those crowds mean that it can be almost impossible to schedule appointments for treatments -- the whole reason you're there to begin with. When Bernard Burt, a veteran travel writer and co-author of the book 100 Best Spas of the World, visited Ancient Cedars Spa at Wickaninnish Inn on Vancouver Island (where a two-night spa package can go for over $500), he found guests scrambling to get all the treatments they wanted. "The spa is just too small," Burt says. "They can't keep up with demand." Ancient Cedars manager Stephanie Molyneaux admits that Burt has "a valid point," adding that the spa plans to add two treatment rooms within the next year.

Jenni Lipa, president of Spa Trek Travel in New York, does her research to avoid the crowds. "I look at the ratio of spa treatment rooms to guest rooms and the ratio of spa staff to clientele," she says. At a destination spa, one treatment room per 10 guest rooms, or one staffer per guest, is a good sign, according to Lipa. "If a 300-room hotel has only three spa treatment rooms, that's a problem."

2. "The brochure rate is just an opening bid."
Everyone knows spas aren't cheap. The nation's top spas -- including the Golden Door in Escondido, Calif., and the Greenhouse in Arlington, Tex. -- will run you around $5,000 per week.

But hidden extra costs can jack up your tab fast, even at a reasonably priced spa. The biggest culprit: gratuities, which are included in the prices at some spas but not at others. "It's appropriate to tip 15% for services, and that can add up if you have three $150 services a day," says Lynn O'Rourke Hayes, editor of online magazine Spa Reporter.

Many spas will also try to sell you pricey skin-care products following your treatment. While you're not required to buy, "they're very pushy sometimes about selling these products," Burt says. "You're relaxed after a massage and susceptible to suggestion. It's big money for them."

3. "We'll rub you the wrong way."
Massages come in a variety of formats these days, from intense deep-tissue work to reiki, in which the masseur barely touches you. When you enter the massage room, you may have no idea what kind you're getting.

Terry Herman, a management consultant and spa industry adviser in Westmont, Ill., thought she was scheduled for a relaxing 45-minute massage when she visited the Heartland Spa in Gilman, Ill., in 1997. Then the masseur began kneading her so forcefully that she almost cried out in pain. Herman, who has chronic back problems, asked him three times to lighten his touch, but, she says, he seemed too absorbed in his work to notice. "I complained to management, but they didn't care," Herman says. The next day, Herman saw that she was covered with bruises. Mary Quinn, Heartland's executive director, says that although she does not recall Herman's visit, "one of the greatest assets of the Heartland is the way we handle guests." She adds that Heartland masseurs are certified by the state of Illinois and must complete in-house training, which includes instructions on how to interact with clients.

Herman had a similar harrowing experience with a facialist at a Chicago day spa. "She broke some of the capillaries on my face," Herman says. "To get them fixed, I would have to get laser surgery."

What's a client to do? "You have the right to ask the therapist to lighten his touch," says Susan Lord, M.D., of the Center for Mind-Body Medicine, an educational institute in Washington, D.C. "If he doesn't listen to you, get off the table right away."

4. "Our therapists aren't trained."
There are today 5,700 spas in the U.S. alone, generating over $5 billion in revenue every year -- a 152% jump since 1997. With so many new spas opening, finding enough trained masseurs, facialists and personal trainers has become a challenge. "With so much demand, it's getting harder and harder to recruit people," says Burt. "Spas have to take what they can get."

And they get away with it, because the rules are lax at best. The International Spa Association (ISPA) -- the closest thing to a governing authority for spas -- requires that employees who provide treatments at its member spas meet certain state requirements for licensing (such as completing 500 hours of training and passing a state exam). But thanks to individual state laws, that rule doesn't amount to much, says Sara Eavenson, co-founder of the Bramham Institute, a spa and spa-training center in West Palm Beach, Fla. "Some states don't require licenses," she says, "which is really scary."

She suggests this litmus test: If you're getting a facial, the ultimate stamp of approval for facialists is certification from CIDESCO, an international school for estheticians. When in doubt, says Robert Stergas, manager of Syracuse, N.Y.'s Onondaga School of Therapeutic Massage, look for massage therapists who have been certified in either New York or Florida, since these states have the highest standards for licensing (in New York, for example, a massage therapist must complete at least 1,000 hours of classroom instruction, followed by a comprehensive exam).

5. "Some of our treatments are silly..."
According to the International Spa Association, 71% of spas say they are adding new treatments this year, which range from the bizarre (like "aura imaging," in which a special camera takes a full-color photo of your "energy field") to the just plain goofy-like the $95 "barbecue wrap" at Dallas's The Spa at the Crescent, in which a massage therapist slathers you with a mixture of honey, tomato paste, cayenne pepper and corn meal.

Do such treatments have any real purpose? Anne Melby, the Crescent's spa director, says that their wrap "exfoliates and smoothes dry skin, stimulates circulation and helps rid the body of toxins. And it smells fabulous -- you just want to eat it." Dr. Lord isn't impressed. "I can't think of any biochemical reason why these food treatments would be useful," she says.

6. "...and others are downright dangerous."
Many people go to spas in search of better health, and many spas have responded by trying to play doctor, offering such procedures as hormone-replacement therapy and chelation therapy, which claims to clean out fatty deposits in the circulatory system. Yet only 3% of spas are officially designated "medical spas," according to the ISPA.

Spas that don't ask specific questions about your medical conditions or allergies should definitely arouse suspicion. Even some of the most traditional spa treatments can be hazardous to your health. Twenty minutes in the sauna, steam room or Jacuzzi can be dangerous for someone who suffers from diabetes, high blood pressure or heart disease, says Mary Tabacchi, a professor at the Cornell University School of Hotel Administration and a member of ISPA's board of directors.

Hydrotherapy, a toxin-purging treatment that involves alternating hot and cold showers, deserves special caution, explains Eavenson. "That's the most dangerous and misunderstood treatment in a spa. Anyone getting into a hot bath should be asked if they have a heart condition. Make sure you ask the therapist what kind of bath you should be having and why."

7. "We're not even really a spa."
According to a recent study by the accounting firm PricewaterhouseCoopers, the number of spas in the U.S. is growing at a rate of 21% a year. More than 70% of these establishments call themselves "day spas" -- meaning no overnight accommodations -- and many inside the industry think that term is getting abused. "Everybody calls themselves a day spa," says Hannelore Leavy, executive director of the Day Spa Association, a 250-member group based in West New York, N.J. "They just put a massage table with a curtain at the back of a salon."

To be accredited by the Day Spa Association, a spa must have a private treatment room for each client receiving a personal service, and attendants must be trained in any products they're using. It should also offer at least four types of massage and four other body treatments (such as body wraps and exfoliation, as well as facials and aromatherapy). Leavy says the DSA visits "most" member spas to check on standards and offers a questionnaire on its Web site (www. dayspaassociation.com) for consumers to voice complaints about particular spas, which the association then tries to resolve.

Pseudo-spas, on the other hand, can put unsuspecting visitors in pretty weird situations. "I had a friend on business in Chicago who asked the concierge at her hotel about local spas," Leavy says. "She wound up in a massage parlor. She got the massage, but was more stressed out when she came out than when she went in."

8. "No one understands what we do."
Sure, glossy travel brochures often overstate the beauty of resorts and hotels. But in the spa industry, the problem of pumped-up advertising is even more pronounced. Why? Mostly because the industry is so new and poorly understood. For starters, there's the problem of ever-changing trends (ever heard of "abhyanga"?), plus the fact that there are few travel agents who are up to speed on the spa industry, making consumers even more reliant on an individual spa's marketing materials. That's why Jenni Lipa recently began a special training program to turn her colleagues into "spa specialists." "Travel agents really don't know how to define a spa," she says.

Unfortunately, you can't rely on many spa magazines either -- like SpaFinder and even Spa Reporter, which get commissions when consumers book spa vacations through them. (An objective source to check out: the Web site Epinions.com, which posts unbiased consumer reviews.)

9. "We're underinsured..."
With the spa industry growing at such a rapid clip, consistent standards have become an afterthought. Industry associations do exist, but membership is strictly voluntary. The biggest one, the ISPA, represents about 1,700 spas world-wide, but its application process isn't exactly grueling. Members must agree to abide by the association's "standards and practices," which include such bare minimums as clean treatment rooms and staffers trained in CPR. "It's difficult for a trade association to come up with any certification, because the laws vary so much from state to state," admits the ISPA's executive director Lynne Walker.

Because spas don't have anyone looking over their shoulder, most have inadequate insurance coverage, says Mary Lynne Blaesser of the Marine Agency, which has provided coverage for over 2,000 spas. "The only insurance spas are required to carry is workers' comp insurance," Blaesser says, which is bad news for consumers. Adds Guy Jonkman, publisher of trade publication Spa Management Journal, "If (a spa) puts you in a bath that's too hot, they often don't have a policy to cover it."

10. "...so if you're not happy, you may never get your money back."
The combination of spotty insurance and almost nonexistent refund policies means one thing for dissatisfied customers: Good luck collecting if something goes wrong -- and that applies to even the most egregious mishaps. Leandros Vrionedes, a personal injury lawyer in New York, had a client whose day-spa facial turned into a horror show. "The esthetician oversteamed the client and applied the wax immediately after," he says. "She wound up taking part of this person's face off -- several layers of skin were removed. The spa argued that it was the fault of the product and we didn't have a case. We argued that it was the procedure." After more than four years of legal wrangling, Vrionedes's client is still in limbo: Although she won the initial case against the spa, the defendant has appealed.

Even when a spa does have insurance, consumers may have a tough time obtaining compensation for injury. "Some insurance companies will fight you tooth and nail," Vrionedes says. Don't assume, though, that you have no case just because of some lengthy waiver that you signed when you arrived at the spa. Some hold up in court, but others won't, according to Vrionedes, especially those that are all-encompassing. If the release "absolves the spa of absolutely everything in the world," he says, sometimes courts will void the agreement.