Mention the word spa and many folks are inclined to think: guilty pleasure.

Not so fast. With baby boomers getting older and hectic lifestyles the norm, the spa industry finds itself returning to its origins in preventive health care.

“It’s a big shift from a place of pampering to a place of wellness,” says Lynne Walker McNees, executive director of the International SPA Assn., based in Lexington, Ky. “You’re getting a lot more savvy spa consumers so they are driving the demand. Even in the last two years we’ve seen the numbers jump.”

Spa visits aren’t limited to the time-tested standards — facials, pedicures and massages.

Instead, a four-day spa package could include teams of doctors working with clients on ways to manage chronic pain. Resorts and hotels often staff certified nutritionists and fitness instructors. Hospitals and medical centers are pairing with spas to offer services for post-surgery patients and corporations.

Even the once-dreaded trip to the dentist has morphed into a pleasant retreat at dental spas that incorporate aromatherapy and massage during teeth cleanings.

“What we’re finding is that if you’re stressed out, you’re not healthy,” Walker McNees says. “After 9-11, we were all rocked to the core. People are looking for a safe haven to take care of themselves.”

More than 155 million spa visits were made in the United States in 2001, according to a PricewaterhouseCoopers study commissioned by the spa association.

The 2002 report also found women aren’t alone in the quest to relax, regroup and recharge. Men account for nearly 24 percent of spa customers.

The Chateau Elan Spa in Braselton, Ga., offers a program that combines spa treatments -- such as this hydrotherapy tub -- with fitness assessments, medical lab work and consultations.

With an estimated 9,600 facilities nationwide and 1,300 in Canada, the spa industry drew $10.7 billion in revenues in 2001. Visits continue to rise — by 71 percent between 1999 and 2001.

“It’s not just ‘make me pretty,'” explains Michael Tompkins, associate hotel director at Canyon Ranch Health Resort in New England’s Berkshire Mountains.

“What we are seeing is spa guests now using us as their primary health care facility,” he says. “Spas are a really safe way to try an alternative approach to preventive medicine. People are looking at spas for the full mind, body, spirit aspect of health.”

A healthful vacation

Canyon Ranch, a luxury destination spa, also provides sanctuary at facilities in southern Arizona, Las Vegas and Florida. For nearly 25 years, its integrative approach has made it a model for the ultimate spa experience.

A weeklong Life Enhancement Program offered at Canyon Ranch’s spa in Tucson, Ariz., focuses on aging, stress reduction, weight management and medical risks. Guests can choose from a broad menu of spa services, such as yoga and therapeutic bodywork. Or, they can try their hand at a culinary nutrition workshop or daily spiritual fitness classes (relaxation, meditation and breathing techniques).

Expect to pay between $1,500-$4,400 for the most popular packages — which stand as bona fide vacations. This year’s summer sampler in Arizona costs $1,590 per person based on double occupancy. The seven-night package is $2,565 (through Sept. 27). Winter/fall rates begin at $2,170.

“It’s a tough economy, but people don’t see this as a luxury or indulgence,” says Dr. Pamela Peeke, the spa association’s medical adviser and contributing columnist for Prevention magazine.

“Physicians so rarely have a chance to deal with prevention,” adds Peeke, assistant clinical professor at the University of Maryland School of Medicine. Spas encourage rest and rejuvenation, Peeke explains, and medical-based services have a legitimate place at spas.

Guests at Canyon Ranch Health Resort in Tucson, Ariz., can choose from services, including a medical stress test.

Winsor Pilates creator and fitness trainer Mari Winsor agreed. At 53, she divides much of her time between her fitness studios in Los Angeles.

“We do a lot of rehabilitative work in our studios,” Winsor says. “The health benefits far outweigh the aesthetics. It’s more about working from the inside out. You do that and your inner beauty shows.”

Obesity, diabetes and heart disease have become universal concerns.

“People my age now work out,” Winsor says. “They’re interested in improving the quality of life. The alternatives for fitness are much better suited for a generation of people who want to be around longer to see their grandchildren.”

Focusing on prevention

This spring, Chateau Elan Spa in Braselton, Ga., launched a pilot program with Tennessee-based Lotusea Wellness Group Inc. The program blends spa treatments, fitness assessments, medical labwork and consultations.

Sandra Breeding, of Johnson City, Tenn., decided to create the Lotusea Wellness Program years after she established a health-oriented franchise aimed at the corporate sector.

“This is a holistic approach,” the former hospital administrator says. “You’ve got to focus on prevention and education, not sickness.”

After considering several locations, Breeding chose Chateau Elan Spa, a 30,000-square-foot European-style health spa that sits on a small lake 40 minutes north of Atlanta.

The picturesque, serene setting and helpful staff ease any qualms about health issues. “It’s so stress-free, you’re not in a waiting room with others who are sick and that makes you feel good for that minute,” Breeding says.

Sessions will be offered monthly through December.