Reflexology

DEFINITION: A therapeutic method of relieving pain and tension by stimulating predefined pressure points on the feet and hands by the use of finger pressure.

• PRINCIPAL PROPOSED USES: Allergy symptoms, asthma, back pain, boosting circulation, chronic fatigue syndrome, diabetes, fibromyalgia, gastrointestinal disorders, headaches, premenstrual syndrome, respiratory infections, restoring bodily functions, skin disorders, stimulation of internal organs
• OTHER PROPOSED USES: Complementary to treatments for conditions such as anxiety, asthma, cardiovascular issues, diabetes, headaches, kidney function, premenstrual syndrome, sinusitis

Overview

Reflexology is based on the belief that reflex points on the feet and hands are connected to and correspond to every part of the body. Charts with organs superimposed on the foot and hand are said to map these points. Reflexology is believed to promote healing by stimulating the nerves in the body and by encouraging the flow of blood, a process that not only quells the sensation of pain but also relieves the source of the pain.

Reflexology traces its roots to ancient Egypt and China. In the early twentieth century, American physician William Fitzgerald concluded that the foot was the best place to map parts of the body for diagnosis and treatment. He divided the body into ten zones and determined which section of the foot controlled each particular zone. Fitzgerald believed gentle pressure on a particular area of the foot would generate relief in the targeted zone. This process was originally named “zone therapy.” A few years later, another doctor, Joe Shelby Riley, published drawings of zones of both the feet and the hands to promote what he named “zone reflex.” In the 1930s, Eunice Ingham, a physiotherapist, further developed Fitzgerald’s maps to include reflex points, which were much more specific than the zones used in Fitzgerald’s maps. It was Ingham who changed the name of zone therapy to “reflexology.”

Reflexology is based on the theory that reflex points located in the feet or hands are linked to or correspond to various organs and parts of the body. According to this theory, stimulation of these points is thought to affect the connected organ or body part. By stimulating the reflex points, reflexologists believe they can relieve a variety of health problems and promote well-being and relaxation.

To represent how the body’s systems correspond to one another, reflexologists use reflexology maps. A good example of a reflexology map exists for the feet. Each foot represents a vertical half of the body. The left foot corresponds to the left side of the body and all organs found there, while the right foot corresponds to the right side of the body and all organs found there. For example, the liver is on the right side of the body, so the corresponding reflex area is on the right foot.

Reflexology is similar to acupuncture and acupressure in that it works with the body’s vital energy through the stimulation of points on the body. However, acupuncture and acupressure points do not always coincide with the reflex points used in reflexology. Reflexology and acupressure are both “reflex” therapies in that they work with points on one part of the body to affect other parts of the body. While reflexology uses reflexes that are in an orderly arrangement and resemble the shape of the human body on the feet and hands, acupressure uses more than eight hundred reflex points that are found along long, thin energy lines called meridians that run the length of the entire body.

Reflexology is sometimes confused with massage. While both massage and reflexology use touch, the approaches are very different. Massage is the systematic manipulation of the soft tissues of the body, using specific techniques (for example, tapping, kneading, stroking, and friction) to relax the muscles. Reflexology focuses on reflex maps of points and areas of the body represented on the feet and hands, using unique “micromovement” techniques to create a response throughout the body. Massage therapists work from the outside in; that is, they manipulate specific muscle groups or fascia to release tension. Reflexology practitioners see themselves as working from the inside out, stimulating the nervous system to release tension.

Mechanism of Action

Several theories purport to explain the mechanisms of action involved in reflexology, but none of these have been scientifically proven. Reflexologists propose that when invisible forces or energy fields in the body are blocked, illness can result. Reflexology promotes healing by stimulating the foot, which increases the flow of vital energy to various parts of the body. Reflexology may also promote healing by releasing endorphins, which are natural painkillers in the body. Reflexology could also stimulate nerve circuits and promote lymphatic flow.

According to the beliefs of reflexologists, energy travels from the foot to the spine, where it is released to the rest of the body. They believe that reflexology releases endorphins and detoxifies the body by dissolving uric acid crystals in the feet. Some reflexologists maintain that a tender or gritty area of the foot or hand reflects a current or past disease in the organ linked to that area.

Scientific Evidence

Available scientific evidence does not support claims that reflexology cures any disease. However, it has been shown to help promote relaxation and reduce pain in some people. Generally, these effects are not well understood, and experts caution that more research is necessary before the therapy can be considered scientifically accepted. The vast majority of what is written about reflexology is anecdotal or from small uncontrolled studies rather than randomized clinical trials.

One of the few randomized clinical trials on the subject compared two groups of persons with multiple sclerosis: one receiving reflexology and the other a sham (fake) treatment. The study concluded that reflexology treatment provided statistically significant improvements in motor, sensory, and urinary symptoms.

Many other studies show some promise but are ultimately inconclusive. A 2003 study looked at persons with cancer pain and found that reflexology seemed to help symptoms for a short time. However, the effects were gone three hours after the treatment was completed. A recheck at twenty-four hours showed no difference between the groups. A 2007 study of eighty-six people with metastatic cancer compared reflexology administered by patients’ partners with reading to patients by their partners. The reflexology group reported less anxiety and less pain. Early evidence suggests foot reflexology may help manage some pain and fatigue in persons with cancer.

Reflexology may also reduce anxiety and improve the general quality of life in persons with cancer. However, some studies have shown that reflexology is no better than foot massage in palliative cancer care. Reflexology may help relieve nausea, vomiting, and fatigue in persons with breast cancer receiving chemotherapy. However, further research is needed before a recommendation can be made.

A 2002 study looked at symptoms of menopause in women. All the women in the study received either a reflexology treatment or a placebo foot massage. Participants reported improved menopausal symptoms; no difference was seen between the foot massage and reflexology groups. Reflexology may relieve premenstrual symptoms or menstrual problems; however, more research is necessary to reach a firm conclusion. Research suggests that reflexology also may have beneficial effects in women with urinary incontinence.

In a Danish study in the early 1990s, 220 people with migraines or tension headaches were evaluated. Eighty-one percent of the participants said they were helped by reflexology. Nineteen percent of those who had been taking medication were able to stop after six months of reflexology treatments. However, because there was no control group, scientists who conducted the study cautioned that other factors could have caused the patients’ improved well-being. Reflexology may relieve migraines or tension headaches and may reduce the need for pain medications, but researchers concluded that further study was needed to determine the benefits, if any, of the therapy.

Reflexology may be useful for relaxation, reducing stress, improving sleep, or relieving anxiety related to other medical problems or surgeries. However, it is not clear if reflexology is better than (or equal to) massage or other types of physical manipulation. Research has been inconclusive.

It is unclear if reflexology can help treat bowel problems like irritable bowel syndrome (IBS). One small, controlled clinical trial showed reflexology to be an effective method of treating encopresis (fecal incontinence) and constipation over a six-week period, but further research is needed to confirm these results. Another study found positive results of reflexology used in the treatment of constipation in older adults. Other research failed to find symptom improvements in individuals with IBS using reflexology. However, the participants did experience better sleep and improved energy.

Positive results have been noted when a number of conditions were treated with reflexology. Preliminary research reports that reflexology is a preferred therapy in women with ankle and foot edema in late pregnancy. Early studies suggest that reflexology may help with overall well-being in pregnant women. However, reflexology does not appear to relieve symptoms such as bloating. Further research is needed before reflexology can be recommended for problems related to pregnancy.

Reflexology may possibly help manage type 2 diabetes in some persons, but more clinical trials are necessary to determine whether it is an effective treatment for diabetes. Early research suggests that reflexology may speed recovery after surgery. However, persons who received reflexology also tended to have poorer-quality sleep. It is unclear whether reflexology can benefit persons with lung diseases. Some research suggests that it may reduce fatigue and insomnia in coal miners with lung disease. Preliminary evidence suggests that reflexology is not helpful for chronic lower back pain. Better research is needed to make a firm conclusion.

Choosing a Practitioner

One should do some research before choosing a reflexologist. The goal is to find a practitioner who has been properly trained and who has adequate experience. Asking friends, family, and other healthcare providers for referrals is a good way to find a reflexologist. One can also visit the websites of professional associations, which provide information on reflexology. One should be sure to ask practitioners about their training and certification and should seek a nationally certified reflexologist, one who not only has trained at an accredited institution but also has passed a national board examination.

The New York Times reported in 2015 that it was becoming increasingly difficult for licensed reflexologists to compete with salons offering cheaper services that they illegitimately claim to be reflexology. Differing and sometimes complicated state laws for practice can also be a challenge for practitioners. Some states have required reflexologists to have a license in massage therapy to practice in that state legally. As there is a marked difference between reflexology and other types of massage, those who specifically desire an authentic reflexology treatment should make sure that the practitioner is actually licensed to perform the service.

Despite this, the number of reflexology practitioners continued to grow. In a review of the literature from 1991 to 2021, one study found the prevalence of foot reflexology research increased steadily during this thirty-year period, with many studies focusing on pain, anxiety, cancer, multiple sclerosis, and chemotherapy. Four primary institutions facilitated reflexology research during this period—Michigan State University, Northwestern University, the University of Exeter, and the University of Tehran. With this increased interest, the field continues to expand, increasing the number of practitioners available and their reflexology specialties.

Safety Issues

As with massage and other forms of bodywork, reflexology can generally be adapted to meet the needs of persons with cancer, for example. Deep pressure and vigorous manipulation of the foot should be avoided during times of active treatment for cancer or if the person has edema in the foot or lower leg. It is recommended that persons with cancer not have pressure applied directly to known tumor sites or to lumps that may be cancerous. People with cancer that has spread to the bone or who have fragile bones should avoid physical manipulation or deep pressure because of the risk of fracture. Bodywork should be provided by a trained professional with expertise in working safely with people who have or had cancer.

People with recent or healing fractures, unhealed wounds, or active gout affecting the foot should avoid reflexology. A person with osteoarthritis affecting the ankle or foot or who has severe circulation problems in the legs or feet should seek medical consultation before starting reflexology. People with chronic conditions such as arthritis and heart disease should talk to their doctors before having any type of therapy that involves moving joints and muscles.

Like other alternative therapies, reflexology is considered complementary to—not a replacement for—science-based medical care. Relying on this type of treatment alone and avoiding or delaying conventional medical care may have serious health consequences.

Bibliography

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