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Reflexology

Other common name(s): zone therapy, reflex therapy, foot reflexology, hand reflexology, ear reflexology

Scientific/medical name(s): none

Description

Reflexology is a treatment that uses pressure on specific areas of the feet with the goal of relieving a variety of problems and balancing the flow of vital energy throughout the body. Some reflexologists press on the hands or ears along with or instead of the feet.

Overview

Evidence from some studies suggests that reflexology may be useful for relaxation and reducing pain and anxiety. However, these results may be at least partly explained by the placebo effect. Available scientific evidence does not support reflexology as a treatment for cancer or any other disease.

How is it promoted for use?

Reflexology is based on the theory that reflex points, located in the feet, hands, or ears, are linked 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 claim that they can relieve a wide variety of health problems and promote well-being and relaxation.

Some proponents claim that reflexology can help conditions such as respiratory infections, headaches, asthma, diabetes, back pain, premenstrual syndrome, and problems with the skin and gastrointestinal tract. They also say reflexology can stimulate internal organs, boost circulation, and restore bodily functions to normal. According to their beliefs, energy travels from the foot to the spine, where it is released to the rest of the body. Some reflexologists say that a tender or gritty area of the foot or hand reflects a current or past disease in the organ linked to that area.

What does it involve?

The reflexologist may start by asking health questions before examining the feet. He or she will gently examine a person's feet while the client sits in a special chair or lies on a massage table, then apply pressure to selected reflex points on the feet. Sometimes the client will notice tender areas on the feet as they are touched. Some people report tingling sensations in other areas of the body while the reflex points are being touched. Most sessions take from 30 minutes to 1 hour. Some people learn to apply reflex pressure to their own or a family member's feet. A few reflexologists work on the hands, and some work on both the hands and the feet. Others work on the ears as well.

Since reflexology is not legally regulated in most states, no formal training may be required before a person can call him or herself a reflexologist. The practitioner may have taken courses from a massage or reflexology school, studied reflexology books, apprenticed with another practitioner, or learned in some other way. There is at least one US group that offers to certify reflexologists who meet their educational standards, pay the testing and certification fees, and pass their test.

Some massage therapists, chiropractors, nurses, and others use reflexology techniques in their practices.

What is the history behind it?

Reflexology traces its roots to ancient Egypt and China. In the early twentieth century, an American physician, William Fitzgerald, MD, decided the foot was the best place to "map" parts of the body for diagnosis and treatment. He divided the body into ten zones and decided which section of the foot controlled each zone. Dr. 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 named Joe Shelby Riley published a book with drawings of zones on both the feet and the hands to promote what he called Zone Reflex. He also mapped a few zones on the outer ear.

In the 1930s, Eunice Ingham, a nurse and physiotherapist, further developed Dr. 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.

Training programs and certification are now available from reflexology organizations, but these organizations are not regulated by any government agency.

What is the evidence?

Available scientific evidence does not support claims that reflexology cures cancer or any other disease. However, it has been shown to help promote relaxation and reduce pain in some people. Most evidence regarding reflexology is based on individual (anecdotal) reports or small studies.

A 2003 study looked at patients with cancer pain and found that reflexology seemed to help symptoms for a short time. However, the effects were gone 3 hours after the treatment. A recheck at 24 hours showed no difference between the groups. A 2007 study of 86 people with metastatic cancer compared reflexology administered by patients' partners to reading to patients by their partners. The reflexology group reported less anxiety and less pain just after the reflexology was given.

A study done in 2002 looked at symptoms in menopausal women. All the women received either a reflexology treatment or a placebo foot massage. They all reported improved menopausal symptoms, with no difference between the foot massage and reflexology groups.

These kinds of study results are often seen with the placebo effect, in which patients feel some temporary improvement in symptoms after they receive a treatment they expect to be effective, even if the treatment is known to be inactive. For example, some patients feel better after taking a pill that contains sugar or some other inactive ingredient, or after a sham procedure. It sometimes takes careful studies to distinguish out this type of effect from a real benefit due to a treatment. In evaluating reflexology, for example, it is not very useful to compare reflexology to no treatment at all or to a completely different treatment, such as listening to someone reading. It is more helpful to compare a reflexology treatment to an ordinary foot massage that is not guided by reflexology theories. So, this 2002 study suggests reflexology and an ordinary foot massage both may help women to relax or may distract them from menopausal symptoms. On the other hand, these results do not support the idea that a particular part of the foot can affect the female reproductive system and specifically improve symptoms of menopause. The placebo effect is still being studied to learn more about how and why it happens; see our document, Placebo Effect.

A 2010 review looked carefully at all the published studies of reflexology to see how each study was done and how it came out. The reviewers concluded that the best evidence they could find did not convincingly show reflexology was an effective treatment for any medical condition.

Are there any possible problems or complications?

As with massage and other forms of bodywork, reflexology can generally be adapted to meet the needs of cancer patients. Deep pressure and vigorous manipulation of the foot should be avoided during times of active treatment for cancer, or if there is swelling in the foot or lower leg. It is recommended that cancer patients 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 (broken bones). Bodywork should be provided by a trained professional with expertise in working safely with people who have cancer and with cancer survivors.

People with cancer and 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.

Relying on this type of treatment alone and avoiding or delaying conventional medical care for cancer may have serious health consequences.

Additional resources

More information from your American Cancer Society

The following information on complementary and alternative therapies may also be helpful to you. These materials may be found on our Web site (www.cancer.org) or ordered from our toll-free number (1-800-227-2345).

Dietary Supplements: What Is Safe?

The ACS Operational Statement on Complementary and Alternative Methods of Cancer Management

Complementary and Alternative Methods and Cancer

Placebo Effect

Learning About New Ways to Treat Cancer

Learning About New Ways to Prevent Cancer

References

Aetna InteliHealth. Reflexology.. Accessed at www.intelihealth.com/IH/ihtIH/WSIHW000/8513/34968/360060.html on January 25, 2011.

American Academy of Reflexology. History of reflexology. Accessed at www.americanacademyofreflexology.com/HistoryOf.shtml on January 25, 2011.

American Reflexology Certification Board. Accessed at http://arcb.net/cms/ on January 26, 2011.

Barrett S. Reflexology: a close look. Quackwatch Web site. Accessed at www.quackwatch.org/01QuackeryRelatedTopics/reflex.html on January 25, 2011.

Cassileth B. The Alternative Medicine Handbook: The Complete Reference Guide to Alternative and Complementary Therapies. New York, NY: W.W. Norton; 1998.

Ernst E, Posadzki P, Lee MS. Reflexology: An update of a systematic review of randomised clinical trials. Maturitas. 2011 Feb;68(2):116-120.

Hodgson H. Does reflexology impact on cancer patients' quality of life? Nurs Stand. 2000;14:33-38.

Oleson T, Flocco W. Randomized controlled study of premenstrual symptoms treated with ear, hand, and foot reflexology. Obstet Gynecol. 1993;82:906-911.

Quattrin R, Zanini A, Buchini S, et al. Use of reflexology foot massage to reduce anxiety in hospitalized cancer patients in chemotherapy treatment: methodology and outcomes. J Nurs Manag. 2006;14:96-105.

Ross CS, Hamilton J, Macrae G, et al. A pilot study to evaluate the effect of reflexology on mood and symptom rating of advanced cancer patients. Palliat Med. 2002;16:544-545.

Stephenson N, Dalton JA, Carlson J. The effect of foot reflexology on pain in patients with metastatic cancer. Appl Nurs Res. 2003;16:284-286.

Williamson J, White A, Hart A, Ernst E. Randomised controlled trial of reflexology for menopausal symptoms. BJOG. 2002;109:1050-1055.

Note: This information may not cover all possible claims, uses, actions, precautions, side effects or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for consultation with your doctor, who is familiar with your medical situation.

Last Medical Review: 04/14/2011
Last Revised: 04/14/2011