What is Reflexology?
Reflexology aims to mobilize the body’s self-healing processes. It is practiced by applying sustained pressure with fingertips to reflex zones or points on the feet, hands and ears. These points correspond to organs or organic functions.
Reflexology is not a massage technique, insist the practitioners, even if it may look like it at first sight. It would be more like shiatsu or acupuncture. Reflexology does not claim to cure specific ailments. Rather, it seeks to bring relief to all kinds of ailments: headaches or back pain, premenstrual syndrome, stress, respiratory problems, multiple sclerosis, adverse effects of chemotherapy, etc.
The reflex points are not exactly the same on the different reflexology charts. This is explained by two factors. First, as the approach continues to evolve, point location identification may vary slightly depending on research and clinical practice. Then the points on the charters would be indicative. Their exact location may differ slightly, depending on the morphology of the individuals. An experienced practitioner should be able to find the points with good precision thanks to the reactions of his patient. For example, a person with a liver problem may experience some pain if the right reflex point for that organ is pressed. (See Reflexology Research in Sites of Interest for interactive charters.
Illustrations and ancient texts suggest that the Chinese and Egyptians used a form of foot reflexology during antiquity. In the West, one of the first books on the subject was published in 1582 by two European doctors, famous in their time, Dr. Adamus and Dr. Atatis.
Modern reflexology dates back to the work of an American doctor, Dr. William Fitzgerald. While searching for a method of anaesthesia in minor surgery, he discovered that the pain experienced by his patients decreased if he applied pressure to certain points of the body. His theory, developed in 1913, is based on an anatomical model that divides the body into 10 energetic zones, from head to toe, each linked to specific parts of the body: the reflex zones.
It was Eunice Ingham (1889-1974), an American physiotherapist and assistant to Dr. Fitzgerald, who developed reflexology as we know it today in the early 1930s, based on this doctor’s discoveries. She is the author of the first treatise on modern reflexology in which the whole body is literally “mapped” on the hands and feet.
Eunice Ingham has given seminars throughout North America. She also founded the first school of reflexology. Now called the International Institute of Reflexology, this school is run by Dwight Byers, Eunice Ingham’s nephew. They are taught in many countries around the world.
Some hypotheses are put forward to explain the mode of action of reflexology. Thus, the stimulation of certain points could mobilize vital energy, Qi, as acupuncture does. Reflexology may also lead to the production of endorphins, stimulate nerves related to various organs or increase lymph circulation in the body. Another explanation is that it may dissolve deposits in certain areas of the foot due to excess uric acid. To date, none of these hypotheses have been scientifically proven.
No official status
Although reflexology is increasingly used as an alternative approach, whether by professionals or in a simple family or personal setting, it has received little official recognition. Currently only Denmark, China and the United Kingdom1 have integrated it into their health care systems. Its practice is often contested in the medical community2-4. On the one hand, its opponents perceive it as a relaxation method with no real therapeutic effect. On the other hand, its supporters want it to be integrated into recognized health care.
In most countries, it is the regional or national associations that ensure that quality and safety standards are met for both training and practice. Founded in 1990, the International Council of Reflexologists5 is an international network that disseminates the latest advances in reflexology and brings together reflexologists, associations and schools (see Sites of Interest).
The scientific literature on the therapeutic effects of reflexology is still in its infancy. There are more case studies than formal scientific research. Recently, 2 systematic reviews have listed the scientific studies published so far on reflexology3,4. Although the results of a few clinical trials are encouraging, the authors of these two reviews come to the same conclusion: the best available data to date do not convincingly show that reflexology is an effective treatment for the conditions investigated.
Possible efficacy Improve the quality of life of cancer patients. Uncontrolled case studies and controlled clinical trials have been published on the effect of reflexology on the quality of life of cancer patients6-10. The case studies reveal that many of them perceive an improvement in their quality of life, a decrease in their emotional and physical symptoms, a decrease in anxiety, a sense of relaxation and an improvement in their general health and well-being. 77-9 The results of the case studies show that many of them feel that they are experiencing an improvement in their quality of life, a decrease in their emotional and physical symptoms, a decrease in their anxiety, a sense of relaxation and an improvement in their general health and well-being.
A systematic review including 5 small studies was published in 2008. The results suggest that reflexology may also bring benefits such as reduced shortness of breath, fatigue, anxiety and pain11. In people who are terminally ill with cancer, 2 case studies have shown that reflexology combined with music therapy can reduce anxiety, pain and isolation and facilitate communication between patients, family members and nurses12.
Two clinical studies have also yielded some promising results in women with breast cancer. In the first, researchers evaluated the effect of reflexology on adverse effects of chemotherapy10. They found a statistically significant decrease in nausea, vomiting and fatigue in reflexology patients compared to the control group.
The second study aimed to verify the effect of reflexology and massage after breast cancer surgery13. The results suggest that compared to conventional treatment, reflexology and massage significantly improve the quality of life after surgery.
Possible effectiveness Contribute to the treatment of certain mental disorders. A study of mentally disordered patients indicates that reflexology has been beneficial in helping them to relax and manage their anxiety and to give them confidence in their healing power14.
Reducing symptoms of premenstrual syndrome. In a randomized trial of 35 women with premenstrual syndrome, one group received true reflexology (feet, hands and ears) and the other group received placebo reflexology15. The treatments, which lasted 30 minutes, were administered once a week for 8 weeks. In women in the reflexology group, various symptoms (breast tenderness, abdominal swelling, menstrual pain, anxiety, depression and irritability) were significantly reduced compared to the control group. These results persisted for up to 2 months after discontinuation of treatment.
Uncertain effectiveness Facilitate pregnancy. Although there are few clinical studies, anecdotal evidence is cited to justify the benefits of reflexology in pregnant women. In particular, it would reduce working time and better regulate contractions16.
A clinical study published in 200317 looked at the effect of reflexology in reducing oedema of the feet and ankles in pregnant women aged 35 and over. Fifty-five women received lymphatic reflexology, relaxing reflexology or rested for an equivalent period of time. The researchers did not measure any significant differences in edema between the 3 groups. However, patients with lymphatic reflexology reported an improvement: they expressed a higher overall level of satisfaction.
Uncertain effectiveness Reduce headaches. An observational study of 220 patients with headaches (chronic migraines or cerebral tension) was published in 199918. Patients were treated for up to 6 months. After 3 months, 81% of patients reported that treatment improved their symptoms and 19% stopped taking medication. However, this study, without a control group, cannot prove the efficacy of reflexology. Indeed, these results could be due to the normal course of the disease or to the simple fact of receiving a massage.
Relieve back pain. In a small clinical study, 40 people suffering from herniated discs received 3 reflexology treatments in one week19. The author reports a reduction in pain (0.75 on average on a scale of 4) in 25 of 40 patients.
In 2008, a pilot study was conducted in 15 subjects with lumbar pain (40 minutes of reflexology, once a week, for 6 weeks)20. Higher decreases in pain levels were observed in subjects treated with reflexology compared to those receiving placebo.
For chronic lower back pain, the results are contradictory. A randomized controlled trial21 published in 1993 showed a greater improvement in pain, muscle contraction and mobility in the reflexology group than in the placebo group. However, in 2007, results from another randomized clinical trial showed no pain benefit after reflexology treatments were added to routine care22.
Improving the quality of life of palliative care patients. A pilot study has yielded promising results in this regard6. Twelve patients, randomly divided into 2 groups, received 3 sessions of authentic or placebo reflexology. Quality of life improved in both groups. However, patients in the experimental group reported more benefits than those in the control group.
In 2008, the authors of the previous study evaluated the use of reflexology in 21 institutionalized patients with mild to moderate dementia23. The results showed that reflexology could lead to a reduction in pain and stress (measured by saliva tests).
Uncertain effectiveness Decrease the symptoms of multiple sclerosis. In 2003, a randomized clinical trial compared the effect of massage alone or in combination with reflexology on the symptoms of multiple sclerosis24. Compared to the massage-only group, patients in the reflexology group showed a greater decrease in numbness, bladder dysfunction and muscle spasms. The reduction in numbness remained significant 3 months after treatment.
In 2009,2 new randomized clinical trials compared reflexology and progressive muscle relaxation25, or reflexology and placebo treatments26. Comparable improvements in parameters (pain, anxiety, fatigue, depression and quality of life) were observed in all groups (reflexology, placebo and relaxation). These results call into question the specific effects of reflexology on MS symptoms.
Uncertain effectiveness Relieve intestinal problems. A clinical study was conducted to evaluate the efficacy of reflexology in the treatment of young patients with chronic constipation and fecal incontinence27. Fifty children between the ages of 3 and 14 received 6 30-minute foot reflexology treatments. Patients’ bowel movements improved during treatment and the frequency of incontinence decreased.
Reflexology has also been used in a number of other situations, such as irritable bowel syndrome28, Parkinson’s disease29, female constipation30, urinary incontinence31, ovulation stimulation32, postnatal sleep33, menopause34 and stress at work35. But there is currently not enough scientific evidence to recommend reflexology in these cases.
Reflexology is an approach that does not appear to involve significant risks. However, certain precautions should be taken, especially with pregnant women. Indeed, some points could stimulate labour induction or increase fetal movements. Caution should also be exercised for people with cancer or diabetes or problems related to the circulatory and lymphatic systems.