Reflexology: A Close Look

Stephen Barrett, M.D.

Reflexology, also called zone therapy, is based on the notion that each body part is represented on the hands and feet and that pressing on specific areas on the hands or feet can have therapeutic effects in other parts of the body. Most proponents claim:

The pathways postulated by reflexologists have not been anatomically demonstrated; and it is safe to assume that they do not exist. Similar rationales are used employed by iridologists (who imagine that eye markings represent disease throughout the body) and auricular acupuncturists who "map" body organs on the ear (a homunculus in the fetal position). The methodology is similar in both of these; and some commentators consider pressing on "acupuncture points" on the ear or elsewhere to be forms of reflexology, but most people refer to that as acupressure ("acupuncture without needles). The Reflexology Research Web site displays charts for foot and hand reflexology. The fees I have seen advertised have ranged from $35 to $100 per session.

Most reflexologists claim that their procedures can relieve stress, which is probably correct with respect to everyday stress. However, many reflexologists describe stress in terms that do not correspond to scientific knowledge. Kevin and Barbara Kunz, for example, state:

The individual's foot reflex areas reflect the individual's overall state of tension that has resulted from a lifetime of adaption to stress. Stress cues in the feet are a roadmap to the reflexologist. Wherever it is found on a foot, it is a sign that stress and its effect have begun to accumulate in the corresponding parts of the body [1]

Many proponents claim that foot reflexology can cleanse the body of toxins, increase circulation, assist in weight loss, and improve the health of organs throughout the body. Others have reported success in treating earaches, anemia, bedwetting, bronchitis, convulsions in an infant, hemorrhoids, hiccups, deafness, hair loss, emphysema, prostate trouble, heart disease, overactive thyroid gland, kidney stones, liver trouble, rectal prolapse, undescended testicles, intestinal paralysis, cataracts, and hydrocephalus (a condition in which an excess of fluid surrounding the brain can cause pressure that damages the brain). Some claim to "balance energy and enhance healing elsewhere in the body." [2] One practitioner has even claimed to have lengthened a leg that was an inch shorter than the other. There is no scientific support for these assertions.

Reflexology was introduced into the United States in 1913 by William H. Fitzgerald, M.D. (1872-1942), an ear, nose, and throat specialist who called it "zone therapy." As noted in the diagram to the right, he used vertical lines to divide the body into 10 zones. Eunice D. Ingham (1899-1974) further developed reflexology in the 1930s and 1940s, concentrating on the feet [3] Mildred Carter, a former student of Ingham, subsequently promoted foot reflexology as a miraculous health method [4-6]. A 1993 mailing from her publisher stated:

Not only does new Body Reflexology let you cure the worst illnesses safely and permanently, it can even work to reverse the aging process, Carter says. Say goodbye to age lines, dry skin, brown spots, blemishes -- with Body Reflexology you can actually give yourself an at-home facelift with no discomfort or disfiguring surgery [7].

Some reflexologists who deny that they diagnose or treat disease claim that the majority of health problems are stress-related and that they can help people by relieving the "stress" associated with various diseases or body organs [1]. This type of double-talk is similar to chiropractic claims that "subluxations" lower resistance to disease and that "adjusting" the spine to correct subluxations will improve health. All ten of the books I have inspected mention scores of health problems that reflexology has supposedly helped.

Pauline Wills, author of the Reflexology and Colour Therapy Workbook, teaches that colors can be applied to "areas where an abnormality has been diagnosed but which has produced no noticeable symptoms in the physical body." She states that the application can be done by imagining colors transmitted through the practitioner's hand or by Firstly, if the practitioner is sensitive to colour, they can visualize it being projected or by using "reflexology crystal torch." [8].

Personal Observations

During the 1990s, I observed at least seven foot reflexologists at work during health expositions. In most cases, the process appeared to be an ordinary prolonged foot massage with little communication between the practitioners and their clients. But at one exhibit, the practitioners claimed that they could reduce stress, cleanse the body of toxins, increase circulation, assist in weight loss, and improve the health of organs throughout the body. On another occasion, I underwent a 15-minute session in which the practitioner felt my foot for diagnostic purposes and then massaged it for "therapeutic" purposes. During the previous year, I had had severe shoulder pain caused by an inflamed tendon that was rubbing against a bony surface inside my left shoulder joint. Thorough medical evaluation had determined that the appropriate treatment was arthroscopic surgery in which a drill is used to shave the bony area that was impinging on the tendon. The reflexologist claimed that he could detect the shoulder problem by feeling my left foot, that it was caused by stress, and that pressing on my foot—perhaps for a few sessions—could solve the problem. His "treatment," which lasted about 10 minutes, consisted of massaging the foot and from time to time, pressing hard on the ball of my foot, a procedure that was quite painful. The "treatment," of course, did absolutely nothing to help my shoulder. A few months later, I had the surgery, which cured the problem immediately and permanently.

Training, "Credentials," and Legal Status

Since reflexology is not recognized by law, no formal training is required to practice reflexology or call oneself a reflexologist. However, some nurses and massage therapists offer reflexology as part of their licensed practice. Some courses are accredited for continuing education for nurses and massage therapists. The most widely publicized training source is probably the International Institute of Reflexology, of St. Petersburg, Florida, which claims to have 25,000 members worldwide [9]. Its seminar on the "Original Ingham Method of Foot Reflexology" are taught by Ingham's nephew, Dwight Byers. Its "Certified Member" status requires 200 hours of instruction plus passage of written and practical tests. As far as I know, this certification process has neither legal nor medical recognition. The Institute's Web site states:

The Ingham Method™ of Reflexology is used primarily for relaxing tension. Doctors agree that over 75% of our health problems can be linked to nervous stress and tension. Reflexology improves nerve and blood supply, and helps nature to normalize.

The International Institute of Reflexology® wishes to make it perfectly clear that it does not purport to teach medical practice in any form; or is the Ingham Method™ of Reflexology intended to replace conventional medical treatment.

Reflexology is a unique modality in the health field. Its purpose is not to treat or diagnose for any specific medical disorder, but to promote better health and well being in the same way as an exercise or diet program. Its practice should not be compared to massage or any other kind of manipulative procedure.

A brochure for a Byers seminar at the Big Sky Somatic Institute quotes him stating:

As a Reflexologist works each reflex, it triggers a release of stress and tension in the corresponding area or body zone, as well as an overall relaxation response. The release of tension unblocks nerve impulses and improves the blood supply to all parts of the body. Because reflexology works from the inside, it also has a balancing effect on each gland, organ and body region. . . ." [10]

Diagnosing or treating disease would constitute the practice of medicine and would be illegal for anyone who does not have a professional license to do these things. Although many diagnose and treat disease, I am not aware of any prosecutions. In some states that license massage therapists, unlicensed reflexologists might also be prosecutable for practicing massage therapy without a license [11].

Sandals, shoe inserts, foot-massage devices and a steering wheel cover based on reflexology theory are being marketed. As far as I know, no such product has a plausible rationale or been scientifically tested. Any medical claims made for such devices would make them "medical devices" under the law and therefore illegal to market without FDA approval.

Research Findings

Although the claims of reflexology are so far removed from scientific reality that testing them might seem a waste of time, a few competent researchers have conducted investigations.

The Bottom Line

Reflexology is based on an absurd theory and has not been demonstrated to influence the course of any illness. Done gently, reflexology is a form of foot massage that may help people relax temporarily. Whether that is worth $35 to $100 per session or is more effective than ordinary (noncommercial) foot massage is a matter of individual choice. Claims that reflexology is effective for diagnosing or treating disease should be ignored. Such claims could lead to delay of necessary medical care or to unnecessary medical testing of people who are worried about reflexology findings.

References

  1. Kunz K, Kunz B. The Complete Guide to Foot Reflexology (Revised). Albuquerque, NM: Reflexology Research, 1993.
  2. Sachs J, New York: Dell Publishing, 1997.Berger J. Reflexology: The A-Z Guide to Healing with Pressure Points.
  3. Benjamin. Eunice D. Ingham and the development of foot reflexology in the U.S. Massage Therapy Journal, Winter, 1989.
  4. Carter M. Helping Yourself With Foot Reflexology. Parker Publishing Company, 1969.
  5. Carter M. Hand Reflexology: Key to Perfect Health. West Nyack, N.Y. : Parker Publishing Company, 1975.
  6. Carter M. Body Reflexology: Healing At Your Fingertips. Parker Publishing Company, 1983.
  7. Spencer R. Mildred Carter announces a new health breakthrough! Blessed relief from 34 common ailments with new body reflexology. Parker Publishing Co., West Nyack, N.Y. Undated flyer received in 1993.
  8. Wills P. Integrating colour with reflexology. Positive Health Magazine, Jan/Feb 1997.
  9. Let us introduce ourselves. International Institute of Reflexology Web site, accessed Feb 25. 2002.
  10. Byers D. Quoted in Somatic Standard 5(1):5, April 2002. Big Sky Institute, Helena, Montana.
  11. Walsh K. The regulatory net. Massage Magazine, March 30, 2001.
  12. Jarvis WT. Reflexology. NCAHF Web site, accessed Feb 25, 2002.
  13. Oleson T, Flocco W. Randomized controlled study of premenstrual symptoms treated with ear, hand and foot reflexology. Obstetrics and Gynecology 82:906-911, 1993.
  14. White AR and others. A blinded investigation into the accuracy of reflexology charts. Complementary Therapies in Medicine 8:166-172, 2000.
  15. Kesselring A. Foot reflexology massage: A clinical study. Forsch Komplementarmed 6 Suppl 1:38-40, 1999.
  16. Brygge T and others. Reflexology and bronchial asthma. Respiratory Medicine 95:173-179, 2001.

This article was revised on September 25, 2004

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