The latest in an occasional series.
Wikipedia describes reflexology as:
an alternative medicine, complementary, or integrated medicine method of treatment involving the physical act of applying pressure to the feet and hand with specific thumb, finger and hand techniques without the use of oil or lotion.
This is essentially a description of massage. So far, so reasonable. Now, though… here comes the pseudoscience:
A natural healing art based on the principle that there are reflexes in the feet, hands and ears and their referral areas within zone related areas, which correspond to every part, gland and organ of the body. [The Reflexology Association of Canada]
Reflexologists posit that the blockage of an energy field, invisible life force, or Qi, can prevent healing. [Wikipedia]
The idea of an invisible life force that can be unblocked by massage is an interesting one. I’ll link to this page on Wikipedia: Vitalism and leave it at that.
Presumably, the assertion that areas in the hands, feet, and ears correspond to every part, gland and organ of the body means that reflexology can help with afflictions in any part, gland or organ of the body. The Association of Reflexologists are being rather modest in this section of their website then:
Reflexology may be used to help restore and maintain the body’s natural equilibrium. This gentle therapy encourages the body to work naturally to restore its own healthy balance. There is some suggestion that reflexology may aid:
- Stress-related conditions
- Back Pain
- Fertility issues
- Sleep disorders
- Hormonal Imbalances
They then go on to write, though, that “Reflexology is suitable for all ages and may bring relief from a wide range of acute and chronic conditions. After having completed a course of reflexology treatments for a specific condition, many people find it beneficial to continue with regular treatments in order to maintain health and well-being.” [Page saved as PDF]
There is at the bottom of the page a list of ailments, with links to information sheets.
The first leaflet is on allergies:
For the lesser problems with allergies, the theory that reflexology brings back systems to balance may be of use here, there is a potential for rebalancing the immune cells and thus reducing the hyper reaction to the allergen.
That reflexology “brings back systems to balance” is not so much a ‘theory‘ as ‘speculation about an ill-defined, invisible life force’.
Despite apparently being founded in nonsense, and therefore an implausible remedy, could it be the case that reflexology works despite being implausible? Well, the available evidence suggests that it may not even be useful for some of the ailments listed by the AOR.
The AOR’s leaflet claims that “the only way to know whether reflexology will help your particular symptoms or problems is to try it and see” – to ask the patient, in other words. I beg to differ (as might Edzard Ernst). If reflexology works, then it should be possible to see an effect in a properly controlled trial.
A search on Pubmed for randomised controlled trials of reflexology and allergies brought up this on asthma and footzone therapy (reflexology by another name, as far as I can tell). The authors “found no evidence that reflexology has a specific effect on asthma beyond a placebo influence”.
Decrease in consumption of beta-2-agonists and increase in peak-flow levels were observed in the group which had received foot zone therapy, but the same changes were observed in the control group. The authors do not find that this investigation demonstrates that foot zone therapy is of effect on the disease bronchial asthma. They conclude, however, that the favourable effect in both of the groups are due to increased care and control which occurred in both patient groups. [My italics]
Other results had even less relevance to reflexology and allergies: there was a paper on Tuina (a kind of back masage) for eczema, one on acupuncture and craniosacral therapy, this on carotid sinus massage, and this on the same topic. More on carotid sinus evaluation, effects of long-term vasodilator therapy in patients with carotid sinus hypersensitivity.
I found no evidence from randomised controlled trials to support the claim that reflexology may be beneficial for those with allergies.
I took a look at some of the other leaflets. The author of the client information on neurological problems leaflet was honest enough to include this:
This is not really an area where reflexology can help
The leaflet on the reproductive system claims that reflexology “may aid the body to normalise its hormone levels” and that this may result in “a rebalanced body that may lead to a reduction in symptoms”. The leaflet goes on:
…allowing the body to adjust gently with support from reflexology may help with the symptoms such as hot flushes, night sweats, anxiety, insomnia and depression.
Pubmed displayed just one randomised controlled trial for reflexology and hot flushes – a paper that concluded that:
Foot reflexology was not shown to be more effective than non-specific foot massage in the treatment of psychological symptoms occurring during the menopause.
On the urinary system: “recurrent bouts of infection may indicate systems out of balance, the theory that reflexology rebalances systems might help heal and possibly prevent further attacks.” I could find nothing on Pubmed to support this statement. No review, no RCT, no clinical trial… nothing.
What little evidence is available does not support the idea that reflexology can help with the symptoms and ailments listed by AOR.
Reflexology is basically a foot massage with added pseudoscience. It might help you to relax, but that’s about it. If you like a nice foot rub and are able to ignore (or simply don’t care about) any nonsense being spouted about meridians then this could be the CAM therapy for you. As long as you’re only using it for relaxation and don’t expect to find relief for, say, allergies.
WT Jarvis tells the tale of the reflexology practitioner who was keen to see if his art could withstand scientific scrutiny. Having seen the results of the test, the reflexologist agreed that reflexology was not an acceptable method of medical screening. Jarvis reports that from that time “his practice would involve simple foot massages for people who wanted them with no diagnostic or therapeutic claims”.
There’s also this paper that looks at the accuracy of reflexology charts: “Despite certain limitations to the data provided by this study, the results do not suggest that reflexology techniques are a valid method of diagnosis.”