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Before engaging in any complementary medical technique, you should be aware that many of these techniques have not been evaluated in scientific studies. Often, only limited information is available about their safety and effectiveness. Each state and each discipline has its own rules about whether practitioners are required to be professionally licensed. If you plan to visit a practitioner, it is recommended that you choose one who is licensed by a recognized national organization and who abides by the organization's standards. It is always best to speak with your primary health care provider before starting any new therapeutic technique.

Reflexology treatments apply pressure to specific points or areas of the feet. According to the principles of reflexology, areas of the feet correspond to different parts of the body, and applying pressure to these areas can affect the corresponding parts of the body. In some cases, pressure may also be applied to the hands or ears.

For thousands of years, techniques similar to reflexology have been used in Egypt and China. A technique called "zone therapy" was developed in the early 20th century by an American physician named William Fitzgerald. Dr. Fitzgerald suggested that maps of the foot could be used to diagnose and treat medical conditions. He divided the body into 10 zones and labeled what he believed to be the corresponding parts of the foot. He proposed that gentle pressure on the foot could bring relief to the corresponding zone.

In the 1930s, Eunice Ingham, a nurse and physiotherapist, further developed these maps to include specific reflex points. Zone therapy was renamed reflexology.

Reflexology charts are diagrams of the feet with corresponding parts of the body. The right foot corresponds to the right side of the body, and the left foot corresponds to the left side.

Modern reflexologists use Ingham's methods, or similar techniques developed by the reflexologist Laura Norman. Massage therapists, chiropractors, podiatrists, physical therapists, and nurses may also use reflexology.

There are several theories that explain the mechanisms behind reflexology, but none of these are 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 pain killers in the body. Reflexology could also stimulate nerve circuits, promote lymphatic flow, or help dissolve uric acid crystals.

Reflexologists often take a full medical history will before examining a patient's bare feet. Clients usually remain fully clothed and either sit with the legs raised or lie on a treatment table. Practitioners begin with gentle massage of the feet, followed by pressure to selected reflex points. This therapy should never be painful.

Therapists may use lotion or oils for lubrication, sometimes including aromatherapy products. Occasionally, instruments are used on the feet, such as sticks of wood, clothespins, combs, rubber balls, rubber bands, tongue depressors, wire brushes, special massagers, hand probes or clamps. Some reflexology books note that clients may feel tingling in the part of the body corresponding to the reflex point being stimulated, although this has not been studied or proven scientifically.

Sessions often last from 30 to 60 minutes, and the course of therapy may last four to eight weeks. Patients can learn and self-administer reflexology techniques. Currently, there are no regulations for reflexology in the United States, and reflexology training or licenses are not required.

Scientists have studied reflexology for the following health problems:

Reflexology may be useful for relaxation, reducing stress, or relieving anxiety concerning 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. Better research is needed to make a recommendation.
Premenstrual syndrome (PMS) and menstrual problems
Reflexology may relieve premenstrual symptoms or menstrual problems. However, more research is necessary to reach a firm conclusion.
Reflexology may relieve migraines or tension headaches and may reduce the need for pain medications. However, research has thus far been inconclusive.
Irritable bowel syndrome, encopresis, constipation
It is not clear whether reflexology can help treat bowel problems. One small, controlled clinical trial showed reflexology to be an effective method of treating encopresis (fecal incontinence) and constipation over a six-week period. Further research is needed to confirm these results.
Chronic lower back pain
Preliminary evidence in humans suggests that reflexology is not helpful for chronic lower back pain. Better research is needed to make a firm conclusion.
Disease diagnosis
Preliminary research regarding reflexology techniques for diagnosing diseases is mixed. Better research is needed to clarify these results.
Ear disorders
A study in children with ear disorders showed that reflexology is less effective than general treatment. Further studies are needed before reflexology can be recommended for treating ear disorders in children.
Fetal activity
A small study reported that foot massage can increase fetal activity during pregnancy. Further studies are needed before conclusions can be drawn.
Leg, ankle, or foot edema
Preliminary research reports that reflexology is a preferred therapy in women with ankle and foot edema in late pregnancy. Further research is needed before conclusions about effectiveness can be made.
Multiple sclerosis
Preliminary evidence suggests reflexology treatment may help manage the motor or sensory symptoms of multiple sclerosis. Additional research is needed to make a firm conclusion.
Comfort and palliative care in cancer patients
Early evidence suggests foot reflexology may help manage some pain and fatigue in cancer patients. Reflexology may also reduce anxiety and improve general quality of life in cancer patients. However, some studies have shown that reflexology is no better than foot massage in palliative cancer care. Better research is needed before a firm conclusion can be drawn.
Thus far, studies have shown that reflexology is no better than placebo at treating asthma.
Chemotherapy side effects
Reflexology may help relieve nausea, vomiting and fatigue in breast cancer patients receiving chemotherapy. However, further research is needed before a recommendation can be made.
Research has suggested that reflexology may be useful for treating colic in infants. However, further research is needed.
Reflexology may help manage type 2 diabetes in some patients. More clinical trials are necessary to determine whether reflexology is an effective treatment for diabetes.
Reflexology may provide some benefits to those suffering from depression. However, numerous studies have not consistently shown that reflexology is useful in treating depression. Further research is needed.
Encopresis, enuresis (fecal soiling and bedwetting) in children
Some studies have suggested that reflexology may help prevent fecal soiling and bedwetting in children.
Strengthening immunity
Some research suggests that self-administered reflexology may help to boost the immune system. Further research is necessary.
Early research suggests that reflexology may reduce the need for pain relief during labor. However, the use of forceps was required by more women receiving reflexology during labor than untreated women.
Lung disease
It is unclear whether reflexology can benefit patients with lung diseases. Some research suggests that reflexology may reduce fatigue and insomnia in coal miners with lung disease.
Early research supports the use of reflexology for treating hot flashes and other menopausal symptoms.
Postoperative recovery
Early research suggests that reflexology may speed recovery after surgery in some patients. However, patients who received reflexology also tended to have poorer-quality sleep. Further research is needed.
Problems in 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 to before reflexology can be recommended for problems related to pregnancy.
Results from early studies suggest that reflexology does not provide any added benefit over nasal irrigation in sinus infections or sinus inflammation.
Urinary incontinence
Research suggests that reflexology may have beneficial effects in women with urinary incontinence. More well-designed studies are necessary to confirm the benefits of reflexology.

Reflexology has been suggested for many other uses, based on tradition or on scientific theories. However, these uses have not been thoroughly studied in humans, and there is limited scientific evidence about safety or effectiveness. Some of these suggested uses are for conditions that are potentially life-threatening. Consult with a health care provider before using reflexology for any use.

Abdominal pain
Allergy diagnosis
Breast cancer
Chronic fatigue syndrome
Chronic illnesses
Developmental care (preterm infants)
Digestive disorders
Elimination of blood toxins
General pain management
Glandular disorders
Gum inflammation
Gynecologic disorders
High blood pressure
Improved blood supply
Kidney stones
Liver disease
Neck pain
Neck stiffness
Noncardiac chest pain
Pancreatic disorders
Peripheral neuropathy in HIV/AIDS
Postmenopausal symptoms
Postoperative nausea and vomiting
"Restoration" of homeostasis
Shingles (herpes zoster and post-herpetic neuralgia)
Spine problems
Stress-related disorders

People with recent or healing fractures, unhealed wounds or active gout affecting the foot should avoid reflexology. If you have osteoarthritis affecting the ankle or foot or severe circulation problems in the legs or feet, seek medical consultation before starting reflexology.

Some reflexology books list conditions that may be negatively affected by this therapy. Examples include diabetes, heart disease or the presence of a pacemaker, unstable blood pressure, cancer, active infections, past episodes of fainting (syncope), mental illness, gallstones or kidney stones. However, there is limited scientific evidence that reflexology can affect these conditions.

Caution is advised in pregnant women, based on reports that rigorous stimulation of the feet may cause contractions of the uterus.

Reflexology should not delay diagnosis or treatment with more proven techniques or therapies.

Reflexology has been suggested for many health conditions, but there is very little evidence that reflexology is effective. Reflexology is likely to be safe for reducing stress or relaxation. However, people with medical conditions should seek the advice of a doctor before starting reflexology. People with recent injuries to the foot should avoid reflexology. Preliminary research suggests that reflexology may not be as effective as other therapies for diagnosing diseases. It is not recommended to rely on reflexology alone to treat potentially dangerous medical conditions. Speak with your health care provider if you are considering the use of reflexology.

The information in this monograph was prepared by the professional staff at Natural Standard, based on thorough systematic review of scientific evidence. The material was reviewed by the Faculty of the Harvard Medical School with final editing approved by Natural Standard.

  1. Natural Standard: An organization that produces scientifically based reviews of complementary and alternative medicine (CAM) topics
  2. National Center for Complementary and Alternative Medicine (NCCAM): A division of the U.S. Department of Health & Human Services dedicated to research

Selected Scientific Studies: Reflexology

Natural Standard has reviewed all of the currently available medical literature to prepare the professional monograph from which this version was created.

Some of the more recent studies are listed below:

  1. Bamigboye AA, Smyth R. Interventions for varicose veins and leg oedema in pregnancy. Cochrane Database Syst Rev 2007;Jan 24, (1):CD001066. Review.
  2. Beachy JM. Premature infant massage in the NICU. Neonatal Netw 2003;May-Jun, 22(3):39-45.
  3. Benchimol M, de Oliveira-Souza R. [Syncope in the elderly: diagnostic utility of carotid sinus massage in head-up tilt test.][Article in Portuguese] Arq Neuropsiquiatr 2003;Mar, 61(1):87-90. Epub 2003;Apr 16.
  4. Beurskens CH, Heymans PG. Positive effects of mime therapy on sequelae of facial paralysis: stiffness, lip mobility, and social and physical aspects of facial disability. Otol Neurotol 2003;Jul, 24(4):677-681.
  5. Bishop E, McKinnon E, Weir E, Brown DW. Reflexology in the management of encopresis and chronic constipation. Paediatr Nurs 2003;Apr, 15(3):20-21.
  6. Brygge T, Heinig JH, Collins P, et al. Reflexology and bronchial asthma. Respir Med 2001;95(3):173-179.
  7. Carpenter JS, Neal JG. Other complementary and alternative medicine modalities: acupuncture, magnets, reflexology, and homeopathy. Am J Med 2005;Dec 19, 118(Suppl 12B):109-117. Review.
  8. Diego MA, Dieter JN, Field T, et al. Fetal activity following stimulation of the mother’s abdomen, feet, and hands. Dev Psychobiol 2002;Dec, 41(4):396-406.
  9. Fassoulaki A, Paraskeva A, Patris K, et al. Pressure applied on extra 1 acupuncture point reduces bispectral index values and stress in volunteers. Anesth Analg 2003; Mar, ;96(3):885-890, Table of Ccontents. Comment in Anesth Analg 2003;Sep, 97(3):925. Author reply, 925-926.
  10. Gunnarsdottir TJ, Jonsdottir H. Does the experimental design capture the effects of complementary therapy? A study using reflexology for patients undergoing coronary artery bypass graft surgery. J Clin Nurs 2007;Apr, 16(4):777-785.
  11. Haynes G, Garske D, Case D, et al. Effect of massage technique on sentinel lymph node mapping for cancer of the breast. Am Surg 2003;Jun, 69(6):520-522.
  12. Kjoller M. [Children with ear disorders who are treated by reflexologists or general practitioners.] [Article in Danish] Ugeskr Laeger 2003;May 5, 165(19):1994-1999.
  13. Kober A, Scheck T, Schubert B, et al. Auricular acupressure as a treatment for anxiety in prehospital transport settings. Anesthesiology 2003;Jun, 98(6):1328-1332.
  14. Kohara H, Miyauchi T, Suehiro Y, et al. Combined modality treatment of aromatherapy, footsoak, and reflexology relieves fatigue in patients with cancer. J Palliat Med 2004;Dec, 7(6):791-796.
  15. Lee YM. [Effect of self-foot reflexology massage on depression, stress responses and immune functions of middle aged women] Taehan Kanho Hakhoe Chi 2006;Feb, 36(1):179-188. Korean.
  16. Lee YM, Sohng KY. [The effects of foot reflexology on fatigue and insomnia in patients suffering from coal workers' pneumoconiosis] Taehan Kanho Hakhoe Chi 2005;Dec, 35(7):1221-1228. Korean. /li>
  17. Mak HL, Cheon WC, Wong T, et al. Randomized controlled trial of foot reflexology for patients with symptomatic idiopathic detrusor overactivity. Int Urogynecol J Pelvic Floor Dysfunct 2007;Jun, 18(6):653-658. Epub 2006;Sep 27.
  18. McNeill JA, Alderdice FA, McMurray F. A retrospective cohort study exploring the relationship between antenatal reflexology and intranatal outcomes. Complement Ther Clin Pract 2006;May, 12(2):119-125. Epub 2006;Mar 29.
  19. Mollart L. Single-blind trial addressing the differential effects of two reflexology techniques versus rest, on ankle and foot oedema in late pregnancy. Complement Ther Nurs Midwifery 2003;9(4):203-208.
  20. Pilkington K, Rampes H, Richardson J. Complementary medicine for depression. Expert Rev Neurother 2006;Nov, 6(11):1741-1751. Review
  21. Raz I, Rosengarten Y, Carasso R. [Correlation ostudy between conventional medical diagnosis and the diagnosis by reflexology (non conventional)]. Harefuah 2003;142(8-9):600-605, 646.
  22. 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;Nov, 16(6):544-545.
  23. Siev-Ner I, Gamus D, Lerner-Geva L, et al. Reflexology treatment relieves symptoms of multiple sclerosis: a randomized controlled study. Mult Scler 2003;9(4):356-361.
  24. Stephenson N, Dalton JA, Carlson J. The effect of foot reflexology on pain in patients with metastatic cancer. Appl Nurs Res 2003;16(4):284-286.
  25. Stephenson NL, Dalton JA. Using reflexology for pain management: a review. J Holist Nurs 2003;Jun, 21(2):179-191.
  26. Stephenson NL, Swanson M, Dalton J, et al. Partner-delivered reflexology: effects on cancer pain and anxiety. Oncol Nurs Forum 2007;Jan, 34(1):127-132.
  27. Tovey P. A single-blind trial of reflexology for irritable bowel syndrome. Br J Gen Pract 2002;52(474):19-23.
  28. Wilkinson IS, Prigmore S, Rayner CF. A randomised-controlled trail examining the effects of reflexology of patients with chronic obstructive pulmonary disease (COPD). Complement Ther Clin Pract 2006;May, 12(2):141-147. Epub 2005;Dec 27.
  29. Yang JH. [The effects of foot reflexology on nausea, vomiting and fatigue of breast cancer patients undergoing chemotherapy] Taehan Kanho Hakhoe Chi 2005;Feb, 35(1):177-185. Korean.

Last updated May 06, 2008

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Chrome 2001
Chrome 2001