Reflexology showing limited benefits

Clinical proof is patchy but foot massage helps in some conditions, writes Professor Edzard Ernst.

Reflexology uses manual pressure applied to specific areas of the feet and sometimes the hands or ears, which allegedly correspond to particular areas or organs of the body.

It is thought the organs of each half of the body are represented on the sole of the corresponding foot. Reflexologists believe health can be assessed by examining the feet to detect imbalances or blocks to energy flow, expressed as tenderness or feelings of grittiness or crystal formation. Practitioners claim that stimulating these areas with pressure or massage can influence bodily functions.

Reflexology is thought to reduce stress, improve circulation, eliminate toxins and promote metabolic homeostasis.

Chronic benign conditions

However, sceptics point out there is no known neurophysiological basis for connections between organs and specific areas of the feet.

Reflexologists treat mostly chronic benign conditions, including asthma, arthritis, back and neck pain, chronic fatigue, digestive problems such as irritable bowel syndrome and constipation, insomnia, migraine and headaches, menopausal symptoms, sinusitis and stress-related disorders.

During a session, a medical history is usually taken before bare feet are examined. Tender or gritty areas are massaged. The strength of pressure varies  between practitioners. For lubrication, therapists may use talc or oil. Some use sticks  to apply extreme pressure, which can be moderately painful.

Weekly treatments are often recommended, as a course of six to eight sessions. For chronic conditions, follow-up treatments may be offered.

One trial found it superior to placebo reflexology for treating premenstrual symptoms, while other studies have found no advantage of reflexology over non-specific foot massage for menopausal symptoms, irritable bowel syndrome or asthma (see table below).

THE EVIDENCE

Encouraging results

  • Premenstrual syndrome.
  • Diabetes.
  • Multiple sclerosis.
  • Headaches.


Negative findings

  • Menopausal symptoms.
  • Irritable bowel syndrome.
  • Asthma.
  • Leg oedema.

Observational studies

Beneficial effects on blood glucose in diabetics have been demonstrated, while patients with multiple sclerosis had improved motor, sensory and urinary symptoms after 11 weeks of reflexology compared with non-specific foot massage.

A large observational study found 81 per cent of patients with headache reported cure or improvement at three months follow-up. However, reflexology had no effect on serum cortisol during surgery, or on leg circumference in pregnant women with leg oedema. Trial results have tended to be negative when placebo effects were adequately controlled and positive when this was not the case.

Foot reflexology is contraindicated in foot conditions such as gout, ulceration or vascular disease. Those with bone or joint conditions of the feet or lower leg should be treated cautiously.

Adverse effects include fatigue, changes in micturition or bowel function and allergy to lubricants.

- Professor Edzard Ernst is director of complementary medicine at the Peninsula Medical School, Universities of Exeter and Plymouth

References

  • Oleson T, Flocco W. Randomized controlled study of premenstrual symptoms treated with ear, hand and foot reflexology. Obstet Gynecol 1993; 82: 906–11.
  • Williamson J, et al. Randomized controlled trial of reflexology for menopausal symptoms. BJOG 2002; 109: 1,050–5.
  • Tovey P A. A single-blind trial of reflexology for irritable bowel syndrome. Br J Gen Pract 2002; 52: 19–23.
  • Brygge T. Zone therapy and asthma. Ugeskr Laeger 2002; 164: 2,405–10.
  • Wang X M. Treating type II diabetes mellitus with foot reflexology. Zhongguo Zhong Xi Yi Jie He Za Zhi 1993; 13: 536–8.
  • Siev-Ner I, et al. Reflexology treatment relieves symptoms of multiple sclerosis: a randomized controlled study. Mult Scler 2003; 9: 356–61.
  • Launso L, et al. An exploratory study of reflexological treatment for headache. Altern Ther Health Med 1999; 5: 57–65.
  • Mollart L. Single-blind study addressing the differential effects of two reflexology techniques versus rest on ankle and foot oedema in late pregnancy. Complement Ther Nurs Midwifery 2003; 9: 203–8.

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