Written by Helen Cooke and the CAM-Cancer Consortium.
Updated October 24, 2016

Reflexology

What is it ?

Reflexology is a treatment modality employing manual pressure to specific areas of the body, usually the feet (occasionally the hands), which are thought to correspond to internal organs, with a view to generating positive health effects 1.

Application and dosage

The therapist takes a case history during the first session, which includes asking about patients’ presenting condition/symptoms and any medications they are receiving. Reflexology is usually received in a semi-upright position or on a reclining chair or couch. The treatment may include some light massage strokes and gentle stretches. Reflexology sessions last for about 30 minutes to one hour. A course of several treatments is often recommended by the practitioner.

History/providers

Although reflexology was widely used in the Far East for centuries and is thought to have originated as long as 5000 years ago, a form of technique referred to as ‘Zone Therapy’ first appeared in Europe in the late 16th century. American ear, nose and throat specialist Dr. William Fitzgerald introduced it as a therapy in the early 20th century after having observed that application of pressure to certain areas of patients’ feet or hands resulted in sensations in a corresponding area of the body. It was further developed by nurse and physiotherapist Eunice Ingham, who introduced it in Europe in the early 20th century. She created a map of 'reflexes' on the feet and hands, which she stated corresponded to different glands, organs and body 2.

Claims of efficacy/mechanism of action/alleged indications

Reflexologists work with the concept that the sole of the foot is a map which represents the entire body. By palpating the foot, areas of tenderness or "grittiness" are purported to indicate an imbalance in the corresponding organ 1. Reflexologists purport to be able to detect subtle changes in specific points on the feet and consider that using various techniques of massage and pressure to these points may affect the corresponding organ, organ system or body 3.

Possible mechanisms of action that have been suggested include a theory of energy mechanisms, suggesting reflexology points are linked to internal organs and structures by energy channels which become blocked in the event of illness and which are re-opened through reflexology 4; a neuromatrix pain theory, where reflexology is believed to relieve pain by transmitting afferent impulses and closing the neural gates in the dorsal horn of the spinal cord, thus blocking pain transmission 4; a lactic acid theory, where it is thought that lactic acid deposited as microcrystals in the feet are crushed by the application of pressure/massage which thereby allows for the free flow of energy 5; a relaxing effect which contributes to relieving tension and stress affecting the autonomic response, which, in turn, affects the endocrine, immune, and neuropeptide systems 5; and finally a theory suggesting that reflexology is simply a method of showing care and concern for patients 5.

Prevalence of use

A European Survey of cancer patients reported that 3.9 % of respondents used some form of manipulative or body-based method (included massage, reflexology and other methods) after their cancer diagnosis 6. 4.5% of respondents were using some form of energy therapy before their diagnosis. The exact prevalence of the use of Reflexology for cancer patients is unknown.

Legal issues

Regulation and registration of complementary therapists varies across Europe. In the UK reflexologists may practice under Common Law and do not have to be registered with one of the federal bodies. Many practitioners have however decided to join a system of voluntary self-regulation. For more information about legal issues for reflexologists in Europe please access the Reflexology in Europe Network 19.

Costs and expenditures

A reflexology session costs between 40-70 Euro. A course of treatment often consists of six to eight sessions.

Citation Helen Cooke, CAM-Cancer Consortium. Reflexology [online document]. http://ws.cam-cancer.org/The-Summaries/Manipulative-body-based/Reflexology. October 24, 2016.

References

  1. Ernst E, Pittler MH, Wider B and Boddy K. Oxford Handbook of Complementary Medicine. Oxford University Press (2008). ISBN 978-0-19-920677-3.
  2. Pitman, V and MacKenzie, K. Reflexology: A practical approach (1997). Stanley Thornes. ISBN: 0-7487-2867-8.
  3. Association of Reflexologists UK website: http://www.aor.org.uk/, accessed 10 August 2016.
  4. Tsay S, Chen H, Chen S, Lin H, Lin K. Effects of reflexotherapy on acute postoperative pain and anxiety among patients with digestive cancer. Cancer Nursing. 2008; 31(2): 109-15.
  5. Stephenson NL, Weinrich SP, Tavakoli AS. The effects of foot reflexology on anxiety and pain in patients with breast and lung cancer. Oncology Nursing Forum. 2000; 27(1):67-72.
  6. Molassiotis A et al. Use of complementary and alternative medicine in cancer patients: a European survey. Annals of Oncology 2005; 16: 655-653
  7. Myers CD, Walton T, Bratsman L, Wilson J, Small B. Massage modalities and symptoms reported by cancer patients: narrative review. J Soc Integr Oncol. 2008; 6(1):19-28.
  8. Ernst E, Posadzki P, Lee MS. Reflexology: an update of a systematic review of randomised clinical trials. Maturitas 2011; 68(2):116-120.
  9. Kim JI, Lee MS, Kang JW, Choi dY, Ernst E. Reflexology for the symptomatic treatment of breast cancer: a systematic review. Integrative Cancer Therapies 2010; 9(4):326-330.
  10. Wilkinson S, Lockhart K, Gambles M, Storey L. Reflexology for symptom relief in patients with cancer. Cancer Nursing. 2008; 31 (5): 354-62. 
  11. Lee SH, Kim JY, Yeo S, Kim SH, Lim S. Meta-Analysis of Massage Therapy on Cancer Pain. Integrative cancer therapies. 2015;14(4):297-304.
  12. Quattrin R, Zanini A, Buchini S, Turello D, Annunziata MA, Vidotti C, Colombatti A, Brusaferro S. Use of reflexology foot massage to reduce anxiety in hospitalized cancer patients in chemotherapy treatment: methodology and outcomes. J Nurs Manag. 2006; 14(2): 96-105.
  13. Berenson SC. Management of cancer pain with complementary therapies. Oncology (Williston Park) 2007; 21(Suppl 4):10-22.
  14. White AR, Williamson J, Hart A, Ernst E. A blinded investigation into the accuracy of reflexology carts. Complement Ther Med. 2000; 8(3):166-172.
  15. Wyatt GA. Sikorskii MH, Rahbar D, Victorson and You M. Health-related quality-of-life outcomes: a reflexology trial with patients with advanced-stage breast cancer. Oncology nursing forum. 2012 39, 568-577 DOI: 10.1188/12.ONF.568-577
  16. Hodgson NA and Lafferty D. Reflexology versus Swedish Massage to Reduce Physiologic Stress and Pain and Improve Mood in Nursing Home Residents with Cancer: A Pilot Trial. Evidence-Based Complementary and Alternative Medicine. 2012. Article ID 456897, 5 pages, 2012. doi:10.1155/2012/456897
  17. Dyer J, Thomas K, Sandsund C and Shaw C. Is reflexology as effective as aromatherapy massage for symptom relief in an adult outpatient oncology population? Complement Ther Clin Pract 2013 19(3): 139-146.
  18. Green VL, Alexandropoulou A, Walker MB, Walker AA, Sharp DM, Walker LG and Greenman J. Alterations in the Th1/Th2 balance in breast cancer patients using reflexology and scalp massage. Experimental and therapeutic medicine 2012. 1, 97-108 DOI: 10.3892/etm_00000018
  19. Reflexology in Europe Website: http://reflexology-europe.org Accessed 3rd October 2016