Editing Reflexology

{{short description|Alternative medical practice involving pressure to parts of the body}}
{{Alternative medicine sidebar |fringe}}
[[Image:Foot Chart1 small.png|right|thumb|An example of a reflexology chart, demonstrating the areas of the feet that practitioners believe correspond with organs in the "zones" of the body.]]

'''Reflexology''', also known as '''zone therapy''', is an [[alternative medicine|alternative medical]] practice involving the [[acupressure|application of pressure]] to specific points on the feet, ears, and hands. This is done using thumb, finger, and hand [[massage]] techniques without the use of oil or lotion. It is based on a [[pseudoscientific]]<ref name=QuackWatch/> system of zones and reflex areas that purportedly reflect an image of the body on the feet and hands, with the premise that such work on the feet and hands causes a physical change to the supposedly related areas of the body.<ref name="Kunz&Kunz1993">{{cite book | last1 = Kunz | first1 = Kevin | last2 = Kunz | first2 = Barbara | title = The Complete Guide to Foot Reflexology | url = https://archive.org/details/completeguidetof00barb | url-access = registration | publisher = Reflexology Research Project | year = 1993 | isbn = 9780960607013 }}</ref>

There is no convincing scientific evidence that reflexology is effective for any medical condition.<ref name="Ernst E 2009 263–6">{{cite journal |journal=Med J Aust |year=2009 |volume=191 |issue=5 |pages=263–266 |title=Is reflexology an effective intervention? A systematic review of randomised controlled trials |author=Ernst E |doi= 10.5694/j.1326-5377.2009.tb02780.x|pmid=19740047|s2cid=17307793 }}</ref>

==Definition==
In a [[Cochrane Collaboration]] review, reflexology is defined as follows: "Reflexology is gentle manipulation or pressing on certain parts of the foot to produce an effect elsewhere in the body."<ref>{{cite journal |last1=Smith |first1=C. A. |last2=Levett |first2=K. M. |last3=Collins |first3=C. T. |last4=Dahlen |first4=H. G. |author-link4=Hannah Dahlen |last5=Ee |first5=C. C. |last6=Suganuma |first6=M. |year=2018 |title=Massage, reflexology and other manual methods for managing pain in labour |url=http://www.cochrane.org/CD009290/PREG_massage-reflexology-and-other-manual-methods-for-managing-pain-in-labour |journal=The Cochrane Database of Systematic Reviews |publisher=[[Cochrane Collaboration]] |volume=2018 |issue=3 |pages=CD009290 |doi=10.1002/14651858.CD009290.pub3 |pmc=6494169 |pmid=29589380 |access-date=2 May 2015}}</ref>

The [[Department of Health (Australia)|Australian Government's Department of Health]] define reflexology as "a system of applying pressure, usually to the feet, which practitioners believe stimulates energy and releases 'blockages' in specific areas that cause pain or illness."<ref name=aus17/>

==History==
Practices resembling reflexology may have existed in previous historical periods. Similar practices have been documented in the histories of [[Ayurveda|India]], China and Egypt.<ref>''Reflexology: A Practical Approach'', p. 185, Vicki Pitman, Kay MacKenzie, [[Nelson Thornes]]</ref><ref name=NS/> Reflexology was introduced to the United States in 1913 by [[William H. Fitzgerald]], M.D. (1872–1942), an [[Otorhinolaryngology|ear, nose, and throat]] specialist, and [[Edwin F. Bowers]]. Fitzgerald claimed that applying pressure had an [[Anaesthesia|anesthetic effect]] on other areas of the body.<ref name=TRH2>{{cite book | last = Norman | first = Laura | author-link = Laura Norman |author2=Thomas Cowan  | title = The Reflexology Handbook, A Complete Guide | publisher = [[Piatkus]] | year = 1989 | page = 17 | isbn = 0-86188-912-6 }}</ref><ref>Fitzgerald, William H.; Bowers, Edwin F. (1917) ''Zone therapy; or, Relieving pain at home''. Columbus, Ohio: I. W. Long, Publisher ([https://archive.org/details/zonetherapyorrel00fitziala California Digital Library]) Accessed Jan. 2015</ref> It was modified in the 1930s and 1940s by Eunice D. Ingham (1889–1974), a nurse and [[physiotherapist]].<ref name=Ingham>{{cite journal | last = Benjamin | first = Patricia | year = 1989 | title = Eunice D. Ingham and the development of foot reflexology in the U.S | journal = American Massage Therapy Journal}}</ref><ref>{{cite web | url = http://www.massagenerd.com/pdf_massage_ebooks/History_Therapies_Rules_Ryan_Hoyme_.pdf | title = Massagenerd.com Presents History of Massage, Therapies & Rules | access-date = 2007-10-12 }}</ref> Ingham claimed that the feet and hands were especially sensitive and mapped the entire body into "reflexes" on the feet, renaming "zone therapy" as reflexology.<ref>[http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/ManualHealingandPhysicalTouch/reflexology cancer.org – Reflexology]</ref> Many of the modern reflexologists use Ingham's methods, or similar techniques of reflexologist Laura Norman.<ref name=NS/>

==Effectiveness==
In 2015, the Australian Government's Department of Health published the results of a review of alternative therapies that sought to determine if any were suitable for being covered by [[health insurance]]. Reflexology was one of 17 therapies evaluated for which no clear evidence of effectiveness was found.<ref name=aus17>{{cite web |url=http://www.health.gov.au/internet/main/publishing.nsf/content/0E9129B3574FCA53CA257BF0001ACD11/$File/Natural%20Therapies%20Overview%20Report%20Final%20with%20copyright%2011%20March.pdf |publisher=Australian Government&nbsp;– Department of Health |author=Baggoley C |title=Review of the Australian Government Rebate on Natural Therapies for Private Health Insurance |year=2015}}
* {{lay source |template=cite web |author=Gavura, S. |date=19 November 2015 |title=Australian review finds no benefit to 17 natural therapies |url=https://www.sciencebasedmedicine.org/australian-review-finds-no-benefit-to-17-natural-therapies |website=Science-Based Medicine}}</ref> Accordingly, in 2017, the Australian government named reflexology as a practice that would not qualify for insurance subsidy, saying this step would "ensure taxpayer funds are expended appropriately and not directed to therapies lacking evidence".<ref name=nosubsidy>{{cite journal |title=Homeopathy, naturopathy struck off private insurance list |author=Paola S |date=17 October 2017 |journal=Australian Journal of Pharmacy |url=https://ajp.com.au/news/homeopathy-naturopathy-struck-off-private-insurance-list/}}</ref>

Reviews from 2009 and 2011 have found no evidence sufficient to support the use of reflexology for any medical condition.<ref name="Ernst E 2009 263–6">{{cite journal |journal=Med J Aust |year=2009 |volume=191 |issue=5 |pages=263–266 |title=Is reflexology an effective intervention? A systematic review of randomised controlled trials |author=Ernst E |doi= 10.5694/j.1326-5377.2009.tb02780.x|pmid=19740047|s2cid=17307793 }}</ref><ref name=Ernst2011>{{cite journal |last1=Ernst |first1=E |last2=Posadzki |first2=P |last3=Lee |first3=MS |title=Reflexology: an update of a systematic review of randomised clinical trials |journal=Maturitas|date=Feb 2011 |volume=68 |issue=2 |pages=116–120 |pmid=21111551 |doi=10.1016/j.maturitas.2010.10.011}}</ref> A 2009 [[systematic review]] of [[randomized controlled trial]]s concludes: "The best evidence available to date does not demonstrate convincingly that reflexology is an effective treatment for any medical condition."<ref name="Ernst E 2009 263–6"/>

There is no clinical evidence that reflexology is effective to treat cancer. [[Cancer Research UK]] have commented that "there is no scientific evidence to prove that reflexology can cure or prevent any type of disease, including cancer".<ref>{{Cite web|date=2024|title=Reflexology and cancer|url=https://www.cancerresearchuk.org/about-cancer/treatment/complementary-alternative-therapies/individual-therapies/reflexology|website=Cancer Research UK|language=en-GB|archive-date=May 8, 2024|archive-url=https://web.archive.org/web/20240508070515/https://www.cancerresearchuk.org/about-cancer/treatment/complementary-alternative-therapies/individual-therapies/reflexology|url-status=live}}</ref>

==Claimed mechanism==
There is no consensus among reflexologists on how reflexology is supposed to work; a unifying theme is the idea that areas on the foot correspond to areas of the body and that by manipulating these one can improve health through one's [[qi]].<ref name=TRH1>{{cite book  | last = Norman  | first = Laura  | author-link = Laura Norman  |author2=Thomas Cowan   | title = The Reflexology Handbook, A Complete Guide  | publisher = [[Piatkus]]| year = 1989| pages = 22, 23| isbn = 0-86188-912-6 }}</ref> Reflexologists divide the body into ten equal vertical zones, five on the right and five on the left.<ref name=NS /> Concerns have been raised by medical professionals that treating potentially serious illnesses with reflexology, which has no proven efficacy, could delay the seeking of appropriate medical treatment.<ref name=ncahf>{{cite web  | title = Reflexology  | publisher = National Council Against Health Fraud  | year = 1996  | url = http://www.ncahf.org/articles/o-r/reflexology.html  | access-date = 2007-01-27  }}</ref>

Reflexologists posit that the blockage of an energy field, invisible [[vitalism|life force]], or [[Qi]], can prevent healing. Another tenet of reflexology is the belief that practitioners can relieve stress and pain in other parts of the body through the manipulation of the feet. One claimed explanation is that the pressure received in the feet may send signals that 'balance' the nervous system or release chemicals such as endorphins that reduce stress and pain. These hypotheses are rejected by the medical community who cite a lack of scientific evidence and the well-tested [[germ theory of disease]].<ref name=NS>{{cite web  | title = Reflexology | publisher = Aetna IntelliHealth  | date = May 6, 2008 | url = http://www.intelihealth.com/IH/ihtIH/WSIHW000/8513/34968/360060.html?d=dmtContent |archive-url= https://web.archive.org/web/20120221233457/http://www.intelihealth.com/IH/ihtIH/WSIHW000/8513/34968/360060.html?d=dmtContent |archive-date= 2012-02-21 | access-date=February 11, 2016}}</ref>

Reflexology's claim to manipulate energy (Qi) is unsupported by science; there is no [[Qi#Scientific view|scientific evidence]] for the existence of life energy (Qi), "energy balance", "crystalline structures" or "[[Meridian (Chinese medicine)|pathways]]" in the body.<ref name=QuackWatch>{{cite web | last = Barrett | first = Stephen | author-link = Stephen Barrett | url = http://www.quackwatch.org/01QuackeryRelatedTopics/reflex.html | title = Reflexology: A close look | publisher = [[Quackwatch]] | access-date = 2007-10-12 | date = 2004-09-25}}</ref>

In ''[[Trick or Treatment? Alternative Medicine on Trial]]'', [[Simon Singh]] states that if indeed the hands and feet "reflect" the internal organs, reflexology might be expected to explain how such "reflection" was derived from the process of [[Charles Darwin|Darwinian]] natural selection, but Singh says that no argument or evidence has been adduced.<ref>Singh, Simon; [[Ernst, Edzard]] (2008). ''Trick or Treatment? Alternative Medicine on Trial''. Transworld. {{ISBN|978-0-593-06129-9}}.{{page?|date=October 2020}}</ref>

[[Image:Reflexology of the Hand.JPG|right|thumb|An example of a reflexology chart of the hand, demonstrating the areas that practitioners believe correspond with organs in the "zones" of the body.]]

==Regulation==
In the United Kingdom, reflexology is coordinated on a voluntary basis by the [[Complementary and Natural Healthcare Council]] (CNHC). Registrants are required to meet Standards of Proficiency outlined by Profession Specific Boards<ref>[http://www.cnhc.org.uk/pages/index.cfm?page_id=47 CNHC – Policies]</ref> but since CNHC is voluntary anyone practicing can describe themselves as a reflexologist. When the CNHC began admitting reflexologists, a skeptic searched for, and found, 14 of them who were claiming efficacy on illnesses. Once pointed out, the CNHC had the claims retracted as it conflicted with the UK's Advertising Standards Authority code.<ref>[http://adventuresinnonsense.blogspot.com/2009/11/cnhc-wishes-to-place-on-formal-record_27.html CNHC Wishes to Thank Simon Perry], adventuresinnonsense.blogspot.com, Friday, 27 November 2009</ref>

Reflexology is one of the most used alternative therapies in Denmark. A national survey from 2005 showed that 21.4% of the Danish population had used reflexology at some point and 6.1% had used reflexology within the previous year.<ref>[http://www.vifab.dk/uk/alternative+medicine/alternative+therapies/reflexology? Reflexology in Denmark] {{Webarchive|url=https://web.archive.org/web/20120404075044/http://www.vifab.dk/uk/alternative+medicine/alternative+therapies/reflexology |date=2012-04-04 }} text from [http://www.vifab.dk/uk Knowledge and Research Center for Alternative Medicine] {{Webarchive|url=https://web.archive.org/web/20120404075044/http://www.vifab.dk/uk/alternative+medicine/alternative+therapies/reflexology |date=2012-04-04 }} a Danish governmental institution</ref> A study from Norway showed that 5.6% of the Norwegian population in 2007 had used reflexology within the last 12 months.<ref>[http://www.nifab.no/om_alternativ_behandling/alternativ_behandling_i_norge/nifab_undersoekelsen Nifab-undersøgelsen] in Norwegian only</ref>

==See also==
* [[Acupressure]]
* [[Foot massage]]
* [[Shiatsu]]

==Notes==
{{Reflist}}

==External links==
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* {{cite web | last = Barrett | first = Stephen | author-link = Stephen Barrett | url = http://www.quackwatch.org/01QuackeryRelatedTopics/reflex.html | title = Reflexology: A close look | publisher = [[Quackwatch]] | access-date = 2011-03-14 | date = 2004-09-25}}
* {{cite web | url = http://skepdic.com/reflex.html | title = Skeptics Dictionary: Definition of Reflexology | last = Carroll | first = Robert Todd | access-date = 2011-03-14  | author-link = Robert Todd Carroll| date = 2007-10-03}}
* {{Skeptoid|id=4024|number=24|date=28 January 2007|title=Reflexology: Only Dangerous If You Use It|access-date=22 June 2017}}
* {{cite web | url = http://www.association.quebec.aqtn.ca/files/Reflexology-full-Literature-Review.pdf | title = Reflexology in the scientific literature&nbsp;– unbiased compilation  | last = AQTN | date = 2013}}

{{Massage types}}
{{Naturopathy}}
{{Pseudoscience|state=autocollapse}}
{{Unproven and disproven cancer treatments}}
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[[Category:Alternative cancer treatments]]
[[Category:Manual therapy]]
[[Category:Naturopathy]]
[[Category:Pseudoscience]]

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