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Reflexology, also known as zone therapy, is an alternative medicine involving application of pressure to the feet and hands with specific thumb, finger, and hand techniques without the use of oil or lotion. It is based on a 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 effects a physical change to the body.
Reviews from 2009 and 2011 have not found evidence sufficient to support the use of reflexology for any medical condition. A 2009 systematic review of randomized controlled trials concludes: "The best evidence available to date does not demonstrate convincingly that reflexology is an effective treatment for any medical condition."
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.
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. Reflexologists divide the body into ten equal vertical zones, five on the right and five on the left. 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.
The Cochrane Collaboration defines reflexology as follows:
- "Reflexology is gentle manipulation or pressing on certain parts of the foot to produce an effect elsewhere in the body."
Reflexologists posit that the blockage of an energy field, invisible 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.
Reflexology's claim to manipulate energy (Qi) has been highly controversial, as there is no scientific evidence for the existence of life energy (Qi), 'energy balance', 'crystalline structures,' or 'pathways' in the body.
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 Darwinian natural selection; but Singh says that no argument or evidence has been adduced.
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, as CNHC is voluntary anyone practising can describe themselves as reflexologists. When the CNHC began admitting reflexologists, a skeptic searched for and found 14 of them claiming efficacy on illnesses. Once pointed out, the CNHC had the claims retracted as it conflicted with the UK's Advertising Standards Authority code.
In Canada, reflexology is not regulated in any province and the expenses incurred are not eligible as medical claims for income taxes. RAC, the Reflexology Association of Canada, has reflexology therapists in all provinces, but there are various other associations in British Columbia, Ontario and Quebec.
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 in life and 6.1% had used reflexology within the previous year. A study from Norway showed that 5.6% of the Norwegian population in 2007 had used reflexology within the last 12 months.
Practices resembling reflexology may have existed in previous historical periods. Similar practices have been documented in the histories of China and Egypt. Reflexology was introduced to the United States in 1913 by William H. Fitzgerald, M.D. (1872–1942), an ear, nose, and throat specialist, and Edwin F. Bowers. Fitzgerald claimed that applying pressure had an anesthetic effect on other areas of the body. It was modified in the 1930s and 1940s by Eunice D. Ingham (1889–1974), a nurse and physiotherapist. Ingham claimed that the feet and hands were especially sensitive, and mapped the entire body into "reflexes" on the feet renaming "zone therapy" to reflexology. "Modern reflexologists use Ingham's methods, or similar techniques developed by the reflexologist Laura Norman."
- Kunz, Kevin; Kunz, Barbara (1993). The Complete Guide to Foot Reflexology. Reflexology Research Project.
- Ernst E (2009). "Is reflexology an effective intervention? A systematic review of randomised controlled trials". Med J Aust. 191 (5): 263–6. PMID 19740047.
- Ernst, E; Posadzki, P; Lee, MS (Feb 2011). "Reflexology: an update of a systematic review of randomised clinical trials.". Maturitas. 68 (2): 116–20. doi:10.1016/j.maturitas.2010.10.011. PMID 21111551.
- Baggoley C (2015). "Review of the Australian Government Rebate on Natural Therapies for Private Health Insurance" (PDF). Australian Government – Department of Health. Lay summary – Gavura, S. Australian review finds no benefit to 17 natural therapies. Science-Based Medicine. (19 November 2015).
- Norman, Laura; Thomas Cowan (1989). The Reflexology Handbook, A Complete Guide. Piatkus. pp. 22, 23. ISBN 0-86188-912-6.
- "Natural Standard". Harvard Medical School. July 7, 2005. Archived from the original on 2012-02-21. Retrieved January 27, 2007.
- "Reflexology". National Council Against Health Fraud. 1996. Retrieved 2007-01-27.
- "Massage, reflexology and other manual methods for managing pain in labour". Cochrane Collaboration. Retrieved 2 May 2015.
- Barrett, Stephen (2004-09-25). "Reflexology: A close look". Quackwatch. Retrieved 2007-10-12.
- Singh, Simon; Ernst, Edzard (2008). Trick or Treatment? Alternative Medicine on Trial. Transworld. ISBN 978-0-593-06129-9.
- CNHC - Policies
- CNHC Wishes to Thank Simon Perry, http://adventuresinnonsense.blogspot.com, Friday, 27 November 2009
- Reflexology in Denmark text from Knowledge and Research Center for Alternative Medicine a Danish governmental institution
- Nifab-undersøgelsen in Norwegean only
- Norman, Laura; Thomas Cowan (1989). The Reflexology Handbook, A Complete Guide. Piatkus. p. 17. ISBN 0-86188-912-6.
- Fitzgerald, William H.; Bowers, Edwin F. (1917) Zone therapy; or, Relieving pain at home. Columbus, Ohio: I. W. Long, Publisher (California Digital Library) Accessed Jan. 2015
- Benjamin, Patricia (1989). "Eunice D. Ingham and the development of foot reflexology in the U.S". American Massage Therapy Journal.
- "Massagenerd.com Presents History of Massage, Therapies & Rules" (pdf). Retrieved 2007-10-12.
- cancer.org - Reflexology
- Barrett, Stephen (2004-09-25). "Reflexology: A close look". Quackwatch. Retrieved 2011-03-14.
- Carroll, Robert Todd (2007-10-03). "Skeptics Dictionary: Definition of Reflexology". Retrieved 2011-03-14.
- Dunning, Brian (2007-01-28). "Reflexology: Only Dangerous If You Use It". Retrieved 2011-03-14.
- AQTN (2013). "Reflexology in the scientific literature - unbiased compilation" (PDF).