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Reflexology (Zone Therapy)


Reflexology (zone therapy) is an alternative medicine, complementary, or integrated medicine method of treatment involving the physical act of applying pressure to the feet and hand with specific thumb, finger and hand techniques without the use of oil or lotion. It is based on what reflexologists claim to be a system of zones and reflex areas that they say reflect an image of the body on the feet and hands, with the premise that such work effects a physical change to the body.[1] A 2009 systematic review of randomised controlled trials concluded that "The best evidence available to date does not demonstrate convincingly that reflexology is an effective treatment for any medical condition."[2]

The Reflexology Association of Canada defines reflexology as:
"A natural healing art based on the principle that there are reflexes in the feet, hands and ears and their referral areas within zone related areas, which correspond to every part, gland and organ of the body. Through application of pressure on these reflexes without the use of tools, crèmes or lotions, the feet being the primary area of application, reflexology relieves tension, improves circulation and helps promote the natural function of the related areas of the body."[3]

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.[4] Reflexologist say that the body is divided into ten equal vertical zones, five on the right and five on the left. There are also three transverse lines, the upper region of the shoulder girdle, the waistline, and the pelvic floor.[5] 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.[6] Reflexology is proposed by reflexologists as a complementary therapy and should not replace medical treatment.[7] A systematic review of the efficacy of reflexology found one study showing a statistically significant effect in the treatment of urinary symptoms in multiple sclerosis patients. All other conditions reviewed in this study showed no evidence of any specific effect.[8]

1 Claimed mechanisms of operation
2 Regulation of reflexologists
3 Criticism

Claimed mechanisms of operation

Reflexologists posit that the blockage of an energy field, invisible life force, or Qi, can prevent healing.[4] 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.[9] These hypotheses are rejected by the general medical community, who cite a lack of scientific evidence and the well-tested germ theory of disease.[10]

Various versions of reflexology have been practised. This has been documented on four continents: Asia, Europe, Africa, and North America. The most common theory is that the earliest form of reflexology originated in China, as much as 5000 years ago. The early Taoists are described as having originated many Chinese health practises.
The Cherokee tribes of North America practise a form of reflexology that they pass from generation to generation.

Reflexology travelled across India, Japan, and China. Traditional East Asian foot reflexology is called Zoku Shin Do in Japanese. This is the foot portion of the Japanese massage technique. The roots of Zoku Shin Do go back to China over 5000 years ago.

Many changes took place in zone therapy, or reflexology, over the years. In China, the practice of acupressure using the fingers turned into the practice of acupuncture using needles. The belief in the reflex points still existed, but the practise was taken in a new direction with a new theory of claimed meridians. The Chinese concept of meridian therapy is a fundamental part of the claims of reflexology.[11]

The precise relationship between the ancient version practiced by the early Egyptians and reflexology as we know it today is unclear because different practices involving the manipulation of the feet in an attempt to affect health have been used throughout the world.

The precursor of current reflexology was introduced to the United States in 1913 by William H. Fitzgerald, M.D. (1872–1942), an ear, nose, and throat specialist, and Dr. Edwin Bowers. Fitzgerald claimed that applying pressure had an anesthetic effect on other areas of the body.[12]

Reflexology was further modified in the 1930s and 1940s by Eunice D. Ingham (1889–1974), a nurse and physiotherapist.[13][14] Ingham claimed that the feet and hands were especially sensitive, and mapped the entire body into "reflexes" on the feet. It was at this time that "zone therapy" was renamed reflexology.
Reflexologists in the United States and the United Kingdom often study Ingham's theories first, although there are also more recently created methods.[10]

Regulation of reflexologists

In the United Kingdom, reflexology is now regulated on a voluntary basis by the Complementary and Natural Healthcare Council (CNHC). Registrants must have full public and professional liability insurance and additional annual courses are a condition of re-registration.

Note: As registration with the CNHC is voluntary anyone may still practice the discipline and describe themselves as reflexologists. In addition, no evidence of the efficacy of any of the techniques of reflexology is required for such registration. (The same applies to all other disciplines being "regulated" by the CNHC.)


Common criticisms of reflexology are the lack of evidence for its claimed effects, or of a scientific or demonstrated basis for its theories, of central regulation, accreditation and licensing, or of medical training provided to reflexologists, and the short duration of training programmes. As with other pseudosciences without any proven effect beyond placebo, if patients rely on them and delay or even reject effective medical treatment there can be significant health risks.

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.[15]

An example of a reflexology chart, demonstrating the areas of the feet that practitioners believe correspond with organs in the "zones" of the body.

An example of a reflexology chart of the Hand, demonstrating the areas of the hand that practitioners believe correspond with organs in the "zones" of the body.

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