MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

Reflexology is the treatment of reflex zones, usually on the sole of the feet, with manual massage and pressure. Reflexologists assume that certain zones correspond to certain organs, and that their treatment can influence the function of these organs. Thus reflexology is advocated for all sorts of conditions. Proponents are keen to point out that their approach has many advantages: it is pleasant (the patient feels well with the treatment and the therapist feels even better with the money), safe and cheap, particularly if the patient does the treatment herself.

Self-administered foot reflexology could be practical because it is easy to learn and not difficult to apply. But is it also effective? A recent systematic review evaluated the effectiveness of self-foot reflexology for symptom management.

Participants were healthy persons not diagnosed with a specific disease. The intervention was foot reflexology administered by participants, not by practitioners or healthcare providers. Studies with either between groups or within group comparison were included. The electronic literature searches utilized core databases (MEDLINE, EMBASE, Cochrane, and CINAHL Chinese (CNKI), Japanese (J-STAGE), and Korean databases (KoreaMed, KMbase, KISS, NDSL, KISTI, and OASIS)).

Three non-randomized trials and three before-and-after studies met the inclusion criteria. No RCTs were located. The results of these studies showed that self-administered foot reflexology resulted in significant improvement in subjective outcomes such as perceived stress, fatigue, and depression. However, there was no significant improvement in objective outcomes such as cortisol levels, blood pressure, and pulse rate. We did not find any randomized controlled trial.

The authors concluded that this study presents the effectiveness of self-administered foot reflexology for healthy persons’ psychological and physiological symptoms. While objective outcomes showed limited results, significant improvements were found in subjective outcomes. However, owing to the small number of studies and methodological flaws, there was insufficient evidence supporting the use of self-performed foot reflexology. Well-designed randomized controlled trials are needed to assess the effect of self-administered foot reflexology in healthy people.

I find this review quite interesting, but I would draw very different conclusions from its findings.

The studies that are available turned out to be of very poor methodological quality: they lack randomisation or rely on before/after comparisons. This means they are wide open to bias and false-positive results, particularly in regards to subjective outcome measures. Predictably, the findings of this review confirm that no effects are seen on objective endpoints. This is in perfect agreement with the hypothesis that reflexology is a pure placebo. Considering the biological implausibility of the underlying assumptions of reflexology, this makes sense.

My conclusions of this review would therefore be as follows: THE RESULTS ARE IN KEEPING WITH REFLEXOLOGY BEING A PURE PLACEBO.

11 Responses to Reflexology = placebo therapy

  • All things considered, reflexology seems a fine hobby, but I think I’ll stick with Star Trek. Less effort, more entertaining, almost certainly similarly impressive results. To each his own.

  • No trial, of any sort, is needed to show that foot massage can be pleasurable.
    That is a given.
    Maybe an inquiry is needed to ascertain why those who style themselves ‘reflexologists’ do not understand that – but it would hardly be worth the effort.
    (Oh, and if the participants had ‘psychological symptoms’ as stated, can they really be said to have been ‘healthy’?)
    Reflexology is a faith that ‘zones’ exist in the immanent world.
    No one but reflexologists share that faith.
    Whatever next? Calls for a ‘randomised controlled trial’ to show ladies (and many men) gain pleasure from having a new hairstyle?Or visiting the gardens of Highgrove House?
    As John Hunter (the father of scientific surgery) said: “Why think about it? Why not do the experiment?”
    (And then, and only then, publish the result).
    Answer: It’s all tosh, and the authors of this article know it.

  • If certain parts of the feet have a direct connection with certain organs, what wondrous piece of pseudoscience would a reflexologist come up with to explain why comprehensive organ failure is not an inevitable consequence of having one or both feet amputated?

  • But Reflexology is widely used by Physiotherapists so it surely must be based upon scientific evidence!

  • The use of Reflexology is in Egyptian hieroglyphics.

  • a lie, just like acupuncture and those millenium technics,
    add all the shit food complements like spiruline, etc etc…promising cancer healing and other crap…without any scientific proof.
    but money flows…50 to 80€ for reflex massage, about 5 to 8 times minimum salary here. please come again hahaha
    charlatanism will never die

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