A Staff Report from the Straight Dope Science Advisory Board

Does reflexology really work?

January 19, 2015

Dear Straight Dope:

My understanding of reflexology is that it is based on the fact that all our nerve endings are in our hands and feet. So a foot massage manipulating specific nerve endings in the feet would have a beneficial effect on the correlating parts of our bodies. What do the scientists say?

SDStaff Bricker replies:

I can’t really tell what they’re saying, Andrea, because they appear to be doubled over in hysterical laughter. I’ll explain why.

Reflexology is a member of the “alternative medicines” family — practices that disdain rigid Western thinking like hypotheses, testing and provable results. Specifically, it posits that every body part, including internal organs, can be reached by touching a specific “reflex area” on the feet.

The mechanics of this connection are the subject of some dispute amongst the various practitioners of reflexology. Most appear to subscribe to the tried and true theory of “Qi.” Qi is the so-called life force or energy flow that pervades every living thing, and the thinking goes that by manipulating this energy flow one can improve or maintain health. Reflexologists in this school believe that applying specific touches to the reflex areas of the feet restores the vital energy flow to these internal organs, improves circulation, unblocks nerve impulse pathways, and has the potential to resolve everything from bedwetting to anemia.

Other reflexologists seem to insist there is an actual physical connection between the areas of the feet and, say, the pancreas, and there are some reflexology charts that claim, as you suggest, that “all nerves end in the feet.” These practitioners seem to be in the minority, although they claim similarly salubrious effects of foot massage for their clients.

Science relies on a testable hypothesis. The offended cries of alternative medicine adherents notwithstanding, scientists would be perfectly willing to believe in a Qi-type life flow connecting the heel to the pituitary gland if only there were some testable, repeatable process by which we could show that people with pituitary problems who had their heels rubbed improved at a greater rate than people who had their toes rubbed. Alas, such is not the case. Dr. William Jarvis, writing for the National Council Against Health Fraud, describes a “how-to” reflexologist manual’s instructions:

Look for constrictions, or the places where the person feels pain or says 'ouch'; check the accompanying charts to determine what body part corresponds to the sore part of the foot. Tell your friend that he either has a problem in that organ or a strong potential for one.

It’s foolproof: if something is found at an alleged reflex point it is "proof" that the system is valid; if nothing is found, the system is still supposedly valid because it predicts future problems. This method represents a no-fail "heads I win, tails you lose" proposition. As obvious as this may be to an objective observer, it is not as apparent to practitioners or clients who have been impressed by the system's seeming validity on a personal or anecdotal level.

Jarvis goes on to describe a study he conducted in an effort to assess the reflexology claims of detecting, predicting, or preventing future disease. Working with a certified reflexologist, he constructed a scheme in which the feet of seventy different subjects were probed to determine which subjects suffered from ailments. The subjects were separated from the reflexologist by a curtain through which their feet protruded, and answered questions by means of pre-determined signs (“That hurts a little,” “That hurts a lot,” and so on) to minimize subconscious cues. The reflexologist agreed that these limitations should not, according to classic reflex foot theory, impair his ability to diagnose disease.

For the majority of cases, the reflexologist’s results were right in line with random guessing. His best showing was “stomach problems,” on which he did about 7 percent better than a random guess would have indicated. As the study’s author dryly observes, “Although 7 percent better than random guessing is enough to make a gambler rich who plays long enough, it is far below an acceptable standard for medical tests.”

Other research has produced similar results. One outlier was a study of 35 women suffering from PMS treated by reflexology or by a placebo foot rub, with the reflexology treatment group showing statistically significantly fewer symptoms than the placebo group. Critics of that study point to the poor quality of the placebo foot massage, described in the study as being either very light or very rough, and suggest that an effective placebo massage would be have to be soothing to be credible. No study has shown definitive clinical improvement unambiguously attributable to reflexology.

That said, it’s beyond cavil that a nice foot massage, done skillfully, is a relaxing — perhaps even transcendent — experience. As an aid to general relaxation, reflexology-type massages are undoubtedly of value; as a medical diagnostic device or cure they are worthless.

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Staff Reports are written by the Straight Dope Science Advisory Board, Cecil's online auxiliary. Though the SDSAB does its best, these columns are edited by Ed Zotti, not Cecil, so accuracywise you'd better keep your fingers crossed.


“Feet First: A Guide to Foot Reflexology,” by Laura Norman, Fireside; (November 1988)

“The Reflexology Atlas,” by Bernard C. Kolster M.D. and Astrid Waskowiak M.D., Healing Arts Press (January 2006)

“Reflexology,” by William Jarvis, from http://www.ncahf.org/articles/o-r/reflexology.html retrieved on 09-30-2009

“Reflexology: A Close Look,” by Stephen Barrett, M.D., at http://www.quackwatch.org/01Quackery...cs/reflex.html retrieved on 10-1-2009

“Randomized controlled study of premenstrual symptoms treated with ear, hand, and foot reflexology,” by T. Oleson and W Flocco, at http://www.ncbi.nlm.nih.gov/pubmed/8...?dopt=Abstract retrieved on 10-1-2009


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