This week, I was browsing through a book store and picked up Reflexology, health at your fingertips by Barbara & Kevin Kunz.  Now, I’ve been treating patients for quite some time and am always skeptical of new and/or alternative medical treatments.  Especially in the realm of alternative medicine.  As a podiatrist, this book caught my attention.  I have heard of Reflexology before and have even had some patients try it as alternative treatments.  Some of my patients have benefited from a visit to their reflexologist.  What I found puzzling , however, was some of these patients went to a reflexologist and found similar relief that I’ve seen from message and physical manipulative therapy.  However, Reflexology is not historically about message therapy.  It is actually about applying pressure to points on top and under your foot to influence and improve the health of corresponding body organs and body parts.  Confused yet?  Here is the ongoing controversy:  Can you really touch a pressure point on your foot and cure that UTI?  Well, instead of debunking the entire concept, I thought I would take the time to do some research on the subject.  Is reflexology science,theory or just quackery?  According to Kunz: “Reflexology is the practice of applying pressure to the specific points on the feet and hands to influence the health of corresponding parts of the body.  “Pressure sensors” on the hands and feet connect with different parts of the body, and as reflexology techniques stimulate these sensors, waves of relaxation are sent throughout the body . . . “ 

History

In Kunz’s book, evidence that reflexology existed is inferred from artifacts and pictographs dating back to ancient Egypt.  These pictographs can be found at the entrance of tombs such as the Physician Ankhamhor at Saqqara dating 2330 BCE.  Other pictographs shows a healer treating the feet of foot soldiers.  Similarly, in ancient China some 5000 years ago, medical texts such as The Method of Toe Observations , for example, made observations to connect foot health to general health.  Similar inferences were made in other cultures and built upon by the western research of medicine and therapy. 

It appears that with the early research in the 1800’s of the reflex as an ‘involuntary response to stimulus’ served as a basis for modern reflexology.  Sir Henry Head (1861-1940) postulated Head Zones or areas of the skin linked to the nervous system as dermatomal patterns or dermatomes.  The term reflexology was later termed by a Russian physician, Vladimir Bethterev in 1917.  The concept of Zone Therapy was influenced by the work of Dr. William Fitzgerald (1872-1942) here in the United States.  This is a concept that divides the body into 10 longitudinal zones, with 5 zones on each side of the body.  In this last century, Eunice Ingham (1879-1974) wrote a book entitled Stories the Feet Can Tell, actually devising charts showing reflex zones of the feet that we see reflexologists use today. 

Reflexology Foot Mapping

Click here to see interactive map 

How does it work?  Well, the foot is divided into various dermatomal patterns that corresponds to particular body part or organ in the body.  The idea is to stimulate the particular ‘zones’ and initiate a corresponding ‘reflex’ that will invoke a beneficial response to that body part or organ. 

The basic concepts of reflexology in the foot include the following:

1. The fight or flight mechanism is rooted in the soles of our feet by processing environmental stimulus.  These sensations, in essence, prepares the body for a possible need in the uptake of oxygen, muscle contraction and levels of blood sugar and whether they are sufficiently met. 
2. Tension in a particular zone of the body can be stimulated to release tension by stimulating the area of the foot responsible for restoring equillibrium in that zone. 
3. Reflexes are thought to work instinctively throughout the foot and pressure to these points can relieve stress .

However, it can be argued that this thought process is conceptual.  Does pressing the bottom of the big toe, for instance, stimulate the pituitary gland.  As Kunz describes, “For example, a single nerve travels from the center of the big toe to the part of the brain responsible for controlling movement, respiration, and cardiac acceleration.  So pressure applied to the center of the big toe, the pituitary gland reflex area, triggers a revival response (as in fight or flight)”. 

Now, as any doctor or anatomist will know, there is really not a single nerve that travels from the big toe to the pituitary gland.  Also, if this concept is true, scientific testing can validate the concept of pituitary stimulation by stimulating pressure receptors under the big toe.  To my knowledge, this has not been studied.  Or maybe its just too ludicrous to study?  Like many arguments made with alternative medical treatments, it is harder to prove that something doesn’t exist rather than prove it does. 

Reflexology . . . the debate continues

According to Chris Mooney, writer for the Washington Monthly reported in 2002, “A recent study in Complementary Therapies in Medicine proved that reflexologists were unable to identify specific illnesses in patients, and another in Respiratory Medicine revealed that reflexology fared no better than a placebo in curing bronchial asthma. But the 25,000-member International Institute of Reflexology in St. Petersburg, Fla., remains unconvinced. “ 

I did a search on Reflexology at the National Center for Complimentary Medicine (NCCAM), an arm of the National Institutes of Health (NIH).  I found very little information on Reflexology.  In Kunz’s book, he sites Chinese studies and Danish trials and studies to support a claim that reflexology is truly legitimate.  That is not surprising since Denmark has more reflexologists than medical doctors.  In recent years, the NIH has come under attack for not properly identifying CAM’s as legitimate or not and spending billions of dollars in research grants, some funded by the CAM organizations themselves. 

The field continues to have its skeptics.   Reflexology is considered a CAM or ‘complimentatary and alternative medicine’ in the medical establishment.  I think where reflexology continues to be controversial with traditional medicine is its proposal that it can alleviate not just symptoms, but disease and infection.  I also believe the chiropractic community has also seen similar controversies in the proposal that certain manipulations of the foot can alleviate certain conditions and infection.  However, I think this is primarily an educational issue.  I believe that most reflexologists understand that reflexology is an adjunct, alternative therapy.  It has been reported that reflexology can help most people by relieving stress from painful conditions such as ovarian cysts, back pain and arthritis to migraine headaches, just to name a few.  Reflexology is also practiced in obstetrics to decrease contraction pain.  It has also been shown to help patients who undergo chemotherapy as adjunct treatment. 

But will massage therapy or general rubbing of your foot, provide the same stress relief?  These are questions that should be addressed and answered to provide validity to the practice of reflexology.  Sometimes, patient testimonials and the word of the International Institute of Reflexology is just not enough to validate a particular practice of medicine as ligitimate. 

Dr. Stephen Barrett, creator of quackwatch.org writes this concerning Reflexology:

“The pathways postulated by reflexologists have not been anatomically demonstrated; and it is safe to assume that they do not exist. Similar rationales are used employed by iridologists (who imagine that eye markings represent disease throughout the body) and auricular acupuncturists who “map” body organs on the ear (a homunculus in the fetal position). The methodology is similar in both of these; and some commentators consider pressing on “acupuncture points” on the ear or elsewhere to be forms of reflexology, but most people refer to that as acupressure (”acupuncture without needles). The Reflexology Research Web site displays charts for foot and hand reflexology . . . Many proponents claim that foot reflexology can cleanse the body of toxins, increase circulation, assist in weight loss, and improve the health of organs throughout the body. Others have reported success in treating earaches, anemia, bedwetting, bronchitis, convulsions in an infant, hemorrhoids, hiccups, deafness, hair loss, emphysema, prostate trouble, heart disease, overactive thyroid gland, kidney stones, liver trouble, rectal prolapse, undescended testicles, intestinal paralysis, cataracts, and hydrocephalus (a condition in which an excess of fluid surrounding the brain can cause pressure that damages the brain). Some claim to “balance energy and enhance healing elsewhere in the body.” One practitioner has even claimed to have lengthened a leg that was an inch shorter than the other. There is no scientific support for these assertions.”

Opponents of reflexology argue that mainstream acceptance of reflexology would lend credibility to a multi-million dollar industry and open the door to the lucrative insurance market.  Whatever the argument, reflexology and alternative medical treatments will continue to have its proponents and provide some patients alternative treatments.  The thing to realize with these treatments, is just like conventional medical treatment, it may work for some and not for others. 

It must be stressed, however, that in order to classify reflexology as a science, it must withstand scrutiny and testing for validation.  Until now, Reflexology has not passed the test of medical science to validate its concept and remains just a expensive foot massage.

Links 

International Institute of Reflexology

Association of Reflexologists 

Reflexology Forum 

Maternity Reflexology

Mooney Chris, Science Fiction  Washington Monthy, April 2002

© Al Kline DPM, 2006