case studies for reflexology

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Testimonials

40 case studies.

Before I became a qualified reflexology therapist, I was a fan. It was my treatment of choice for specific purposes. In a metaphorical sense, our feet are instrumental in moving us forward, I was committed to moving forward in a healthier way.

During my training as a therapist, I was thrilled to discover, that as soon as I began to apply reflexology therapy myself, I began to witness immediate benefits for my clients.

I was fortunate to have had a great variety of clients for my 40 case studies which were a requirement of my diploma qualification. I was presented with a wide range of feet of all ages , shapes,

colours, textures and sizes. Each pair told their own unique story. As time went on I began to notice patterns and traits that corresponded with the individual themselves.

The results were noticeable and varied. Relaxation was the benefit most reported by my 10 clients. In fact one person told me it was the first time that they ever managed to feel so relaxed.

case studies for reflexology

As relaxation provides optimum conditions for the body to heal itself and carry out all its functions with ease and efficiency, I considered this to be a very important benefit for my clients. Along with the invitation to relax, another client reported that the opportunity to do 'nothing' for one whole hour was rare. At the end of the course of treatments, this client had made a life decision which would improve his career opportunities.

"Reflexology provides many benefits for wellbeing. These benefits cannot be guaranteed or predicted at the outset but with the client and the therapist working together there are usually good results."

I noted in my case studies that many clients enhanced their treatment by implementing some of the suggestions recommended to them as part of the agreed treatment plan. These ranged from taking in some extra walking, fresh air, water and self-treating the reflexes on the hands.

case studies for reflexology

Perhaps as a result of their resolve, some of the results were quite impressive, such as, the absence of sciatica pain (for as long as 2 months after treatment), improved breathing for a client who had high blood pressure, and a client who started a walking routine and then decided that jogging was more fun.

My overall conclusion of my 40 case studies? Reflexology provides many benefits for wellbeing. These benefits cannot be guaranteed or predicted at the outset but with the client and the therapist working together there are usually good results.

A person's body and mind has a wonderful ability to heal and maintain wellbeing but peoples lives are often busy and stressful. Sometimes a change in the routine is needed, a slowing down to allow for mindful listening and the development of a more self-caring attitude in order to get back on track and achieve balance once more.

Reflexology is an effective holistic treatment, performed mainly on the feet but also on the hands/ears/face. It takes into account the whole person in their environment to provide an opportunity for positive change.

The therapist applies specific and varied pressure to areas of the feet (or hands) known as reflexes, which correspond to specific organs or systems of the body. In doing so, circulatory systems (blood, lymph) are stimulated, along with the nervous, excretory and endocrine systems. The whole person (mind and body) can benefit as a result.

While reflexology is  a highly respected complementary therapy and some doctors may even recommend it to their patients, it is not a replacement for medical diagnosis and treatment.

case studies for reflexology

Caroline Cunningham

I love reflexology, it has served me well in my path of transformation to becoming much healthier and happier. I specialise in helping clients who want to succeed with their personal and business goals. I do this by providing reflexology therapy and personalised support and strategies for managing stress and achieving balance. My therapy services are available in Carlow and Dublin and nearby counties in Ireland. Through my blogs I hope more people will be inspired to take steps to improve their wellbeing. Read more about  my educational background and expertise here.

case studies for reflexology

Calming & Super Knowledgeable

Katie dunne, tullow, co. carlow, incredibly relaxing home treatment cancer care, claire, dublin,         motivation & focus        , maria muffat, dublin, energised & fewer headaches, s. lynch, dublin, helpful physically & emotionally, hazel, dublin,             feeling at ease            , melanie, dublin,           stress-free zone           , colette coughlan, dublin.

case studies for reflexology

            Walking on Air            

Read more..., anna scheller u.s.a, tummies settled & sleeping better, a. o’shea, carlow, motivation & focus, feeling at ease, stress-free zone, walking on air.

Many people with health insurance are not aware that they have cover for reflexology therapy and that they are missing out on this valuable health and wellbeing benefit. "The fact that Irish Health Insurers cover reflexology, in my view, adds to the credibility of the effectiveness of the therapy." I provide a bespoke reflexology wellness […]

"Letting go of old ways and making big life decisions during these periods of transition, left me feeling quite unsteady at times. I was in danger of triggering past anxieties, accumulating tension upon tension." I was someone with a goal. I wanted to change my ways to be more positive, to embrace new experiences and […]

In September 2017, I had the opportunity to study with the first reflexologist in the world to attain Doctorate level of education in the field of reflexology therapy. During our training module Dr. Samuel covered the theory and practice of Nerve Reflexology with specific application for Pain relief. As I am also a former Science […]

Reflexology Case Study

case studies for reflexology

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What Is Reflexology and What Are the Benefits?

  • How It Works
  • Effectiveness
  • What to Expect

Reflexology is a practice based on the premise that areas and organs in the body are linked to reflex areas on the hands and feet.

Reflexology is considered a complementary therapy, meaning that it is meant to be used alongside conventional medical care rather than instead of it. There is no scientific evidence to prove that it can prevent or cure any type of disease. However, some studies show it may help relieve certain symptoms, such as pain and anxiety .

Trials on reflexology should be viewed critically, as many are poorly designed. Results from studies have been mixed, but some offer promising results in symptom relief that are worth exploring further.

Read on to learn more about reflexology and ways it may be helpful.

boonchai wedmakawand / Getty Images

What Is Reflexology?

Reflexology is a practice that involves applying different amounts of pressure to specific points on the feet or hands. These points are believed to link with certain organs or other parts of the body.

The practice claims to cause relaxation and healing in those parts of the body, but this has not been proven.

How Does Reflexology Work?

Reflexology is based on the theory that all areas of the body correspond with and can be mapped onto areas of the hands and feet. Typically, the feet are used in reflexology, but in some circumstances, the hands or ears may be used.

Reflexologists use hand and foot maps that illustrate points that correspond to certain areas of the body.

Reflexology Association of Canada.

During a reflexology session, pressure and stimulation using the reflexology technique are applied to these points to improve blood and energy circulation, give a sense of relaxation, and maintain homeostasis (bodily systems remaining stable as they adjust to changing conditions).

The exact mechanism of action (how it works) for reflexology has not yet been determined, but there are some proposed theories:

  • Nerve impulse theory : Proposes that stimulation of specific reflex points on the feet enhances nervous system connection to the parts of the body that correspond to those points. It's suggested that benefits from reflexology stem from the involvement of the central and autonomic nervous systems . Reflexology may work by stimulating the release of endorphins (chemicals made by the nervous system to manage pain , reduce stress, and enhance mood).
  • Hemodynamic theory : Proposes that stimulation from reflexology enhances blood flow to the corresponding organ or body area.
  • Energy-related theories : Proposes that body parts can communicate using electromagnetic fields, and this communication can become blocked or congested. Reflexology may restore energy flow and open these blockages, possibly by breaking up lactic acid crystals stored in the feet.
  • Fascia involvement : Proposes that reflexology may influence changes in the fascia (a thin membrane or fibrous sheath that covers and separates body organs), which in turn affects certain areas of the body.

None of these theories have been sufficiently supported by quality evidence, and more research is needed.

Because it is non-invasive and low-risk for side effects, reflexology may be suggested as a treatment in addition to conventional medical care to see if it helps a person feel better. However, it should not replace medical care and conventional treatment.

Does Reflexology Really Work?

Studies have shown reflexology may be effective in certain situations such as:

  • Lowering heart rate and blood pressure
  • Improving labor pain during delivery, duration of labor, and anxiety in pregnancy
  • Significantly decreasing pain and moderately decreasing nausea in cancer patients

Researchers involved in a 2014 review concluded reflexology had a positive effect on the health and well-being, quality of life, stress, anxiety, and pain levels of the participants. They also noted studies had small sample sizes and further research is needed to better understand the use, effectiveness, and mode of action of reflexology.

What Are the Benefits of Reflexology?

While not proven, there is some evidence that reflexology may help with the following:

  • Pain reduction
  • Mood elevation
  • Stress relief
  • Improvement in feelings of anxiety
  • Improved sleep

It is also a low risk for causing side effects or complications and may be a useful complementary treatment (check with your healthcare provider first).

As stress and pain are linked to health problems, it's possible that by alleviating these, reflexology could indirectly lead to other health benefits (though not as a treatment or cure for specific illnesses or conditions).

Although there's no evidence, other possible benefits of reflexology include:

  • Improving the immune system
  • Recovery from illness
  • Improving fertility
  • Balancing hormones
  • Improving digestion
  • Reducing arthritis pain

Reflexology has not been scientifically proven to cure or prevent any type of medical condition or disease. Research trials have shown mixed results, but there are few quality trials with evidence to suggest that reflexology may help with pain , relaxation, and stress relief.

Support for reflexology largely comes from anecdotal sources (people who say it helped them) and flawed or unreliable studies (e.g., small sample sizes, and a methodology that is not well-controlled ). Conclusive evidence that reflexology works is lacking.

Still, the fact that many people seem to feel better after reflexology sessions has led to theories about how reflexology may make people feel better—even if reflexology techniques and methods are not backed by evidence.

Factors that may influence the effectiveness of reflexology (and the legitimacy of study results) include:

  • Environment/ambiance : Reflexologists often use relaxing music , lighting, and scents during reflexology sessions which could help to facilitate relaxation and stress relief, as well as reduce anxiety and pain.
  • Support from reflexologist : During the session, especially when lying face up, the person can talk to the reflexologist, share their worries and concerns, work through personal challenges, or gain clarity. This psychological support, especially coupled with a relaxation response, could prompt improvement in health and well-being.
  • Physical touch : Human touch has been shown to work as a tool to bring comfort and promote healing. Reflexology sessions involve touch, such as stroking, massaging , and manipulation of soft tissue.
  • Placebo effect : It's possible that expecting positive outcomes can create positive outcomes through the power of suggestion. This doesn't mean that the positive results aren't real. It means that they may not have occurred specifically due to the reflexology treatment itself (or the procedure alone).

Whether or not reflexology techniques are directly responsible for results, they may still benefit some people and may be worth a try as long as it doesn't interfere with standard medical care.

Is Reflexology Safe to Try?

Reflexology is considered safe for most people, but as with any health program, it should be discussed with your healthcare provider before starting sessions.

The biggest safety concern with reflexology is the potential for its use in place of conventional treatments. Reflexology should only be used in addition to conventional medical treatments . It is not considered an effective treatment for conditions on its own. Using it instead of seeking care from a healthcare provider could lead to:

  • Missed/inaccurate diagnosis
  • Ineffective treatment
  • Delayed treatment
  • Worsening condition in the absence of effective treatment

See a Qualified Reflexologist

Make sure to choose a reflexologist who is properly trained and qualified. Ask them where they trained and see if they are registered with any credible associations, such as the Association of Reflexologists.

Look for red flags. A reflexologist should not:

  • Diagnose medical conditions
  • Prescribe medications
  • Treat for specific conditions
  • Claim to cure anything
  • Work against conventional medicine
  • Encourage you to stop taking prescribed medication or go against your healthcare provider's treatment plans or recommendations

If you notice any red flags or feel uncomfortable for any reason, it's OK to stop the session and/or stop seeing that reflexologist.

Generally, reflexology is thought to have few side effects. Some people may experience effects such as:

  • Light-headedness
  • Emotional response
  • Needing to urinate more often

If you experience any negative effects, talk to your reflexologist (and/or healthcare provider if it's more than a temporary, minor effect).

Who Should Not Do Reflexology?

There are some situations when reflexology may not be advised. Before trying reflexology, talk to your healthcare provider to ensure it's safe for you. Tell your reflexologist about any medical conditions you have, treatments you are doing, and medication you're taking.

Reflexology may not be appropriate if some conditions are present, including:

  • Problems with circulation in the feet
  • Inflammation or blood clots in the leg veins
  • Foot ulcers
  • Fungal conditions of the feet (such as athlete's foot )
  • Low platelet count (you may bruise or bleed more easily)

What to Expect From a Reflexology Session

Reflexology sessions typically last 30 to 60 minutes.

At the beginning of the first session, or intake, the reflexologist will:

  • Ask some general questions about your medical history (e.g., health, lifestyle)
  • Explain how reflexology works, what it does not do (such as treat specific illnesses), and what to expect
  • Have you sign a consent form (not every practice requires this)
  • Give time and space for you to ask questions (if the reflexologist is dismissive of your questions/concerns or not forthcoming with information, consider that a red flag)

You usually lie down or sit in a reclining chair during sessions. You will stay fully clothed, except for your feet, if your feet are being worked on.

Reflexology sessions shouldn't hurt. They are typically relaxing and soothing, but there may be discomfort when a sensitive reflex is being worked on. Tell your reflexologist if you are feeling pain or discomfort so they can adjust their pressure or technique. It's also okay to stop the session at any time.

During the session, your reflexologist will:

  • Work on your feet, hands, ears, or a combination, depending on your needs, wants, and accessibility
  • Wash your feet and soak them in warm water (possibly)
  • Assess your feet for open wounds, rashes, sores, warts, or bunions, and ask you about any foot or leg pain you may be experiencing (if working on feet)
  • Encourage you to do what feels comfortable (e.g., talk, rest, sleep), and encourage feedback as you go
  • End the session in a calm, peaceful way that may involve stroking the hand or offering food

Reflexology is a practice that involves stimulating certain areas of the feet and sometimes hands and/or ears. The theory behind this is that areas on the feet and hands correlate with areas and organs of the body.

There is not enough evidence to support reflexology as a treatment or cure for any condition. Some studies show positive health benefits, but most studies on reflexology are poor quality, small, or flawed.

Reflexology may help with stress relief , pain relief, anxiety, and relaxation in combination with other treatments.

McCullough JEM, Liddle SD, Sinclair M, Close C, Hughes CM. The physiological and biochemical outcomes associated with a reflexology treatment: a systematic review . Evidence-Based Complementary and Alternative Medicine . 2014;2014:1-16. doi:10.1155/2014/502123

Cancer Research UK. Reflexology and cancer .

National Center for Complementary and Integrative Health. Reflexology .

Whatley J, Perkins J, Samuel C. Reflexology: exploring the mechanism of action . Complementary Therapies in Clinical Practice . 2022;48:101606. doi:10.1016/j.ctcp.2022.101606.

Embong NH, Soh YC, Ming LC, Wong TW. Revisiting reflexology: concept, evidence, current practice, and practitioner training . Journal of Traditional and Complementary Medicine . 2015;5(4):197-206. doi:10.1016/j.jtcme.2015.08.008

Kotruchin P, Imoun S, Mitsungnern T, et al. The effects of foot reflexology on blood pressure and heart rate: A randomized clinical trial in stage-2 hypertensive patients . J Clin Hypertens (Greenwich). 2021 Mar;23(3):680-686. doi: 10.1111/jch.14103

Liang X, Wu S, Li K, et al. The effects of reflexology on symptoms in pregnancy: A systematic review of randomized controlled trials . Heliyon. 2023 Jul 19;9(8):e18442. doi: 10.1016/j.heliyon.2023.e18442

Anderson KD, Downey M. Foot Reflexology: An Intervention for Pain and Nausea Among Inpatients With Cancer . Clin J Oncol Nurs. 2021 Oct 1;25(5):539-545. doi: 10.1188/21.CJON.539-545

University of Minnesota. What does the research say about reflexology?

Huang HC, Chen KH, Kuo SF, et al. Can foot reflexology be a complementary therapy for sleep disturbances? Evidence appraisal through a meta-analysis of randomized controlled trials . J Adv Nurs. 2021 Apr;77(4):1683-1697. doi: 10.1111/jan.14699

McGill University. Reflexology research doesn’t put its best foot forward .

Tabatabaeichehr M, Mortazavi H. The Effectiveness of Aromatherapy in the Management of Labor Pain and Anxiety: A Systematic Review . Ethiop J Health Sci. 2020 May;30(3):449-458. doi: 10.4314/ejhs.v30i3.16

Li D, Li Y, Bai X, et al. The Effects of Aromatherapy on Anxiety and Depression in People With Cancer: A Systematic Review and Meta-Analysis . Front Public Health. 2022 May 30;10:853056. doi: 10.3389/fpubh.2022.853056

Morrison I. Keep calm and cuddle on: social touch as a stress buffer . Adaptive Human Behavior and Physiology. 2016;2(4):344-362. doi: 10.1007/s40750-016-0052-x

Association of Reflexologists. What is reflexology?

Ontario College of Reflexology. What is reflexology?

University of Minnesota. What can I expect in a first reflexology visit?

Therapeutic Reflexology Institute. Reflexology therapy .

By Heather Jones Heather M. Jones is a freelance writer with a strong focus on health, parenting, disability, and feminism. 

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People often ask if there are any evidence-based studies to substantiate the claims clients make of reflexology. There are hundreds.

Most studies investigate whether or not reflexology has a positive effect on specific health challenges. Studies that explore the mechanism or route by which reflexology actually works – the "how of it" – are extremely expensive to conduct, so most studies have not focused on that goal.

Research literacy (the ability to find, understand and critically evaluate research findings) is very valuable for educating clients and groups to whom you may wish to speak regarding the benefits reflexology can offer. Below are links to case studies and randomized controlled studies conducted worldwide. Abstracts are generally available at no cost; full research data often involves a fee.

Internet Search Engines

  • https://pubmed.ncbi.nlm.nih.gov
  • https://www.sciencedirect.com
  • http://scholar.google.com
  • http://translate.google.com/?hl=en&tab=wT  

Research Websites

American Academy of Reflexology http://www.americanacademyofreflexology.com

National Institutes of Health Clinical Reflexology Trials http://clinicaltrials.gov/ct2/results?term=reflexology

National Institute for Health and Care Excellence (NICE) https://www.evidence.nhs.uk/search?q=reflexology

Reflexology Research Project reflexology-research.com

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Website Disclaimer: The information contained in this website is for general information purposes only, and provided by the Reflexology Association of America. While we endeavor to keep the information up to date and correct, we make no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, suitability or availability with respect to the website or the information, products, services, or related graphics contained on the website for any purpose. Any reliance you place on such information is therefore strictly at your own risk. Every effort is made to keep the website up and running smoothly.

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Therapeutic reflexology book – case studies.

Therapeutic Reflexology: A Step-by-Step Guide to Professional Competence contains case studies that show how reflexology practiced alone or with an allied therapy helped someone meet a health challenge.

Chapter 5: Reflexology, Massage, and Allied Practices

· Reflexology and Massage Assist Runner · Aromatherapy Enhances Relaxation During Reflexology · Reflexology and Acupuncture Help Retiree · Engineer’s Legs Improve with Reflexology and Lymphatic Drainage

Chapter 6: Wellness Models

· Lifestyle Changes Improve Chronic Fatigue Syndrome

Chapter 7: Session Fundamentals and Charting

· A Question of Frequency

Chapter 15: Integumentary System

· Reflexology and Poor Circulation

Chapter 19: Cardiovascular System

· Scar Tissue and the Heart Reflex

Chapter 20: Sensory System

· Reflexology and Cochlear Degeneration · Reflexology and Taste

Chapter 21: Respiratory System

· Reflexology and Costochondritis

Chapter 22: Endocrine System

· Reflexology and Hyperthyroidism

Chapter 23: Lymphatic System and Immunity

Chapter 25: urinary system.

· Reflexology and Kidney Stones · Reflexology, Kidney Function, and Nerve Flow

Reflexology

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Research on reflexology

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close up of reflexologist hands on a foot

However, reviewers of the research have noted that the quality of reflexology studies is mixed and more high-quality research is needed.

What do summaries of the research say?

One large review by Kunz and Kunz (2008) summarized 168 research studies and abstracts from journals and meetings from around the world. Many of these studies originated in peer-reviewed journals in China and Korea. All of the studies had information about the frequency and duration of the reflexology application. Based on the studies they reviewed, Kunz and Kunz concluded that reflexology may:

✔  Impact specific organs

For example, fMRI readings demonstrated an increase in blood flow to kidneys and to the intestines.

✔  Improve symptoms

In particular, positive changes were noted in kidney functioning with kidney dialysis patients.

✔  Induce relaxation

Though EEG measurements of alpha and theta waves, researchers saw that blood pressure was decreased, and anxiety was lowered.

✔  Reduce pain

Twenty-seven studies demonstrated a positive outcome for reduction in pain; e.g., AIDS, chest pain, peripheral neuropathy of diabetes mellitus, kidney stones, and osteoarthritis.

Other systematic reviews are cautious in saying that reflexology may:

  • Learn more about diabetes have a positive effect on type 2 diabetes (Song, 2015)
  • exert a beneficial effect on lowering blood pressure and incontinence (Song, 2015)
  • have a positive impact on blood pressure (McCullough, 2014)
  • be effective for tingling in MS (Yadav, 2015)

These reviews note that the quality of research studies on reflexology is generally low. 

A systematic review conducted by Ernst, Posadzki, and Lee (2011) critically evaluated the effectiveness of reflexology in the treatment of human conditions. Twenty-three RCTs met their inclusion criteria, with 8 suggesting that reflexology had beneficial effects, 14 showing no effectiveness, and one being equivocal. The authors note that the quality of the studies was often poor and encourage researchers to base future studies on the standards of the CONSORT ( http://www.consort-statement.org/ ) for trial design and reporting.

What about research for specific conditions?  

Below are some specific examples of research that examines the possible role of reflexology in alleviating various health concerns.

Hudson (2015) found that patients receiving reflexology prior to varicose vein surgery reported significantly lower intra-operative anxiety and shorter pain duration than participants receiving treatment as usual.

Williamson et al (2002) found that both reflexology and foot massage reduced anxiety and depression in postmenopausal women. In addition to this study, see the studies listed under Cancer Treatment.

Cancer treatment

These studies showed reduction of pain, nausea, diarrhea or constipation, and improved quality of life with reflexology.

  • In a controlled study with 87 patients, Hodgson (2000) found 100% improvement in the reflexology group in quality of life categories of appearance, appetite, breathing, communication (with doctors, family, nurses), concentration, constipation/diarrhea, fear of future, isolation, mobility, mood, nausea, pain, sleep/tiredness. The placebo group reported 67.6% improvement in these categories.
  • Stephenson et al. (2000) conducted a qualitative study in a hospital on 24 patients receiving reflexology with breast and lung cancer. Researchers noted a "significant decrease in pain" for patients with breast cancer. While this was a small sample, the well-controlled research design yielded meaningful results.
  • Milligan et al. (2002) looked at the impact of reflexology on the quality of life of 20 cancer patients. It found quality of life improved through a reduction of physical and emotional symptoms. This is a small sample, however.

Kim, Lee, Kang, Choi, and Ernst (2010) reviewed one randomized clinical trial (RCT) and three nonrandomized controlled clinical trials (CCTs), the only studies out of 60 potential studies to meet their criteria of controlled quantitative trials with physical or psychological outcomes. The studies showed significant reduction in pain, nausea/vomiting, and fatigue with reflexology, and improved sleep and mood. In short, all four studies suggested beneficial effects of reflexology for women with breast cancer.

The problem, according to the review authors, is that flaws in the studies jeopardize the validity of their results.  The review maintains that  "the main limitations of the included studies were small sample sizes, inadequate control for nonspecific effects, a lack of power calculations, and short follow-up or treatment periods" (p. 329).  Inadequate blinding and inadequate allocation concealment are factors that could also contribute to selection bias, leading to enhanced treatment effects. Their final conclusion, based on these four studies, was that there is "insufficient evidence for the effectiveness of reflexology as a symptomatic treatment for breast cancer." (pp 329-330).

Key to the understanding of these studies, and to the interpretation of all of the studies discussed in this section, is that it is difficult to plan and execute a well-designed study on reflexology that meets all of the parameters. Randomized control trials are the gold standard in health research, but these require blinding, which is always an issue with reflexology where the practitioner knows whether they are delivering reflexology or not.

Cardiovascular system

Ebadi et al (2015) looked at the effect of reflexology on reflexology on physiologic parameters and mechanical ventilation weaning time in patients undergoing open-heart surgery and found no difference in physiologic parameters, but a significantly shorter weaning time for those receiving reflexology.

Frankel (1997) conducted a pilot study to identify the effects of reflexology and foot massage on the physiology of the body, measuring baroreceptor reflex sensitivity and the link between pressure to the feet, as well as the baroreceptors of the  heart  (neurons). Results showed that pressure sensors in the feet are linked to the same part of the brain as the baroreceptor reflex. This small, single-blinded study included 24 subjects - 10 received reflexology, 10 received foot massage, and 4 were the control.

Diabetes Type 2

A 2015 systematic review by Song et al reported that self-administered foot reflexology might have a positive effect in type 2 diabetes, but the low quality of the included study and the lack of adequately reported clinical outcomes obscure the results.

An RCT by Dalai et al (2014) examining symptom management in type 2 diabetes concluded that the reflexology group showed more improvements in pain reduction, glycemic control, nerve conductivity, and thermal and vibration sensitivities than those of control subjects with statistical significance.

Migraine/tension headache

Testa (2000) conducted a blind, random trial, in which 32 patients with headaches were evaluated after a session with foot reflexology and at a 3-month follow-up. Results showed that foot reflexology was at least as effective as drug therapy (Flunarizin).

Multiple sclerosis

The guideline development subcommittee of the American Academy of Neurology (2014) explored complementary and alternative medicine in multiple sclerosis and found that reflexology is possibly effective for tingling but only Level C evidence.

A small study by Nazari (2015) concluded that reflexology reduces fatigue in women with MS.

Koc and Gozen (2015) note a statistically significant difference in pain scores of infants suffering from acute pain between the reflexology and control groups. The infants in the reflexology group also had lower heart rates, higher oxygen saturation, and shorter crying periods than the infants in the control group.

Gordon et al. (2010) compared the effectiveness of foot reflexology, foot massage, and regular treatment (control group) in children (1-12 years) with chronic idiopathic constipation over a 12-week period. The study design was a randomized control trial. The authors report that the reflexology group had the greatest increase in the number of bowel movements and the greatest reduction in constipation symptom scores. There were significant differences between reflexology and control groups; however, there was no significant difference between reflexology and massage for bowel frequency, and no significant difference between control and massage groups for bowel frequency or overall constipation symptom scores.

Physiological research

Dr. Jesus Manzanares, a physician from Spain, has spent years studying the neurophysiological basis for reflexology. Dr. Manzanares' research has identified and biopsied deposits (which reflexologists have traditionally referred to as "crystals") that were located in reflex areas of the feet. These deposits are associated with pain, contain nervous fibers, and have different characteristics based upon their degree of acuity or chronicity (Manzanares, 2007). A brief overview of his unpublished work can be found at his website ( www.manzanaresmethod.com ). Using thermographic pictures of the soles of the feet before and after reflexotherapy, along with similar pictures of the spinal column, Dr. Piquemal was able to show a change in the thermal pattern on the sole of the feet "that was reflected on the skin of the back for each of the five selected [cutaneous] zones" (2005). The importance of this research is that it ties reflexology work on the feet to blood flow of inner organs (lung, liver, stomach, pancreas, and small intestine), either through vasoconstriction or vasodilation via the autonomic nervous system. It appears that reflexology may be able to play a role in regulating blood flow disturbance, at least to these organs.

Postoperative symptoms

From their research in India, Choudhary, Kumar, and Singh (2006) reported two groups who received interventions postoperatively. Group I received foot reflexology for 15-20 minutes at transfer to the Recovery Room, 2 hours postoperatively. Group II received conventional pain medication (NSAID and Opiods). The results were statistically significant at all four time intervals for the reflexology group showing a decrease in use of medication over the conventional group. A significant decrease in pain was also noted in the reflexology group at all time intervals. When the pain score was compared before and after treatment in the reflexology group, statistical significance was seen at 2 and 6 hours postoperatively. Using two groups for comparison, Choudhary and Singh (n.d.) also added hand reflexology to conventional medications for nausea and vomiting postoperatively. They found a significant decrease in the group who had reflexology plus conventional medication.

Healey et al. (2002) conducted a randomized, controlled study of 150 subjects examining reflexology for alleviation of chronic sinusitis. Participants who received reflexology therapy comprised the control group. The other two groups received nasal irrigation procedures. Results showed equal improvement in both groups.

In an article entitled "The Saline Solution?" Andrew Weil, MD, commented, "After two weeks of daily treatment, more than 70% of those practicing nasal douching reported improved symptoms. But surprisingly, the group that practiced reflexology massage - pressure to feet or hands, appeared to fare equally as well. The unexpected results for this technique may prompt further research."

Brendstrup, E & Launse, L. (1997). Headache and Reflexological Treatment. The Council Concerning Alternative Treatment, The National Board of Health, Denmark.

Choudhary, S., Kumar, G., & Singh, K. (Spring 2006). Reflexology reduces the requirement and quantity of pain killers after general surgery. Reflexology Across America . Retrieved from Reflexology Association of America website: http://www.reflexology-usa.org/assets/dr_shweta_research_study.pdf .

Choudhary, S. & Singh, T. (n.d.). Efficacy of reflexology in prevention of post-operative nausea vomiting. Retrieved from Reflexology Association of America website: http://www.reflexology-usa.org/assets/Dr_Shewta_Research_Post_Operative_Nausea.pdf .

Dalal K, Maran VB, Pandey RM, Tripathi M. (2014). Determination of efficacy of reflexology in managing patients with diabetic neuropathy: a randomized controlled clinical trial. Evid Based Complement Alternat Med. 2014:84303

Ebadi A, Kavei P, Moradian ST, Saeid Y. (2015). The effect of foot reflexology on physiologic parameters and mechanical ventilation weaning time in patients undergoing open-heart surgery: A clinical trial study. Complement Ther Clin Pract ., 21(3):188-92.

Ernst, E., Posadzki, P., & Lee, M. (2011). Reflexology: An update of a systematic review of randomised clinical trials. Maturitas 68 , 116-120. Retrieved from http://www.elsevier.com/locate/maturitas .

Gordon, J., Alder, E., Matthews-Smith, G., Hendry, I., & Wilson, D.(November 2010). The effectiveness of reflexology as an adjunct to treatment in childhood idiopathic constipation: A single line randomised controlled trial (The SOCC Project). Paper presented by Amy Kreydin at the Reflexology Associaton of Canada Conference, Winnipeg, British Columbia.

Healey, D, et al. (2002). Nasal Irrigation for the Alleviation of Sinonasal Symptoms. Presented Sept 25 at the American Academy of Otolaryngology.

Frankel, B.S.M. (1997). The effect of reflexology on baroreceptor reflex sensitivity, blood pressure and sinus arrhythmia, Complementary Therapies in Medicine, 5, 80-84.

Hodgson, H. (2000). Does reflexology impact on cancer patients' quality of life?" Nursing Standard, 14 (31), 33-38.

Hudson BF, Davidson J, Whiteley MS. (2015). The impact of hand reflexology on pain, anxiety and satisfaction during minimally invasive surgery under local anaesthetic: A randomised controlled trial. Int J Nurs Stud . S0020-7489(15)00231-X

Kim, J-I., Lee, M., Kang, J., Choi, D., & Ernst, E. (2010). Reflexology for the symptomatic treatment of breast cancer: A systematic review. Integrative Cancer Therapies, 9. 326-330. doi: 10.1177/1534735410387423.

Kim M.S. et al. (2001). Effects of hand massage on anxiety in cataract surgery using local anesthesia. J Cataract Refract Surg, 27 (6):884-90.

Koç T., Gözen D. (2015). The Effect of Foot Reflexology on Acute Pain in Infants: A Randomized Controlled Trial. Worldviews Evid Based Nurs . Jul 28. [Epub ahead of print]

Kunz, B. & Kunz, K. (2008). Evidence-Based Reflexology for Health Professionals and Researchers: The Reflexology Research Series . This book can be purchased from http://www.reflexology-research.com/researchforresearchers.html .

Manzanares, J. (September 2007). The science behind reflexology deposits. Paper presented at the International Council of Reflexologists, Anaheim, California. Retrieved from Reflexology Association of America website: http://www.reflexology-usa.org/articles/manzanares_research_biopsy.pdf .

McCullough JE, Liddle SD, Sinclair M, Close C, Hughes CM. (2014). The physiological and biochemical outcomes associated with a reflexology treatment: a systematic review. Evid Based Complement Alternat Med.2014:502123.

Milligan, M. et al. (2002). Int J. Oalliat Nurs, 8 (10), 489-96.

Nazari F, Shahreza MS, Shaygannejad V, Valiani M. (2015). Comparing the effects of reflexology and relaxation on fatigue in women with multiple sclerosis. Iran J Nurs Midwifery Res . 20(2):200-4.

Piquemal, M. (September 2005). Global effect of reflexology on blood flow. Paper presented at the International Council of Reflexologists, Amsterdam and summarized by Christine Issel for the ICR Newsletter (Vol. 15, No. 1, March 2006, pp 18-19), reprinted at the Reflexology Association of America website: http://www.reflexology-usa.org/assets/Piquemal_Article.pdf .

Rahbar, M., Wyatt, G., Sikorskii, A., Victorson, D., & Ardjomand-Hessabi, M. (2011, in press). Coordination and management of multisite complementary and alternative medicine (CAM) therapies: Experience from a multisite reflexology intervention trial, Contemporary Clinical Trials . doi: 10.1016/j.cct.2011.05.015.

Sikorskii, A., Wyatt, G., Victorson, D., Faulkner, G., & Rahbar, M. (2009). Methodological issues in trials of complementary and alternative medicine interventions, Nursing Research 58(6) , 444-451. Retrieved from http://www.nursing-research-editor.com .

Song HJ, Choi SM, Seo HJ, Lee H, Son H, Lee S. (2015). Self-administered foot reflexology for the management of chronic health conditions: a systematic review. J Altern Complement Med., 21(2),69-76.

Stephenson, N.L. et al. (2000). The effects of foot reflexology on anxiety and pain in patients with breast and lung cancer. Oncology Nursing Forum, 27 (1), 67-72.

Sudmeier, I., et al. (1999). Anderund der nierendurchblutung durch organassozilerte reflexzontherapie am fuss gemussen mit farbkodierter Doppler-sonograhpie. Universitatsklinik fur Innere Medizin, Inssbruk, Austria. Forsch Komplementarmed, 6 (3), 129-34.

Testa, G.W. (2000). A study on the effects of reflexology on migraine headaches. Accessed on May 24, 2007, from http://members.tripod.com/GTesta/Dissertationall.htm .

Ying, Ma. (1998). Clinical observation demonstrated the influence upon arterial blood flow in the lower limbs of 20 cases with type II diabetes mellitus treated by foot reflexology. China Reflexology Symposium Report, China Reflexology Association, Beijing, 97-99.

Weil, A. (January, 2002). The Saline Solution? Self Healing , p 2.

Williamson et al (2002). Randomised controlled trial of reflexology for menopausal symptoms. BJOG An International Journal of Obstetrics and Gynaecology, 109 (9) p 1050-1055.

Wyatt, G., Sikorskii, A., Bush, R., & Mukherjee, R. (2010). Team science of nursing, engineering, statistics, and practitioner in the development of a robotic reflexology device, Journal of the Society for Integrative Oncology, 8(1),14-19. doi: 10.2310/7200.2009.0017

Wyatt, G., Sikorskii, A., Rahbar, M., Victorson, D., & Adams, L. (2010). Intervention Fidelity: Aspects of complementary and alternative medicine research, Cancer Nursing, 33(5), 331-342. doi: 10.1097/NCC.0b013e3181d0b4b7

Yadav V, Bever C Jr, Bowen J, Bowling A, Weinstock-Guttman B, Cameron M, Bourdette D, Gronseth GS, Narayanaswami P. (2014). Summary of evidence-based guideline: complementary and alternative medicine in multiple sclerosis: report of the guideline development subcommittee of the American Academy of Neurology. Neurology . 82(12):1083-92.

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Academy of Ancient Reflexology

Professional Therapeutic Reflexology

Grad case studies

Case study reports.

As part of their final training, some of the students in the Academy’s Therapeutic Hand and Foot Reflexology Professional Certification choose to devote a significant amount of time to developing and implementing a case study with an individual suffering from a chronic health condition.

I am very proud to publish those reports on this website. May all reflexologists use the valuable results indicated in these reports to reach out and help more and more people living with these debilitating and often life-threatening diseases.

  • The Effect of Reflexology on Chronic Back Pain by Rebecca Tate, LMT ( 89 KB PDF)

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Case Studies

Relief from agonising back pain, client a was in his early 70s when he first came to see me for a holistic massage therapy session.  he had suffered five weeks of agonising pain with a trapped nerve and associated disturbed sleep. despite various medications, including diazepam and morphine sulphate, from his doctors and sessions with a physiotherapist at cheltenham general hospital, the pain was unrelenting.  his first holistic massage session provided him with some pain relief and after further sessions his initial pain disappeared.  he said: “i can now get on with enjoying my life again and i feel five years younger”, sleep improved and pain relieved, client b was in her 40s when she first came to see me for a holistic massage therapy session. she had been the main carer for both of her parents and her mother had recently passed away. it was a very challenging time for her. her job was very sedentary and she complained of an aching neck, shoulders and upper back and had trouble sleeping. after her second holistic massage the pain receded. she only suffered pain after driving or working for long periods.  she said: “after the sessions with jayne i felt much looser generally and i was able to stop taking painkillers. after further sessions, my sleeping habits have continued to improve and my shoulder pain is gradually disappearing.  “i feel as if a great weight has been lifted from my shoulders and my thoughts are much more positive.”, client c saw her stress ease and her life improve, client c was 36-years-old, a stressed and busy mother of two young children, with a puppy and a part-time job. she had no time for herself and was holding tension in her shoulders.  after three holistic massages she realised her lifestyle was causing her the stress and pain - and she needed to re-assess her priorities. she put in place a new way of working and living. she practised relaxation exercises when she found herself tightening her shoulders – which released the tension and prevented stress accumulating.    “holistic massage enabled me to stop and take time out from a busy and hectic lifestyle. i was able to clear my mind, reassess my life and feel positive about the future,” she said., stress reduced and skin and breathing symptoms improved, client d was 27 when she came to see me for a reflexology therapy session. she was under a lot of stress at work and was suffering from a flare up of her asthma and a flare up of her eczema on her hands and face. by using reflexology massage on the points relating to her adrenal glands her body relaxed, her breathing deepened and felt easier. the intensity and frequency of her eczema flare-ups reduced. she also investigated her diet and eliminated any eczema-related foods. she said: “i would highly recommend visiting jayne, she is a wonderful person and so easy to talk to. jayne has helped me with so much more than just improving my skin condition, for which i am very grateful.”, child’s stomach problems disappear, client e was only seven-years-old when she first came to see me for a reflexology session. she had been experiencing severe stomach pains followed by bouts of diarrhoea for several months. her mother could see no reason, or find no cure for her daughter’s discomfort despite investigations using conventional medicine. she was concerned at the possibility of her daughter taking long-term medication to treat the symptoms. client e received twice-weekly reflexology sessions for three weeks, then four “maintenance and support” sessions spread over four months.  her relieved mother said: “my daughter has not experienced any symptoms since the reflexology and we would not hesitate to use reflexology again.”, taxi driver now free of back pain, client f was 47 when he came for a holistic massage therapy session. he was a taxi driver doing local trips and airport runs. he had suffered from various aches and pains, which he thought were his for life. sitting in a car all day exaggerated his back problem and he realised he needed help. regular holistic massage sessions eased the pain and he realised the importance of taking regular breaks. he began scheduling his jobs to arrive at his destination early enough to get out and walk around for a while before starting the drive back home. he also learnt to alter his seat position slightly at regular intervals to reduce repetitive strain on certain muscles.  sessions were spread out as the pain decreased and he no longer needs holistic massage. he said: “i feel so good. i never thought this would happen. i thought i’d be stuck with these aches and pains for life. having the massages over a period of time worked wonders and i was totally surprised what it did for my body. it loosened all the tension. it was brilliant.”, contact info, 01242 602582 [email protected] 42, greet road, winchcombe,  cheltenham, gloucestershire,  gl54 5jt, © 2018 – jayne burke holistic therapist – all rights reserved privacy policy.

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Case Study 20: in Reflexology

by Ann Gillanders (more info)

listed in reflexology , originally published in issue 20 - May 1997

CYSTITIS is the inflammation of the bladder, and is usually acute, with scalding pain on the passing of water. It has a rapid onset. The patient feels off-colour. There is pain in the centre, low in the abdomen, which is worse when urine is passed. There is frequently passing of small amounts or merely the sensation of wanting to. Most cases resolve themselves without the need for deep-acting agents.

Bacteria invade when there has been continued irritation such as that of sand or gravel in the urine. Bacillus coli resides in the rectum but may invade the bladder. Urine is often turgid and evil smelling. By travelling down the ureters kidney infection may be conveyed to the lining of the bladder.

A common cause is diuretic indiscretion, such as too much spicy food, curries, peppers, vinegar, coffee, alcohol, tea, too much and too strong cola and other stimulants. Too much meat concentrates urine, as do other high purine foods.

Plenty of fluids should be drunk, either in the form of herbal teas, alfalfa, or bottled waters rather than coffee or tea. These dilute the irritating effect of uric acid in the urine.

Mandy was a very attractive 24-year-old and came to me with a history of chronic cystitis which had occurred during the last 12 months. The infections caused a lot of low pelvic and back pain. She often had a raised temperature and frequent episodes of passing small amounts of urine during the night, which gave her a very disturbed sleeping pattern.

She seemed an anxious young woman, although on the initial consultation there was no real evidence of the reason for her emotionally stressed state. During the treatment sessions the area of the bladder and pelvic areas were extremely sensitive to pressure; in fact, the slightest pressure gave rise to extreme discomfort in her feet and made the general pressure unacceptable to her.

Mandy also reported that during the attacks of cystitis she was quite sure that her eyes became affected as they were normally sore, irritating and watery. She had reported this fact to her GP who said that there was no link between cystitis and eye conditions whatsoever. However, when she was introduced to the benefits and understanding of Reflexology, I explained to her how the kidney and eye areas are in the same related areas and it is very common to find when people have bladder inflammations that their corresponding area, the eye, is extremely sensitive and can cause the symptoms of soreness, watering and sensitivity that she described.

Mandy used to bring her three-year-old son with her, so the treatment sessions were not as relaxed as I would have liked them to be, but she explained that she had nobody to leave her young son with and so it was necessary for him to accompany her in order that she could continue regular Reflexology treatments.

We worked out a rota for a weekly treatment session. I said that in normal situations six sessions should give good, satisfactory relieving results, then maybe the occasional treatment on a monthly basis would be advisable for her.

There was very little improvement until the third session, when she said that she had noticed that she felt generally much calmer and very relaxed after treatment, and in fact the night following the treatment session would give her uninterrupted sleep for eight or nine hours, which was most unusual.

She still suffered a lot of low pelvic discomfort, however, and frequency in her urinary output during the daytime. I asked her to return to her GP for yet another urine check just to make sure that there was nothing underlying. There is sometimes the problem of another associated illness linked to urinary frequency and low pelvic pain. However, after her visit to her GP, who gave her a further examination and tested her urine, he confirmed that she was in fact still suffering from chronic cystitis and recommended yet another course of antibiotics, which she declined. The antibiotics always gave her an intense attack of thrush, therefore she had a dual problem to cope with.

Over the next few weeks there appeared to be a great improvement in her urinary condition but it was not until the eighth treatment that she confided in me that her husband had left her and their young son just a year before for another woman, and it was from this period of time that her first attack of cystitis had occurred.

It often happens that when we have emotional hurts which are very close to our heart our reproductive or urinary areas are most commonly affected, almost as a hurt to our very femininity.

Reflexes in the feet that revealed sensitivity: Cystitis

Mandy was quite sure that her eyes were sensitive and watery during her bouts of cystitis. I explained to her that the kidney and eye areas are in the same related areas and it is quite common to find an eye problem during bouts of urinary tract disorders. The kidneys were sensitive, but the bladder was acutely sensitive even when the slightest pressure was applied.

Beneficial herbs, vitamins and dietary advice: Cystitis

Tea, coffee, alcohol and any caffeine-type drinks, such as cola, should be avoided. Echinacea is a good immune stimulant and excellent for cystitis as it also acts as an anti-inflammatory. Dandelion leaf and horsetail are recommended. Plenty of fluids are advisable and those with a barley base are especially beneficial, lemon barley in particular. Cranberry helps to prevent the bacteria from adhering to the bladder. Vitamin C: 1—3g daily. Vitamin C helps boost the immune system to fight infection.

DIABETES MELLITUS (Mellis means sweet: Greek) occurs as a result of diminution or absence of insulin supplied by the beta cells of the Islets of Langerhans.

Chris was in his sixties when he came to me having suffered from diabetes for many years. His diabetes had been very difficult to control all his life, and he had suffered as a result arterial corrosion of the eyes and the kidneys. He had also had two mild heart attacks. At the time of coming to see me his main problem was an inability to walk any great distance because of intermittent claudication in his legs, which meant that after very short periods of walking he had cramp-like seizures in his calf muscles which made him have to stop whatever he was doing. The main sensitivities which appeared in the feet were in the eyes, kidneys, heart and groin areas. This indicated the arteriosclerosis that he suffered due to the diabetes.

He was constantly exhausted and had a very restricted lifestyle, although he did take quite an interest in his engineering company, which he had built up over 30 years. He was treated very regularly over a period of eight weeks with hardly any results, which made me feel that perhaps this treatment was going to be of little support for him. However, he was insistent on continuing, and I am so pleased that he did because on the ninth treatment he suffered quite a severe reaction to the treatment.

An angry rash appeared all over his body. He had excessive bowel actions, which was most unusual for him as normally he suffered from constipation and had to rely on laxatives to help any bowel action. After this rather major cleansing of the system he began to make great strides. The main benefit he achieved was the ability to walk distances; the breathless condition which resulted from his mild heart attacks improved considerably; and he was able to take an interest in jobs in the garden which previously had been completely out of the question. Chris was very impressed by the benefits of Reflexology and after three months (12 treatments carried out consistently on a weekly basis) his improvement was so marked that he suggested that he would like to come to have a regular Reflexology treatment every fortnight. This he did and he lived for another nine years, constantly having Reflexology; he described it as his life support.

During the nine years of treatment from me he hardly ever had a problem with maintaining his insulin (blood sugar) levels, which was very encouraging as previously he had had no end of increases and then decreases in his insulin injections in an attempt to try to control his very difficult condition.

Chris was a fine man. He was over-generous to all who came his way, was loved by all members of his staff and family, and when he died (he did in fact die of kidney failure), he left a large sum of money to the Diabetic Trust.

Reflexes in the feet that revealed sensitivity: Diabetes

The eye reflexes were sensitive in both feet. The kidneys were also very painful. The damage to the heart was apparent from the reaction in the heart reflex area. Congestion in the groin area revealed the congestion in the arteries which caused the cramp-like seizures in his legs (intermittent claudication).

Beneficial herbs, vitamins and dietary advice: Diabetes

The diet suitable for diabetics would have been discussed by the doctor or dietician in charge of the case. The dosage of insulin and the number of units of carbohydrate is all-important. However, a good, basic, nutritious diet, free from junk foods and refined sugar, provides a positive direction for any health condition. The use of garlic is advised for the general health of the arteries.

Frozen Shoulder

Edward contacted me. He needed an urgent appointment, as the pain and disability in his shoulders was so intense that he was not able to sleep at night. Although only 38 years old, he said that he walked about like an old man of 80.

There seemed to be little reason for his shoulder restriction. He had been married for a couple of years and had just had his first child and his work did not involve any heavy physical lifting. His job was demanding. As a computer programmer for a large company he sat for hours in front of a screen and the more he worked throughout the day, the more his pain and discomfort increased.

His doctor had treated the problem initially with pain-killing tablets, and because the condition failed to improve he then had two cortisone injections. He described the pain of these injections as 'agonising' and initially had some relief but six months later he was back to square one. The sensitivity in his shoulder reflexes were extreme, his thoracic spine and neck also revealed a lot of tension and inflammation.

After his first treatment he reported that in fact the condition seemed worse. I reassured him that this was not unusual; often the condition gets a little worse before it gets much better following a treatment of Reflexology, particularly the first one.

Edward attended for his weekly appointments and very gradually an improvement began. First and foremost, his pain levels decreased and then gradually he was able to raise his arms a little more each week.

As we got to know each other he said that he had found the responsibilities of marriage, a mortgage and a new baby rather a strain and he did constantly worry about his job security and so on.I explained that the shoulders are traditionally where we 'shoulder our responsibilities'. Tense shoulders often mean that we are carrying too many burdens. Our shoulders get painful and rigid when we are not expressing our real needs, when perhaps we are doing something that we would rather not be doing.

He said he was scared of sharing these insecurities with his wife in case she felt that he was a bit weak and watery.

Maybe the acceptance of the cause of his condition helped admirably but after eight sessions of Reflexology his shoulder condition became a thing of the past. Edward still comes back from time to time. He says that when he feels like 'the milkmaid carrying her yoke' he rings for another appointment.

Reflexes in the feet that revealed sensitivity: Frozen Shoulder

Acute sensitivities appeared in his shoulders, neck and thoracic spine.

Beneficial herbs, vitamins and dietary advice: Frozen Shoulder

Soothing herbal teas such as chamomile are indicated to help towards relaxation in tense and stressful situations. B5 (pantothenic acid): 250 mg 2—4 times daily may help to alleviate painful symptoms. Vitamin C: 1—2 g daily helps tendons and bones. Vitamin E is known for its certain anti-inflammatory properties.

Irritable Bowel Syndrome

IRRITABLE BOWEL SYNDROME (IBS) This condition was previously known as 'mucous colitis' or 'spastic colon', and was believed to be associated with psychosomatic rather than allergic causes.

Food is said to be responsible for one-third of cases, but X-ray fails to reveal evidence. Prostaglandins are implicated. Females are far more susceptible than males. Cow's milk and antigens in beef can precipitate the condition.

The two main symptoms are abdominal pain and altered bowel habit. Pain is usually relieved on opening the bowels or on passing wind. Diarrhoea with watery stools may alternate with constipation and a sensation that the bowel is incompletely emptied. There is flatulence and passing of mucous between stools.

The chronic condition may cause weight loss and poor health, calling for treatment of the underlying condition. Sufferers are usually hard-striving perfectionists who find it difficult to relax.

It is said that men express their dis-ease by experiencing duodenal or stomach ulceration which is common in mentalities as described above.

Pauline came to me in a very stressed state. She was only 42 but looked far older. Her life had been very complicated and sad for the previous four years. Her marriage had failed, resulting in a divorce, and she was having quite a time in trying to hold down a job as a sister-in-charge of the accident and emergency department at her local hospital.

She had two children in her care, a boy of thirteen and a daughter of ten. Her son in particular was very difficult to manage following her divorce and seemed to blame her for the breakdown of the marriage.

Finances were strained, as Pauline was trying to maintain the family home and had a mortgage to pay and all the usual expenses of running a home, car and family. She frequently worked extra shifts at the hospital when money became short, and now, just to add to these problems, she had irritable bowel syndrome. It had become so bad that the attacks of diarrhoea in the morning, when they were at their worst, were embarrassing, to say the least.

She experienced quite excruciating pain on her left side, which was the descending part of the colon. The frequent bowel actions had caused haemorrhoids, so now sitting was painful and she was nearly at the end of her tether.

She had had numerous bowel function tests at the hospital and various medications from the doctor, so I knew that nothing sinister was underlying. It is always essential when a patient presents with alarming symptoms such as she had that all possibilities of a severe disease are eliminated. Remember, doctors have access to all forms of X-ray screening devices whereas Reflexologists do not.

Pauline's feet certainly did tell the tale. The intestinal area was so sensitive that she could hardly bear any pressure on the reflexes, particularly in the descending and sigmoid colon on the left foot. Her stomach and liver reflexes were over-sensitive too, and that poor old solar plexus area again, the great seat of emotions and feelings. Locked in there I am sure were all the hurts and pains of her divorce, the heavy responsibilities of being a single parent, and uncertainty regarding her future.

Apart from her irritable bowel, Pauline had such severe pains in her neck, shoulders and the tops of her arms that at times she could hardly hold a shopping bag.

People who have a lot of responsibilities and take the problems of the world on their shoulders frequently suffer arm and shoulder pains – you know, rather like the milkmaid carrying a yoke, heavy weights across the shoulders!

Always remember, the arms and hands are the wings of the heart, they encircle your heart, so heavy emotional burdens affecting your innermost feelings affect your arms and hands – your wings!

It was quite hard to know where to start. You can't say, 'Why don't you change your job, let somebody else have your children for a while, have a break?' All those things were impossible.

Having somebody to talk to who understood helped immensely. Reflexology did the rest.

I gave Pauline a light general treatment, and also some body massage, which she said was a luxury. 'Do you realise, nobody has touched me for three years?' she said.

I asked her to telephone me the next day to report any reaction. She said that she slept very well, the best night's sleep she had had for many months. Her bowel actions had been the same, but she felt less stressed and her shoulders and arms were definitely less painful.

Very, very slowly over the next few weeks her diarrhoea improved, the daily morning routine of eight or nine visits to the toilet reduced to two or three. Her energy levels started to improve, and that consequently gave her more emotional strength to cope with her son, who blamed her for his lack of a father.

I have suggested to Tony (her son) that he go and live with his father – just to see if he is happier there. He obviously does not like what I have to offer him, she said. Perhaps a few months there will help us all.

After the sixth treatment I noticed a marked reduction in sensitivity in the colon, and to me this reflected that the inflamed colon had begun to heal. Pauline's symptoms were greatly improving now, and some days she was not troubled by her bowel condition at all. She stuck rigidly to the dietary advice.

There was little she could do to reduce her work load at the hospital. She had a responsible, demanding job and there was very little she could delegate. However, as she put it, 'If I can get rid of some of my health problems I will be able to cope more confidently with my job.'

I suggested to Pauline that she take Slippery Elm Food after a busy shift at the hospital instead of trying to eat a rushed meal often at odd times. The bark of the elm is well known for its healing process, particularly of the digestive system.

I worked hard with Reflexology and Pauline put in her 50 per cent, which is so essential in achieving a good result.

Pauline had ten treatments in all, and then a further three on a monthly basis. Her bowel condition improved dramatically. She looked 10 years younger and life took on a better meaning.

Tony, who left to live with his father, returned home after four months with a much improved disposition, realising that it takes two parents to create a situation that culminates in divorce and there is always another side to the story.

Reflexes in the feet that revealed sensitivity: Irritable Bowel Syndrome

The stomach and liver reflexes were sensitive. This was mainly due to the digestive system being out of balance. The intestinal areas on both feet were so sensitive that even the lightest pressure on her feet was hardly bearable. The sigmoid colon and rectum on the left foot were acutely sensitive. The inflammation in this part of the colon was at its worst and the rectum was painful because of the haemorrhoids. The solar plexus is easily upset by emotional disturbance. This was another area that caused a strong reaction to the treatment session.

Beneficial herbs, vitamins and dietary advice: Irritable Bowel Syndrome

When there is such an acutely inflamed condition in the digestive system it is recommended that you choose perhaps a weekend when you can take life easy and go on a two-day grape fast. Eat nothing but grapes, as many as you like, chew the kernel and swallow. Also drink pints and pints of pure spring water. The grape is a healing fruit; that is why for many centuries it has been taken to the sick as a luxury; the luxury being the fruit, not the cost. Today, grapes are very reasonable in price.

Slippery Elm Food is available in powder form and can be made up in milk as a drink. It is quite pleasant and should be taken first thing in the morning and always last thing at night. Slippery elm is soothing and healing to the entire digestive system.

Coffee and alcohol must be avoided. For the first few weeks, or until you get an improvement, eat fish, chicken, root vegetables, rice, pasta, potato, pears and stewed apples and avoid a lot of roughage.

There is usually a problem in the emotional field, a feeling of being unable 'to digest' a certain situation or irritation in the personal life. An inability to accept an inflammatory situation!

The physical symptoms of irritable bowel are often accompanied by fatigue, depression and anxiety. Gentle exercise such as curl-ups help to strengthen abdominal muscles and promote normal intestinal contractions. Acidophilus supplements contain lactobacillus-acidophilus which helps to repopulate the intestinal flora with beneficial bacteria. Pantothenic acid is essential for proper functioning of the gastrointestinal tract. Herbal antispasmodic complex such as valerian, hop, hawthorn and passiflora are known to have soothing properties. Peppermint oil capsules can be taken, as peppermint oil has a well-proven antispasmodic effect on the stomach and intestines.

Further Reading

If you would like further information on Irritable Bowel Syndrome, please consult Issue 13 of Positive Health Magazine (to order: phone +44 (0)117-983 8851). For more in-depth information on Irritable Bowel Syndrome, please consult Irritable Bowel Syndrome by Lynn Toohey Ph.D. (from Issue 14, also available from +44 (0)117-983 8851).

LARYNGITIS is an acute infectious illness of the larynx which often spreads to other parts of the throat and sometimes the ear. The infection causes hoarseness, swelling and pain in the throat and often results in a complete loss of voice.

Simon was a dental surgeon who, for the last two and a half years, had repeated episodes of laryngitis which often lasted for several weeks. He said he had suffered many throat infections as a child. There was no real pattern to these attacks apart from the fact that his voice was reasonably normal, although a little husky, in the mornings and became increasingly huskier and weaker as the day progressed. He was a very conscientious man, a perfectionist in his work and had worked very hard to build up his successful practice.

He had gone through the usual routine examinations with an ear, nose and throat specialist but nothing abnormal had been discovered.

The courses of antibiotics, which he had resorted to in a desperate attempt to improve his condition, gave him very little relief. His doctor had referred him for allergy testing wondering if there was something he was using in his work that was affecting his throat, particularly in view of the fact that the condition improved once he was away from his practice. The only time his voice returned to near normal was when he took his twice-yearly holiday.

There was considerable sensitivity in his throat and neck area; in fact, the whole shoulder, thoracic spine and head areas were acutely sensitive to even the lightest pressure, and the diaphragm and solar plexus revealed a strong reaction. The most acutely sensitive areas however, were his adrenal glands. 'What on earth have my adrenal glands got to do with my throat condition?' he asked.

A very accurate picture was emerging of a sensitive, conscientious, hard-working dentist who was under considerable pressure, and his body was indeed in a tense condition, which was why his adrenal glands were so sensitive. His shoulder, neck and thoracic spine were reacting and this, in the main, would have been due to hours of standing over patients in rather fixed position.

His body was reacting to stress by a loss of voice. After explaining the situation to Simon, he tended to agree with my findings. He attended for treatments on a twice-weekly basis, although he was reluctant at first to agree to two treatments a week because of his heavy workload. However he did agree that really his health came first and if Reflexology could sort out his repeated laryngitis then he would be overjoyed. Simon attended for two months and had eight treatments in all. There was a remarkable change in his condition within the first three treatments and after two months his voice was nearly back to normal.

Reflexes in the feet that revealed sensitivity: Laryngitis

There was considerable sensitivity in the throat, neck and head. The area of the thoracic spine and shoulder also reacted to pressure. The adrenal glands were acutely sensitive, also the diaphragm and solar plexus.

Beneficial herbs, vitamins and dietary advice: Laryngitis

As a good immune boost, echinacea, 100—200 mg daily for a 2—3 week period. Balm of Gilead natural throat pastilles will help ease the huskiness.

References Case Studies and Illustrations: Taken from Gateways to Health & Harmony with Reflexology by Ann Gillanders. The Alden Press, 1997. Used with permission.

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About  Ann Gillanders

Ann Gillanders qualified in Reflexology in 1976 under the method developed in the USA by Eunice Ingham, the founder of modern Reflexology. She is the Principal of The British School of Reflexology. Sidebar intro In this article, Ann Gillanders outlines case studies of how – using Reflexology – she has helped patients suffering from Cystitis, Diabetes, Frozen Shoulder, Irritable Bowel Syndrome and Laryngitis. She also includes information on beneficial herbs, vitamins and dietary advice to help sufferers.

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What’s reflexology, and how does it work?

Posted: January 18, 2024 | Last updated: January 18, 2024

<p>Reflexology is a type of <a href="https://www.starsinsider.com/health/421167/self-massage-tips-to-ease-aches-and-pains" rel="noopener">massage</a> that's based on the premise that areas and organs in the body are linked to reflex areas on the hands, feet, and ears. The practice is considered a complementary therapy, meaning that it shouldn't replace conventional medical care. And while it still needs more scientific research to prove that it can prevent or cure any type of disease, some studies show it may help relieve certain symptoms, such as pain and anxiety.</p> <p>Intrigued? Click on to learn more about how reflexology works and whether you should try it.</p>

Reflexology is a type of massage that's based on the premise that areas and organs in the body are linked to reflex areas on the hands, feet, and ears. The practice is considered a complementary therapy, meaning that it shouldn't replace conventional medical care. And while it still needs more scientific research to prove that it can prevent or cure any type of disease, some studies show it may help relieve certain symptoms, such as pain and anxiety.

Intrigued? Click on to learn more about how reflexology works and whether you should try it.

You may also like:

<p>Typically, the feet are used in reflexology, but in some circumstances the hands or ears may be used as well.</p>

What body parts are used in reflexology?

Typically, the feet are used in reflexology, but in some circumstances the hands or ears may be used as well.

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<p>Reflexologists use hands and feet maps that illustrate what points correspond to which areas of the body.</p>

Reflexology maps

Reflexologists use hands and feet maps that illustrate what points correspond to which areas of the body.

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<p>During a session, pressure and stimulation are applied to these points to improve blood and energy circulation.</p>

How does reflexology work?

During a session, pressure and stimulation are applied to these points to improve blood and energy circulation.

<p>Stimulating these points gives a sense of relaxation. It also maintains homeostasis, which are bodily systems that remain stable as they adjust to changing conditions.</p>

The sensations during reflexology

Stimulating these points gives a sense of relaxation. It also maintains homeostasis, which are bodily systems that remain stable as they adjust to changing conditions.

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<p>The origins of reflexology date back to 2500 BCE in ancient Egypt. Evidence in historical documents suggests that reflexology may have been used, as it illustrates medical practitioners performing hand and foot treatments.</p>

Origins of reflexology

The origins of reflexology date back to 2500 BCE in ancient Egypt. Evidence in historical documents suggests that reflexology may have been used, as it illustrates medical practitioners performing hand and foot treatments.

<p>The exact reason as to why reflexology works hasn't yet been determined. However, there are some suggested theories.</p>

Different theories

The exact reason as to why reflexology works hasn't yet been determined. However, there are some suggested theories.

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<p>This theory suggests that the stimulation of specific reflex points enhances nervous system connection to the parts of the body that correspond to these points. It backs the idea that the benefits from reflexology stem from the involvement of the central and autonomic nervous systems.</p>

Nerve impulse theory

This theory suggests that the stimulation of specific reflex points enhances nervous system connection to the parts of the body that correspond to these points. It backs the idea that the benefits from reflexology stem from the involvement of the central and autonomic nervous systems.

<p>The hemodynamic theory proposes that stimulation from reflexology enhances blood flow to the corresponding organ or area of the body.</p>

Hemodynamic theory

The hemodynamic theory proposes that stimulation from reflexology enhances blood flow to the corresponding organ or area of the body.

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<p>This theory suggests that body parts can communicate using electromagnetic fields, which can become blocked or congested. Reflexology may open these blockages.</p>

Energy-related theories

This theory suggests that body parts can communicate using electromagnetic fields, which can become blocked or congested. Reflexology may open these blockages.

<p>Another theory proposes that reflexology may influence changes in the fascia, which is a thin membrane that covers and separates body organs. </p>

Fascia involvement

Another theory proposes that reflexology may influence changes in the fascia, which is a thin membrane that covers and separates body organs. 

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<p>While more research is needed into these theories, reflexology can still be suggested as a treatment in addition to conventional medical care. However, it shouldn't be used in place of conventional treatments.</p>

An additional treatment

While more research is needed into these theories, reflexology can still be suggested as a treatment in addition to conventional medical care. However, it shouldn't be used in place of conventional treatments.

<p>Support for reflexology largely comes from anecdotal sources, meaning people who say it helped them. The fact that many people seem to feel better after reflexology sessions certainly helps its case! </p>

Does reflexology really work?

Support for reflexology largely comes from anecdotal sources, meaning people who say it helped them. The fact that many people seem to feel better after reflexology sessions certainly helps its case! 

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<p>Some studies have found a couple of factors that may influence the effectiveness of reflexology.</p>

Factors that influence its effectiveness

Some studies have found a couple of factors that may influence the effectiveness of reflexology.

<p>Reflexologists (people who practice this technique) often use relaxing music, lighting, and scents during sessions, which could help with relaxation and stress relief.</p>

Environment/ambiance

Reflexologists (people who practice this technique) often use relaxing music, lighting, and scents during sessions, which could help with relaxation and stress relief.

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<p>During the session, the person can talk to the reflexologist about their worries, and work through personal challenges. This psychological support could prompt improvement in one's well-being.</p>

Support from reflexologist

During the session, the person can talk to the reflexologist about their worries, and work through personal challenges. This psychological support could prompt improvement in one's well-being.

<p>Reflexology sessions involve touch, such as stroking and massaging, which has been shown to bring comfort and promote healing.</p>

Physical touch

Reflexology sessions involve touch, such as stroking and massaging, which has been shown to bring comfort and promote healing.

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<p>Some believe that having the expectation of positive outcomes can indeed create positive outcomes, via the power of suggestion. This means that the positive results may not have occurred specifically due to the reflexology treatment itself.</p>

Placebo effect

Some believe that having the expectation of positive outcomes can indeed create positive outcomes, via the power of suggestion. This means that the positive results may not have occurred specifically due to the reflexology treatment itself.

<p>Whether or not reflexology techniques are directly responsible for results, they may be worth trying.</p>

It's worth trying

Whether or not reflexology techniques are directly responsible for results, they may be worth trying.

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<p>Reflexology sessions typically last between 30 and 60 minutes. Clients remain fully clothed during treatments, except for the feet and lower legs. After sanitizing the feet, the reflexologist will then activate the reflex points on each side until the whole body has been treated.</p>

What to expect

Reflexology sessions typically last between 30 and 60 minutes. Clients remain fully clothed during treatments, except for the feet and lower legs. After sanitizing the feet, the reflexologist will then activate the reflex points on each side until the whole body has been treated.

<p>Reflexology is linked to many potential benefits, such as pain reduction, relaxation, mood elevation, and improvement in feelings of anxiety.</p>

Benefits of reflexology

Reflexology is linked to many potential benefits, such as pain reduction, relaxation, mood elevation, and improvement in feelings of anxiety.

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<p>As stress and pain are linked to health problems, by alleviating these reflexology could indirectly lead to other health benefits.</p>

Possible results

As stress and pain are linked to health problems, by alleviating these reflexology could indirectly lead to other health benefits.

<p>In addition, people have reported that reflexology helped them clear <a href="https://www.starsinsider.com/health/531438/sinus-infection-cold-or-allergies-how-to-tell-the-difference" rel="noopener">sinus</a> issues, ease arthritis pain, and improve digestion.</p>

Additional benefits

In addition, people have reported that reflexology helped them clear sinus issues, ease arthritis pain, and improve digestion.

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<p>Reflexology is thought to have few side effects, but they include light-headedness, tender feet, emotional response, and needing to urinate more often.</p>

Risks and side effects of reflexology

Reflexology is thought to have few side effects, but they include light-headedness, tender feet, emotional response, and needing to urinate more often.

<p>If you experience any negative effects, talk to your reflexologist or healthcare provider if it lasts for a somewhat lengthy period of time.</p>

Should you experience any negative effects...

If you experience any negative effects, talk to your reflexologist or healthcare provider if it lasts for a somewhat lengthy period of time.

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<p>Talk to your healthcare provider to ensure it's safe for you. Also, tell your reflexologist about any medical conditions you may have, and/or medications you're taking.</p>

Before trying reflexology

Talk to your healthcare provider to ensure it's safe for you. Also, tell your reflexologist about any medical conditions you may have, and/or medications you're taking.

<p>Reflexology may not be appropriate if certain conditions are present. These may include problems with feet circulation, inflammation or blood clots in the leg veins, fungal conditions, gout, or foot ulcers.</p>

Who shouldn't do reflexology?

Reflexology may not be appropriate if certain conditions are present. These may include problems with feet circulation, inflammation or blood clots in the leg veins, fungal conditions, gout, or foot ulcers.

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<p>If you’re pregnant, make sure to tell your reflexologist before your session, as some points on your feet are believed to help induce labor.</p>

A warning if you're pregnant

If you’re pregnant, make sure to tell your reflexologist before your session, as some points on your feet are believed to help induce labor.

<p>Reflexology is considered safe for most people. However, the biggest safety concern with it is the potential for its use in place of conventional treatments. Therefore, always talk to a medical professional.</p>

Is reflexology safe?

Reflexology is considered safe for most people. However, the biggest safety concern with it is the potential for its use in place of conventional treatments. Therefore, always talk to a medical professional.

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<p>Make sure to choose a reflexologist who is properly trained and qualified. If you notice any red flags or feel uncomfortable for any reason, it's okay to stop the session.</p> <p>Sources: (Verywell Health) (Healthline) </p> <p>See also: <a href="https://www.starsinsider.com/lifestyle/522057/the-mystical-and-powerful-plants-of-ancient-medicine">The mystical and powerful plants of ancient medicine</a></p>

Make sure you see a qualified reflexologist

Make sure to choose a reflexologist who is properly trained and qualified. If you notice any red flags or feel uncomfortable for any reason, it's okay to stop the session.

Sources: (Verywell Health) (Healthline) 

See also: The mystical and powerful plants of ancient medicine

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Foot Reflexology: Recent Research Trends and Prospects

Foot reflexology is a non-invasive complementary therapy that is increasingly being accepted by modern people in recent years. To understand the research trends and prospects of foot reflexology in the past 31 years, this study used the Web of Science core collection as the data source and two visualization tools, COOC and VOSviewer, to analyze the literature related to the field of foot reflexology from 1991 to 2021. This study found that the number of articles published in the field of foot reflexology has been increasing year by year, and the top three journals with the most articles are Complementary Therapies in Clinical Practice, Therapies in Medicine, and the Journal of Alternative and Complementary Medicine. The top three most prolific authors are Wyatt, Sikorskii, and Victorson, and the core institutions in the field of foot reflexology are Michigan State University, Northwestern University, Tehran University of Medical Sciences, and the University of Exeter. Foot reflexology has been shown to have a moderating effect on anxiety, fatigue, and cancer, and is a topic of ongoing and future research. This study uses this bibliometric analysis of foot reflexology literature to provide an overview of prior knowledge and a reference direction for modern preventive medicine.

1. Introduction

Reflexology is an ancient therapy that was used by the early Chinese, Egyptians, and North American indigenous tribes for healing, but it was not until the 19th century that the medical community, nursing, and complementary and alternative medicine (CAM) practitioners began to explore it scientifically. In reflexology, there are five zones on each side of the body, each of which spreads down the arm and is confined to a single finger, while also extending down the body and leg until it aligns with a corresponding toe on the foot [ 1 ]. Reflexology is also known as regional therapy and reflex massage therapy. Its principle is that each area of the hands and feet represents each part of the body, such as the heart, liver, spleen, lungs, kidneys, and other internal organs, and when various areas of the hands and feet are massaged, it can stimulate energy, blood, nutrition, or nerves, resulting in therapeutic effects, including relieving mental stress, detoxifying the body, promoting blood circulation, losing weight, delaying aging, and improving internal health [ 2 ], as shown in Figure 1 .

An external file that holds a picture, illustration, etc.
Object name is healthcare-11-00009-g001.jpg

Foot reflexology chart.

On the physical, emotional, and spiritual levels, reflexology often improves individuals’ physical health and well-being. Briefly, people choose reflexology because:

  • It does not use any drugs or chemicals and is the best choice for many health problems;
  • It can reduce pain;
  • It helps maintain physical flexibility and athleticism;
  • It relaxes the limbs, especially the hands and feet, and the whole body;
  • It stimulates the body to release pain-relieving chemicals;
  • It can be used as a means of preventing disease;
  • It promotes recovery from physical injury, especially for the hands and feet [ 3 , 4 ];
  • It triggers the release of endorphins and enkephalins, which help relieve pain and improve mental energy and well-being [ 5 ].

CAM can be divided into four types of treatment: (1) traditional Asian medical systems (TAMS), including traditional Chinese medicine, acupuncture, and acupressure; (2) alternative medicinal systems (AMS), including homeopathy and herbal therapy; (3) manual body-based therapies (MBBTs), including massage therapy, chiropractic therapy, osteopathy, and reflexology; and (4) mind-body therapies (MBTs), including hypnotherapy and psychotherapy [ 6 , 7 ]. Reflexology is one of the most commonly used modalities of CAM in Europe [ 8 ]. The most common reason for using CAM is dissatisfaction with the outcome of traditional medical care (CAM is most commonly used for musculoskeletal problems). A survey of reflexology use in the United Kingdom found an average one-year prevalence of 41.1% and an average lifetime use of 51.8% [ 9 ]. Usage rates for older adults in the United States range from 23% to 62.9% [ 10 ]. In Taiwan, the one-year usage rate is 85.65% [ 11 ]. In many countries, CAM is associated with the cosmetic industry and unorthodox medicine, and CAM is actively used in hospices, nursing homes, and obstetrics in healthcare settings. A study of clinicians showed that, on average, physicians consider CAM to be moderately effective, and 23.3% of them consider it to be an effective method of treatment [ 12 ] and would recommend it to their patients. The most common reasons for recommendation are to relax musculoskeletal pain, chronic disease, and nerve pain [ 13 , 14 , 15 ]. There is a worldwide shift in the attitude towards CAM due to its use as secondary care and integration into mainstream medical care [ 16 ]. In general, complementary and alternative medicine is increasingly recognized as a safe and effective way to reduce pain and illness [ 16 ]. It is also a non-invasive and inexpensive form of health care that can be used by most people (including children, the elderly, cancer patients, and pregnant women) [ 17 ]. Foot reflexology is one of the methods used by complementary and alternative medicine in medical treatment [ 1 , 18 ], and it differs from general foot massage as it targets the reflex zones of the feet corresponding to the body part in a deeper manner. Foot reflexology has been trained and certified by professional foot reflexologists as researchers [ 19 , 20 ], and it is commonly used in medical institutions as adjunctive therapy in an attempt to relieve pain or improve sleep when nurses are caring for patients.

Two internationally recognized reflexology methods are the Ingham method and the Rwo Shur method. The Ingham method is performed without using any tools, while the Rwo Shur method uses tools such as wooden sticks [ 4 ]. It is considered to be the most commonly used CAM for older people [ 21 ]. However, studies have also shown that younger people are more likely to use CAM than older people [ 22 ]. The founder of the Rwo Shur method (also known as Father Josef’s method), Father Josef Eugster Johann, suffered from osteoarthritis. After reading Gesund in die Zukunft (The Future of Health) by Schwester Hedi Masafret, he invented a new therapeutic method of foot reflexology to treat his osteoarthritis and suggested that “this home remedy could save medical expenses.” He founded the Fr. Josef Eugster Holistic Human Development (H.D.) Association and trained many foot reflexologists who have since helped scores of patients with stroke, insomnia, stomach pain, and neurological and skeletal disorders. Furthermore, the H.D. Association continues to explore reflexology clues in various parts of the body and develop new techniques that are useful in restoring health [ 23 ]. The World Health Organization (WHO) stated in 1990 that the combination of traditional drug-free podiatric medicine with modern surgical medicine can improve individuals’ understanding of their health while increasing medical coverage [ 24 ]. Thus, it is clear that foot reflexology is gradually being used as a non-invasive complementary therapy in medicine, nursing, and CAM practitioners to promote health restoration and the revitalization of various body parts at all ages as it has been proposed to enhance blood flow, relax the body, and improve injury healing [ 25 ].

Most clinical studies have found foot reflexology to be effective in reducing pain, including headache pain, back pain, joint pain [ 26 ], cesarean pain [ 27 ], acute pain in infants [ 28 , 29 ], pregnancy pain [ 30 ], labor pain [ 31 , 32 , 33 , 34 , 35 , 36 ], leg edema in pregnancy [ 37 ], postpartum women’s fatigue [ 38 ], pain from surgical medical examinations [ 39 , 40 ], organ removal or transplant pain [ 41 , 42 , 43 , 44 ], and various cancer pains [ 45 , 46 , 47 , 48 , 49 ]. It can also be used as a treatment for individual musculoskeletal cases [ 50 ]. In addition, foot reflexology is also an effective treatment for strokes, insomnia, asthma, diabetes, premenstrual syndrome, dementia, cancers, multiple sclerosis, and idiopathic detrusor overactivity [ 51 , 52 , 53 ]. It has also been studied for use in hospice units to alleviate discomfort and pain in patients at the end of life [ 54 ]. In fact, there are many studies exploring reflexology on the quality of life with cancer.

This study used bibliometric methods to uncover the development patterns in the field of foot reflexology research and to provide new academic perspectives and insights. To the best of our knowledge, no peer review published literature has summarized and analyzed the development of foot reflexology thus far. This study provides a comprehensive review of the research progress in the field of foot reflexology from its infancy to its peak between 1991 and 2021 (there has been research conducted prior to 1991 but it had poor methodology and publications) and offers insights into the prospects and opportunities for research in the field of foot reflexology. At the same time, the research results could facilitate the design and development of foot reflexology assistive tools and bring about a healthier and safer life for humans, giving greater value and energy to life.

2. Materials and Methods

2.1. data sources.

In this study, the Web of Science (WOS) core collection was used to search the relevant literature in the field of foot reflexology. The search period covered a total of 31 years, from 1991 to 2021, and the process included an advanced search using TS = (“Foot massage” or “foot massage” or “reflexology”) as keywords to search all academic publications on topics related to foot reflexology. A total of 806 papers were retrieved, and 801 valid papers were obtained by importing the above keywords into COOC [ 55 ].

2.2. Analytical Methods

This study used the bibliometric software COOC version 12.6, which includes the abilities of data extraction, data cleaning, descriptive statistics, relationship construction, cluster mapping, theme evolution, and research frontiers, to analyze the data, and then imported the data into the VOSviewer visualization software (developed by Nees Jan van Eck and Ludo Waltman, researchers at Leiden University’s Center for Science and Technology Research; Leiden; Netherlands) for subsequent analysis [ 50 ]. The data were analyzed from the perspectives of the annual number of publications, journals, prolific authors, research institutions, authors and collaboration networks of research institutions, keywords, highly cited papers, and research fields, in order to provide an important reference for subsequent research and practitioners of foot reflexology [ 56 ].

From 1991 to 2021, the Web of Science Core Collection collected 806 papers related to foot reflexology, of which there were 5 duplicates. The types of literature included 612 research papers, 107 review papers, and 82 papers of other types [ 55 ]. There were 414 publications in the field of foot reflexology, of which 94% were in English and 6% were in another language, including 1063 institutions in 62 countries, covering 75 research directions and 102 research areas [ 57 ].

The following subsections address the bibliometric profile of the literature on foot reflexology in terms of the annual number of publications, journals, prolific authors, research institutions, authors and collaboration networks of research institutions, keywords, and highly cited papers.

3.1. Annual Number of Publications

The evolution of the steady growth of foot reflexology-related research publications between 1991 and 2021 revealed that foot reflexology research results are increasing due to the advantages of foot reflexology as a complementary medicine and the findings and applications from relevant research (as shown in Figure 2 ) as well as journals accepting CAM reflexology articles for publication and an increasing number of researchers interested in CAM and reflexology.

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Distribution and cumulative volume of foot reflexology papers published over the years.

The development of foot reflexology can be roughly divided into three stages, namely, the initial nascent stage, the primary growth stage, and the rapid development stage. The initial nascent stage (1991–2006) lasted for 16 years, with a total of 128 publications and an average of 8 publications per year. During the primary growth stage (2007–2015), scientific researchers began to show great interest in foot reflexology research, and the total number of publications grew to 241 publications, with an average of 27 publications per year. During the rapid development stage (2016–2021), the number of annual publications accelerated, with a total of 434 publications accumulated over six years and an average of 72 publications per year, representing nine times the amount of research performed during the primary growth stage. This study of CAM and foot reflexology found that the significant papers in the field were mainly concentrated in the initial nascent stage (eight papers in total, accounting for 53% of the number of significant papers), and the remaining seven papers (47%) were concentrated in the primary growth stage. The results of previous studies, therefore, laid the foundation for future studies. The rapid turnover of research papers published in the third stage, with the number of papers exceeding 102 for the first time in 2021, showed a trend of diversified growth in the field of foot reflexology and its richer research content, indicating the extensive and prominent importance of this field in the world scientific community and reflexology practitioners.

3.2. Journals

In this study, by counting the number of foot reflexology papers in the Web of Science Core Collection against foot reflexology source publications, it was found that 801 papers were published in 414 journals during the past 31 years. The top 10 countries in terms of the number of papers issued were the United States (33.3%), the United Kingdom (23.9%), the Netherlands (4.1%), Switzerland (3.9%), Germany (3.6%), Iran (3.6%), Turkey (3.6%), Canada (3.1%), Australia (2.9%), and India (2.9%). Taiwan (0.5%) ranked 14th among the 28 countries in which the papers were published. Among the top 15 journals with the most published articles, Complementary Therapies in Clinical Practice accounted for 11.1%, Complementary Therapies in Medicine accounted for 9.6%, the Journal of Alternative and Complementary Medicine accounted for 6.30%, Evidence-based Complementary and Alternative Medicine accounted for 3.90%, and the Cochrane Database of Systematic Reviews accounted for 3.10%, which together accounted for one-third of the total number of published articles. The Journal Citation Indicator (JCI) values for these journals fell between 0.73 and 1.31, indicating the average citation impact of the articles published over the past three years was above the standard. In 2020, the journal ranking where the foot reflexology papers were published was between Q1-Q2, and the influence factor is in the top 25–50%. The top three publishers were Elsevier (27.4%), Wiley (11.7%), and Lippincott Williams & Wilkins (6%). The top 15 journals publishing the most articles on foot reflexology are listed in Table 1 .

The top 15 journals publishing the most articles on foot reflexology (in order of the total number of publications).

There are 414 journals in total, and the top 15 are listed in the table above.

To identify the main countries and regions involved in the field of foot reflexology as well as international collaborations, this study visualized the interactions between countries and regions. Figure 3 shows the geographical distribution of the main countries worldwide and the knowledge domains of the co-authorization. This research found 62 countries around the world participating in the study of reflexology. The nodes represent different countries, while the sizes of the nodes represent the domain activity and scientific output of the country. The various colors represent different clusters of the co-location matrix based on the corresponding countries. The connection between the two nodes indicates their knowledge collaboration. The thickness of the lines indicates the degree of collaboration. Obviously, the stronger the connection between two nodes, the deeper the contact and cooperation between the two countries. From the figure, 12 clusters could be seen. Figure 4 shows the top 15 countries with the most published papers, among which the top three countries were the United States, Iran, and Turkey, and Table 2 presents the related research in each country, which mostly focuses on the application analysis of foot reflexology. As can be seen from the following graphs, a great deal of effort and cooperation in the progress of foot reflexology research has been conducted in every country in the world. This indicates that the future trend in this field is for many countries and regions to value and expect more diversified cooperation and development.

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Clusters of similar topics in foot reflexology studies in countries around the world (conditions are calculated with a keyword frequency ≥ 5 and a country frequency ≥ 10).

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The top 15 countries for foot reflexology paper production.

Clusters of published papers by country and research topic.

3.3. Prolific Authors

The foot reflexology research during this time frame covered 140 categories, and there were more than 2716 authors in the Web of Science Core Collection. The top 15 authors with the most publications are shown in Figure 5 , with the top three authors being Wyatt, Sikorskii, and Victorson. Wyatt, Sikorskii, and Victorson have published 13 papers together, and Wyatt and Sikorskii have published 26 papers together. Wyatt began his research on reflexology for cancer and family caregivers in 2006 [ 46 , 49 ]. He collaborated with Sikorskii and Victorson on reflexology for cancer symptom management in 2007 and explored methodologies in CAM intervention trials in 2009–2010. He began his research on reflexology for advanced breast cancer in 2012–2013, studied clinical trials on caregiver-provided reflexology in 2015–2017, and began a number of ongoing randomized controlled trials for symptom management through family caregiver-provided reflexology for patients with advanced breast cancer in 2018–2021. Today, Wyatt is committed to researching the pain and psychological impact of reflexology on women with advanced breast cancer. As such, foot reflexology has progressed to the level of research that enhances patients’ psychological comfort to reduce pain.

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Author rankings related to foot reflexology.

3.4. Research Institutions

This study analyzed important research institutions studying foot reflexology, which could help researchers to gauge the important global research power and make an integrated consideration. After the analysis, 1183 research institutions involved in the field of foot reflexology were found, and the top 15 research institutions are shown in Table 3 . In this study, the institutional attributes of the top 15 research institutions were obtained by a Google query. From 1991 to 2021, Michigan State University (the United States) appeared the most frequently (32 times), which was twice as often as Northwestern University (USA) in second place (15 times). The top 15 institutions were mostly medical universities (53%), research universities (40%), and government units (7%). The top three institutions in terms of independent journal publication capacity were Michigan State University (11 articles), which focused on breast cancer patients and reflexology, followed by the All India Institute of Medical Sciences (8 articles), which focused on epilepsy patients. The third place was taken by Iran’s Tabriz University of Medical Science (6 articles), which studied multiple applications of reflexology (including elderly sleep, women in labor, and adult coronary artery surgery). This study found that inter-institutional collaborations and co-publications were common, with a maximum of 16 institutions and a minimum of 2. The mode of collaboration was mostly a consortium of national university research institutions, but multinational research institutions and banks were also involved.

The top 15 research institutions in terms of the number of articles published on foot reflexology.

3.5. Collaborative Network of Prolific Authors and Research Institutions

There were a number of closely collaborating author clusters within prolific authors and institutions with strong subcluster ties, as illustrated by the red, blue, and yellow clusters, using papers by Victorson (a medical scientist in the United States), Sikorskii (a psychiatry researcher in the United States), and Wyatt (a nursing researcher in the United States) as the core of their papers. The thickness of the line in Figure 6 represents the frequency of collaboration. The same color of a line means the same research topic, and the color change of a line between two points means that after collaborating for a period of time, the research direction changed. If the colors are similar at first, it means the research topic is highly similar. The red dots represent the three authors, Victorson, Wyatt, and Rahbar, who collaborated most closely with Northwestern University and the University of Texas Health Science Center at Houston on the topic. The blue dots represent collaborations between Sikorskii, Frames, and Michigan State University. The green dots represent Badger, Lehto, and Tesnjak’s collaborations with Michigan State University and the University of Arizona. The yellow dots represent Sikorskii and Tamkus’ affiliation with Northwestern University. The purple dots represent Wyatt’s cross-collaboration with Michigan State University across different research themes. The same authors worked on different areas of foot reflexology [ 57 ]. The collaborative network of highly productive authors and research institutions is shown in Figure 4 .

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The collaborative network of prolific authors and research institutions in the field of foot reflexology research between 1991 and 2021.

3.6. Popular Keywords

Out of the word cloud created from the keywords used during the last 31 years, the top 15 high-frequency words were reflexology, CAM, massage, pain, anxiety, nursing, quality of life, cancer, fatigue, breast cancer complementary medicine, pregnancy, multiple sclerosis, constipation, and chemotherapy [ 59 ], as shown in Figure 7 .

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Reflexology keyword cloud.

3.6.1. Evolution of Keywords over the Years

In this study, the evolution of the keywords related to reflexology papers was studied by filtering 10 keywords for each year under the condition of an occurrence frequency ≥ 5. From the results of the analysis, the top three keywords accumulated over the 31 years were reflexology, massage, and complementary medicine. The term “alternative medicine” appeared for the first time in 1995 [ 60 ]; “massage” appeared for the first time in 1996; “foot reflexology” appeared for the first time in 1997; and “complementary medicine” appeared for the first time in 1998. Next, the most common keyword-related topics were anxiety, with 45 papers mentioning this keyword for 11 consecutive years out of the 31; quality of life, with 23 papers listing it for 8 out of 31 years; fatigue, with 19 papers listing it for 11 out of 31 years, with 19 papers; and sleep, with 14 papers listing it for 7 out of 31 years. Among the disease categories, reflexology was mainly investigated in relation to cancer, chemotherapy, lower back pain, hemodialysis, constipation, coronary angiography, and other topics. In the discussion related to women, foot reflexology for pregnancy was used as a keyword continuously for 9 out of 31 years, with 12 papers, while foot reflexology for breast cancer was used as a keyword continuously for 7 years out of 31 years, with 8 papers total. The development of foot reflexology is described below. In the initial nascent stage (1991–2006), alternative therapies, massage, and foot reflexology generated the first concepts and theoretical discussions. It was not until the primary growth phase (2007–2015) that quality of life, anxiety, fatigue, sleep, pregnancy, and breast cancer began to be studied as topics. In recent years, during the rapid growth phase (after 2016), research related to foot reflexology has expanded to explore its role in CAM and related applications, including hemodialysis, prosopagnosia, constipation, chest pain, intensive care unit case symptom management, and comparison of pre- and post-surgical intervention trials. In addition, this study found annual publications in the field of foot reflexology containing topics such as massage, anxiety, fatigue, and cancer over a five-year period from 2017–2021.

3.6.2. Keyword Co-Occurrence Clustering

From the reflexology keyword co-occurrence clustering, five clusters of related studies could be found. In the reflexology keyword co-occurrence clustering map shown in Figure 8 , these clusters are presented in different colors: (1) orange, representing foot reflexology and female status; (2) red, representing foot reflexology and quality of life; (3) light blue, representing foot reflexology as CAM; (4) dark blue, representing foot reflexology and cancer research; and (5) light yellow, representing foot reflexology and CAM system evaluation.

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Reflexology keyword co-occurrence clustering graph.

3.7. Highly Cited Papers

Highly cited papers tend to be published in high-impact journals (journals with high average citation rates), reflecting the influence and trends of the field [ 61 ]. This study found 15 highly cited papers in foot reflexology research (with ≥ 100 citations), as shown in Table 4 . Most of the highly cited papers with more than 100 citations were published during the initial nascent stage (1999–2005, eight papers) and the primary growth stage (2006–2015, seven papers), which laid the cornerstone for the later rapid development of foot reflexology.

The top 15 highly cited papers in foot reflexology (cited ≥ 100 times).

3.8. Future Research Directions

According to Clarivate Analytics’ Web of Science classification, most publications in the field of foot reflexology are related to ten major categories: integrative complementary medicine; nursing; oncology; medicine, general and internal; neurosciences and neurology; psychology; health care sciences and services; rehabilitation; biomedical social sciences; and obstetrics and gynecology, as shown in Figure 9 . In terms of the number of publications, these ten major categories are the main directions of future foot reflexology research. The ten research directions account for 61% of the publications related to foot reflexology, indicating that the applications of foot reflexology are no longer a single direction of research but focus more on the breadth and depth of research in medical, nursing, and psychological applications. At the same time, these directions are also the future research trends of preventive medicine [ 7 , 62 ].

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Top 10 research areas for foot reflexology.

4. Discussion

This study used COOC and VOSviewer bibliometric software to analyze the annual number of publications, journals, prolific authors, research institutions, authors, and collaboration networks of research institutions, keywords, highly cited papers, and research fields. It explored the research progress and the lineage of foot reflexology during the 31 years from 1991 to 2021 [ 57 , 63 ]. This study was based on a literature review and comparison with research results that could be used as a basis for the future development of the field of foot reflexology [ 56 ]. The results of the analysis are summarized below.

  • The research publications on foot reflexology from 1991 to 2021 could be divided into three stages: (1) the initial nascent stage; (2) the primary growth stage; and (3) the rapid development stage. As for the current phase of rapid development, the number of publications has increased year by year, from 1 paper in 1991 to 102 papers in 2021, an increase of 102 times, indicating that academics have begun paying more attention to foot reflexology.
  • Complementary Therapies in Clinical Practice is the most published journal, and although its influence factor was not the first among the top 10 journals, it has been gradually gaining attention and influence over the past 31 years. The influence factor of the Cochrane Database of Systematic Reviews was 9.289, indicating the high quality of its included papers and its strong influence in the field of foot reflexology, as well as its importance as a source of information for research on foot reflexology. Another factor to consider is that researchers are now wanting to research reflexology and journals are more willing to publish CAM research.
  • Wyatt, Victorson, and Sikorskii are among the more active scholars in the field of foot reflexology research publications and they have established numerous extensive collaborations.
  • Michigan State University, Northwestern University, the University of Exeter, and the University of Tehran were found to be the core institutions for foot reflexology research.
  • Regarding the prolific authors and collaboration networks of research institutions, this study found that Victorson, Wyatt, and Rahbar have worked closely with Northwestern University and the University of Texas Health Science Center at Houston; Sikorskii and Frames have worked closely with Michigan State University; and Badger, Lehto, and Tesnjak have worked closely with Michigan State University, which is the largest institution in terms of cross-collaboration across different research themes. Michigan State University is the largest institution in terms of cross-collaboration across different research themes, with strong cross-collaboration often occurring between different authors and institutions.
  • According to the statistics of the authors’ keyword usage, the top 15 keywords were reflexology, CAM, massage, pain, anxiety, nursing, quality of life, cancer, fatigue, breast cancer, complementary medicine, pregnancy, multiple sclerosis, constipation, and chemotherapy.
  • The number-one cited paper was published in 2001 by Thomas, Nicholl, and Coleman and titled “Use and Expenditure on Complementary Medicine in England: A Population Based Survey”, which has been cited 451 times.
  • Research on foot reflexology involves research in integrative complementary medicine, nursing, oncology, medicine, neuroscience and pathology, psychology, health care science and services, rehabilitation, sociobiological sciences, and obstetrics and gynecology from a whole-person care perspective.

Limitations and Recommendations

Although this study analyzed the current state of research on foot reflexology, limitations remain. The limitations and recommendations of this study are as follows.

  • The search was mainly focused on the Web of Science; Web of Science was used because it is a popular scholarly search system for experts and researchers, and it has numerous high-quality publishing houses and academic papers.
  • Web of Science did not find any of the studies on labor duration and pain which is a limitation.
  • In this study, only the annual number of publications, journals, prolific authors, research institutions, authors and collaboration networks of research institutions, keywords, highly cited papers, and research fields were considered. Future studies should develop more diversified directions or do a cross-analysis of empirical research cases. At the same time, interviews with experts, technicians, and people who have received foot reflexology should be conducted to compare the differences between foot reflexology and traditional foot massage, as the design and development of foot reflexology hand tools could be promoted by understanding the feelings of the recipients. All of the above will lead to more breakthroughs and discoveries in foot reflexology, which is expected to bring more multidimensional thoughts and provide cross-disciplinary support to human beings.

5. Conclusions

This study was a bibliometric analysis of 31 years of literature in the field of foot reflexology from 1991 to 2021. A substantial literature review and analysis were conducted to understand the past, present, and future directions of foot reflexology. This study found that the top three most productive journals are Complementary Therapies in Clinical Practice, Therapies in Medicine, and the Journal of Alternative and Complementary Medicine; the top three most prolific authors are Wyatt, Sikorskii, and Victorson; and the core institutions in the field of foot reflexology are Michigan State Univ, Northwestern Univ, and Univ Tehran Med Sci, Univ Exeter.

Foot reflexology practitioners are continuing to study the pathological characteristics of the foot in relation to various parts of the body while exploring the fluency and precision of the techniques being used. It is also expected that the concept of foot reflexology will be introduced to family members to protect the health of the whole family and to provide physical and psychological relief to patients with serious clinical conditions. Furthermore, this study aimed to bring more attention to the use of foot reflexology as a CAM modality in preventive medicine in the future. These healthcare methods can become a part of people’s lives and give them a more solid, comprehensive, and healthy sustainable life value.

Funding Statement

This research received no external funding.

Author Contributions

Data curation, C.-Y.C.; investigation, C.-Y.C.; methodology, C.-Y.C.; project administration, C.-Y.C.; resources, D.-C.C. and T.-Y.L.; software, C.-Y.C.; supervision, D.-C.C. and T.-Y.L.; validation, T.-Y.L.; writing—original draft preparation, C.-Y.C. and T.-Y.L.; writing—review and editing, D.-C.C. and T.-Y.L. All authors have read and agreed to the published version of the manuscript.

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Conflicts of interest.

The authors declare no conflict of interest.

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Reflexology

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Reflexology is a practice in which different amounts of pressure are applied to specific points on the feet or hands. These points are believed to match up with certain other parts of the body. Reflexology is claimed to cause relaxation and healing in those parts of the body, but this has not been proven.

  • In a study funded by the National Cancer Institute, women with advanced breast cancer who received reflexology treatments showed improvement in a few symptoms, such as shortness of breath, but not others, such as nausea or pain. In this study, reflexology was safe even for the most fragile patients.
  • A small amount of research suggests that reflexology might be helpful for reducing a burning or prickling sensation sometimes associated with multiple sclerosis, but there’s insufficient evidence to support the use of reflexology for most multiple sclerosis symptoms.
  • There’s too little evidence on reflexology for irritable bowel syndrome to allow any conclusions to be reached about whether it’s helpful.

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    Reflexology Case Study Example of a student massage case study I choose to do a case study using Reflexology on the feet. I prepared for my treatment by setting the mood with relaxing music and dimmed lights. I prepared a mixture of epsom salts in hot water poured it over stones for a foot bath before my client arrived.

  21. Reflexology Case Study

    Reflexology Case Study Published on 4 June, 2014 | Case Studies Reflexology Treatment/Case Study I welcomed Client & explained to Client as to how long the treatment would take and that I would speak to her after treatment in regards to any reflexes that are out of balance.

  22. What's reflexology, and how does it work?

    Reflexology may open these blockages. Reflexology is a type of massage that's based on the premise that areas and organs in the body are linked to reflex areas on the hands, feet, and ears. The ...

  23. Foot Reflexology: Recent Research Trends and Prospects

    Reflexology is an ancient therapy that was used by the early Chinese, Egyptians, and North American indigenous tribes for healing, but it was not until the 19th century that the medical community, nursing, and complementary and alternative medicine (CAM) practitioners began to explore it scientifically.

  24. Reflexology

    Health Information Reflexology Reflexology Reflexology is a practice in which different amounts of pressure are applied to specific points on the feet or hands. These points are believed to match up with certain other parts of the body. Reflexology is claimed to cause relaxation and healing in those parts of the body, but this has not been proven.