What is Reflexology?
Reflexology is a complementary therapy involving gentle manipulation or pressure applied primarily to the feet (but also hands, ears, or face), based on the theory that stimulating specific points on these areas can help rebalance the mind and body and relieve symptoms. 1
Theoretical Foundation
The practice is rooted in the concept that certain zones or points on the feet, hands, and ears correspond to internal organs and other body parts. 2 Practitioners use reflexology maps showing these purported connections and apply targeted pressure with the belief that this can energize and rejuvenate corresponding body systems. 2
Clinical Recognition and Applications
Recognized Uses in Oncology
The Society for Integrative Oncology and ASCO formally recognize reflexology as an integrative therapy option in cancer care: 1
For pain during systemic cancer treatment: Seven randomized trials evaluated reflexology for reducing pain during chemotherapy, chemoradiotherapy, targeted, and/or hormonal therapy, with six trials showing significantly less pain compared to controls. 1
For chemotherapy-induced peripheral neuropathy (CIPN): Two small RCTs showed that reflexology (including aromatherapy self-foot reflexology) improved peripheral neuropathy symptoms, reduced interference with daily activities, and had positive effects on mood, with no reported side effects. 1
Implementation Methods
Reflexology can be delivered in different ways: 1
- By trained reflexologists in clinical settings
- As a self-care approach where patients are trained to perform self-foot reflexology
- By trained caregivers for home-based symptom management
Evidence Quality and Limitations
The scientific evidence for reflexology remains limited and of low quality overall. 3 A 2011 systematic review of 23 RCTs across various medical conditions found that nine high-quality RCTs generated negative findings, while only five generated positive findings, concluding that evidence does not convincingly demonstrate reflexology as effective for any specific medical condition. 3
Physiological Evidence
A 2014 systematic review examining physiological and biochemical outcomes found: 4
- Of 34 objective outcome measures analyzed, only three studies showed significant between-group changes favoring reflexology (blood pressure, cardiac index, and salivary amylase)
- Overall study quality was low
- Most positive findings were within-group changes rather than superior to control interventions
Safety Profile
Reflexology appears to have a favorable safety profile with minimal adverse effects when performed by trained practitioners. 1 No serious adverse events have been reported in clinical trials, making the risk-benefit ratio favorable for patients seeking complementary symptom management. 1
Clinical Context and Caveats
Important Limitations
- The precise mechanism of action remains unclear and scientifically unproven 5
- The theoretical basis (energy meridians, zone therapy) lacks scientific validation 6
- Adequate practitioner training is necessary to ensure consistency of service 2
- Benefits appear primarily in symptom management rather than disease modification 1
When to Consider
Reflexology may be incorporated as part of integrative care when: 1
- Patients are undergoing systemic cancer treatment and experiencing pain
- Conventional pain management is insufficient or poorly tolerated
- Patients desire non-pharmacological complementary approaches
- The goal is to improve self-efficacy and patient engagement in their care