Written by Helen Cooke and the CAM-Cancer Consortium.
Updated October 24, 2016


What is it ?

Reflexology is a treatment modality employing manual pressure to specific areas of the body, usually the feet (occasionally the hands), which are thought to correspond to internal organs, with a view to generating positive health effects 1.

Application and dosage

The therapist takes a case history during the first session, which includes asking about patients’ presenting condition/symptoms and any medications they are receiving. Reflexology is usually received in a semi-upright position or on a reclining chair or couch. The treatment may include some light massage strokes and gentle stretches. Reflexology sessions last for about 30 minutes to one hour. A course of several treatments is often recommended by the practitioner.


Although reflexology was widely used in the Far East for centuries and is thought to have originated as long as 5000 years ago, a form of technique referred to as ‘Zone Therapy’ first appeared in Europe in the late 16th century. American ear, nose and throat specialist Dr. William Fitzgerald introduced it as a therapy in the early 20th century after having observed that application of pressure to certain areas of patients’ feet or hands resulted in sensations in a corresponding area of the body. It was further developed by nurse and physiotherapist Eunice Ingham, who introduced it in Europe in the early 20th century. She created a map of 'reflexes' on the feet and hands, which she stated corresponded to different glands, organs and body 2.

Claims of efficacy/mechanism of action/alleged indications

Reflexologists work with the concept that the sole of the foot is a map which represents the entire body. By palpating the foot, areas of tenderness or "grittiness" are purported to indicate an imbalance in the corresponding organ 1. Reflexologists purport to be able to detect subtle changes in specific points on the feet and consider that using various techniques of massage and pressure to these points may affect the corresponding organ, organ system or body 3.

Possible mechanisms of action that have been suggested include a theory of energy mechanisms, suggesting reflexology points are linked to internal organs and structures by energy channels which become blocked in the event of illness and which are re-opened through reflexology 4; a neuromatrix pain theory, where reflexology is believed to relieve pain by transmitting afferent impulses and closing the neural gates in the dorsal horn of the spinal cord, thus blocking pain transmission 4; a lactic acid theory, where it is thought that lactic acid deposited as microcrystals in the feet are crushed by the application of pressure/massage which thereby allows for the free flow of energy 5; a relaxing effect which contributes to relieving tension and stress affecting the autonomic response, which, in turn, affects the endocrine, immune, and neuropeptide systems 5; and finally a theory suggesting that reflexology is simply a method of showing care and concern for patients 5.

Prevalence of use

A European Survey of cancer patients reported that 3.9 % of respondents used some form of manipulative or body-based method (included massage, reflexology and other methods) after their cancer diagnosis 6. 4.5% of respondents were using some form of energy therapy before their diagnosis. The exact prevalence of the use of Reflexology for cancer patients is unknown.

Legal issues

Regulation and registration of complementary therapists varies across Europe. In the UK reflexologists may practice under Common Law and do not have to be registered with one of the federal bodies. Many practitioners have however decided to join a system of voluntary self-regulation. For more information about legal issues for reflexologists in Europe please access the Reflexology in Europe Network 19.

Costs and expenditures

A reflexology session costs between 40-70 Euro. A course of treatment often consists of six to eight sessions.


Helen Cooke, CAM-Cancer Consortium. Reflexology [online document]. http://cam-cancer.org/The-Summaries/Manipulative-body-based/Reflexology. October 24, 2016.

Document history

Last update and revision in October 2016 by Helen Cooke.
Fully revised and updated in September 2014 by Helen Cooke.
Fully revised and updated in June 2012 by Helen Cooke.
Summary first published in March 2011, authored by Helen Cooke.


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  16. Hodgson NA and Lafferty D. Reflexology versus Swedish Massage to Reduce Physiologic Stress and Pain and Improve Mood in Nursing Home Residents with Cancer: A Pilot Trial. Evidence-Based Complementary and Alternative Medicine. 2012. Article ID 456897, 5 pages, 2012. doi:10.1155/2012/456897
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  19. Reflexology in Europe Website: http://reflexology-europe.org Accessed 3rd October 2016