Reflexology

Reflexology is a gentle, hands-on therapy in which the practitioner uses their hands, thumbs and fingers to press on particular points of the feet, hands, face and outer ears. It rests on the belief that areas of the feet, hands, face, lower legs and ears correspond to other parts of the body, including organs and glands. Reflexology is also known as zone therapy or reflex therapy.

Description

Reflex points and maps

A reflex, in reflexology, is a point on the feet (or hands, face or ears) that is believed to match another part of the body. According to the philosophy of reflexology, every organ, gland and part of the body has a matching reflex on the feet; for example, the tip of the big toe on the left foot corresponds to the left side of the brain. Reflexologists believe that working these reflexes with specific techniques has a direct effect on the matching organ. The practitioner is guided by a reflex map, a chart showing which zones of the body relate to each reflex point.

Techniques and methods

Pressure is applied with techniques such as thumb- and finger-walking, "hook and backup" and rotating on a point. The Reflexology Association of Australia identifies four main methods. The most widely used is the Ingham method, in which the thumb or finger bends and straightens while keeping steady pressure across the area being worked (thumb-walking). Others include Rwo Shur, practised in parts of Asia, and newer approaches that draw on acupressure and Ayurveda.

A session

Reflexology is usually given one to one by a trained practitioner. A session usually lasts about an hour. The practitioner first asks detailed questions about the person's lifestyle and past and current health. The person then sits or reclines with bare feet while the practitioner looks at their feet, relaxes them with gentle massage and works on the reflex points. Reflexology isn't meant to hurt, but the pressure should be felt. Some professional associations suggest weekly sessions for six to eight weeks, then follow-up sessions as needed.

How practitioners explain it

Several explanations have been put forward. The simplest is that reflexology brings deep relaxation, which may ease stress, lift mood and so reduce the effects that go with them, such as the perception of pain. Another is that pressure stimulates the nervous system, leading to relaxation. The Association of Reflexologists in the United Kingdom describes an energetic effect that moves the body towards balance and self-healing; this draws on the idea of a vital energy, or qi, from Chinese and East Asian culture. The 2024 review notes that there is a lack of evidence supporting these theories.

Scope

What it includes

• Pressure on reflex points of the feet, hands, face and outer ears, guided by a reflex map
• A health and lifestyle history at the start of a session, and gentle massage of the feet

What it is not

• It is not diagnosis or treatment of conditions. Reflexologists don't diagnose, prescribe or treat specific conditions. Professional associations say reflexology aims to treat "whole people not symptoms", and many state in their codes of practice that reflexologists must not claim to treat specific conditions.
• It is not foot care. Treating foot problems such as corns, calluses, bunions and ingrown toenails is outside a reflexologist's scope of practice; these should be seen by a doctor or podiatrist.
• It is not massage or acupressure. Massage works on muscles or fascia to release tension, and acupressure points lie along meridians running the length of the body rather than only on the extremities.
• Its effects are not established. The Australian Government's 2015 review found no clear scientific evidence that reflexology was effective. A 2024 systematic review for the government's Natural Therapies Review included 174 studies. It found low-certainty evidence that reflexology may improve sleep quality, and in some groups may reduce fatigue and improve health-related quality of life, but the evidence for every other outcome was of very low certainty. The reviewers concluded that it isn't possible to draw confident conclusions about the effects of reflexology for any condition or outcome, citing serious concerns about how the studies were designed and the possibility that studies showing large benefits were more likely to be published.

Traditions and lineage

The Ingham method is named after Eunice Ingham, an American. She is credited with developing the foot maps and reflexology charts that are still in use, and with bringing reflexology to people outside medicine in the 1930s.

Context

Within Spiritualism

Spiritfold has found no published source linking reflexology with Spiritualism.

The difference between reflexology and Spiritualist healing can be seen in published guidance on healing. The National Spiritualist Association of Churches in the United States describes Spiritualist healing as a form of mediumship and as complementary, not alternative, to other treatment. Its guidance says spiritual healers should not make a medical diagnosis, recommend a specific type of treatment or manipulate the recipient's body. Reflexology, by contrast, is a hands-on technique in which pressure is applied to set points according to a map.

In Australian Spiritualism

The New Age Spiritualist Mission in Unley, South Australia, lists "Hand Reflexology" among its past workshops, alongside colour healing, dowsing, psychometry, mediumship and spiritual healing.

In his 1981 study of Sydney Spiritualists, Paul Gillen recorded that one medium who served the city's churches was a former acupuncturist and, at the time of his fieldwork, was involved in what he called "zonal therapy", which he described as based on correspondences between the body's organs and parts of the feet. Gillen also recorded that spiritual healing was not considered incompatible with other treatments, including orthodox medicine. "Zone therapy" is one of the recognised alternative names for reflexology.

A Spiritualist perspective

Reflexology has found its way into Spiritualist settings, as the Unley workshops and the Sydney medium described above show. A Spiritualist would see nothing wrong with a church hosting a workshop on it or a medium practising it, so long as everyone understands that it is a separate skill and not part of spiritual healing.

The difference is worth spelling out. A reflexologist works with pressure points and a reflex map; a spiritual healer works as a medium, attuning to spirit and letting healing be given, without technique or diagnosis. It is fitting, too, that reflexologists' own codes say they must not claim to treat conditions, which sits well with the Spiritualist view that a healer neither diagnoses nor prescribes. If one person offers both, they should keep the two clearly apart, so that nobody mistakes a reflexology session for healing or the other way round. Whichever is offered, ask before touching, explain what you are doing, and encourage people to follow their doctor's guidance and never give up their medical treatment.

Reflexology in Australia

Where it is offered

In Australia, reflexology is offered in some major cancer hospitals and services as part of integrative oncology.

Training and associations

The national HLT52515 Diploma of Reflexology is a current qualification in the Health Training Package. It describes reflexologists as practitioners who may be self-employed or work in a larger health service, and requires at least 120 hours of work as part of its assessment. No licensing, legislative or certification requirements apply to it.

Reflexologists who have completed certificate- or diploma-level training accredited under the Australian Qualifications Framework can join the Reflexology Association of Australia (RAoA) or the Australian Traditional Medicine Society (ATMS). Both bodies set standards for practice and ethical conduct, although the 2024 review found no apparent formal requirement for continuing professional education. Better Health says professional practitioners hold a current first aid certificate and professional indemnity insurance.

Regulation

Reflexology is not regulated under the Health Practitioner Regulation National Law, so reflexologists don't have to be registered as health practitioners. Instead, standards for practice and ethical conduct are set by professional associations such as the RAoA and ATMS, and no licensing requirements apply to the national diploma. By way of comparison, in the United States reflexologists are tested and certified by the American Reflexology Certification Board, an independent body whose stated aim is to protect the public by making sure practitioners are competent.

Private health insurance and the Natural Therapies Review

Since 1 April 2019, reflexology has been one of 16 natural therapies that private health insurers can't cover. This followed the 2015 review of the government rebate on natural therapies, which found too little evidence to draw firm conclusions about how clinically effective the therapies were.

The government then set up the Natural Therapies Review to look at the evidence again and advise whether any of the excluded therapies should once more be eligible for subsidy through the private health insurance rebate. It was first led by the Chief Medical Officer, Professor Brendan Murphy, and then by Professor Michael Kidd, with support from the National Health and Medical Research Council. The review deliberately left out safety, quality and cost-effectiveness, because studies of these therapies generally lack that information. It also stated that it was not meant to guide individual choices about practising or using the therapies.

Professor Kidd recommended that seven therapies become eligible again, but did not recommend reflexology. The review's question was about public subsidy through private health insurance, not about whether people may practise or use reflexology.

Safety and good practice

Better Health describes reflexology as a complementary therapy that works alongside medical care. It advises people to:

• be guided by their doctor or specialist
• be very wary of any reflexologist who suggests giving up conventional treatment
• never stop a medical treatment on a reflexologist's advice
• talk to their doctor if they have a medical condition.

Some professional associations have guidelines intended to prevent practices that are unsuitable for a client and to keep clients safe. Neither the 2024 systematic review nor the wider Natural Therapies Review assessed safety.

Related modalities

• Massage
• Shiatsu
• Acupuncture
• Iridology

Further reading

• Better Health Channel. "Reflexology". Department of Health, State Government of Victoria, 2015.
• Cochrane Australia. Systematic review of evidence on the clinical effectiveness of reflexology. Australian Government Department of Health, 2024.
• Department of Health, Disability and Ageing. "Natural Therapies Review 2024". Australian Government.
• National Training Register. "HLT52515 Diploma of Reflexology". training.gov.au.