Positive Health Online

I studied for my reflexology diploma nearly 25 years and in those days I spent a lot of time explaining to people what reflexology actually was. There were few articles about it and virtually no research. Another ancient healing science - Acupuncture - was and still is better known worldwide, but reflexology has become, in subsequent years, one of the leading complementary therapies as it is effective, non-invasive and only the hands and feet need be accessed. The premise is that by stimulating tiny reflex points that correspond to parts of the body, the body may be triggered to help heal itself and maintain a sense of well-being and homoeostasis (balance). Tracey Smith, Research Manager, at the Association of Reflexologists (AoR) told me that most of what has been found about reflexology, both in the past and currently, relies of certain people’s experiences of reflexology. She indicated that, initially, it was the originator of modern reflexology, Eunice Ingham in the 1930s, that informed the process of reflexology and now this similar guidance is more likely to be from the CPD providers. She says “Very little of what is actually taught on reflexology courses is based on published scientific research. This has not changed over time and partially because of this we have a rather poor evidence base. So while there is lots of belief about the therapy, there is very little scientific proof “. [1]

Fig 1   Hand Reflexology

In my own development of Vertical Reflex Therapy (VRT) in the 1990s, I undertook some small studies with the cooperation of two GPs who offered medical support and verification on Pain reduction and increased mobility in older people[2] and also VRT self-help in the work place.[3] The latter relied on the empirical monitoring by the small sample of employees and chronic conditions for six months or more.  The results of the pain and mobility study with older people were positive and interesting and in 1997, I presented them to the doctors and nursing staff at the St Monica Trust organisation, in Bristol, who run care villages for chronically sick older people. In both cases some participants reported a 60% plus improvement that was maintained two months later. The sample groups were extremely small (under 10 people) so my attempts at research were useful to me and my colleagues, but made no impression as far as research was concerned because the exacting protocols had not been met.  This article looks at the problems that face reflexologists who want to contribute valid research and contains an interesting reflexology research project by a senior gynaecologist that took place at Whipps Cross Hospital in London in 1994.[4] Bringing reflexology research right up to date, very pertinent studies on reflexology as a method of pain relief have been undertaken by Dr Carol Samuel in 2013. She was the first non-qualified person to gain a PhD in Reflexology and Pain Management and her research is reported below.

Fig 2   Vertical Foot Reflexology

Tracey Smith of the AoR has been watching the research world of reflexology for the past 16 years. Prior to her training as a reflexologist, she was a scientist and she told me “The one thing you are taught early on as a scientist is that research underpins everything you do. If you go back to the start of scientifically published reflexology research you would probably start with the Oleson and Flocco paper in 1993 on premenstrual syndrome. This study has not yet been reproduced or bettered either in methodology or results by more up to date research which is somewhat disappointing over a timeframe of 23 years. While there has been an increase in numbers of published studies, changing from one published every few years to several a year, the size of the projects have remained disappointingly small.

There has however been a change in how research is being produced. Reflexologists are becoming actively involved in formulating the research projects. Where, in the past the reflexologist was used as a ‘tool’ they are now becoming an integral part of the research team. This means the research is not only more relevant to the world of reflexology but also means it is fairer to its original concepts, that it’s not just reduced to a reflex point that can be omitted rather than the w-holistic therapy that it is.

The other interesting change is where the research is originating from. Classically, research into reflexology published in English has come from the UK and the USA; while there haven’t been lots of studies there has been a steady drip feed of information. What is interesting is that there are other countries that are beginning to produce research into reflexology with new and interesting ways of using it. The two countries I am aware of that are beginning to make their mark are Iran and Turkey. Over the last few years some really interesting small studies have emerged. Possibly there is a different understanding of complementary therapies; perhaps there is a greater feel for the non-medicalization of health in these countries”.

Research into reflexology is certainly getting better, there is more of it, the methodology is getting sharper, the reflexologists are becoming more involved and it is more likely to become published, but still it is a tiny drop in the ocean compared the research produced on other complementary therapies. What it needs is repetition and reproduction. Repetition is where a positive study is repeated by the same researchers on a different group of clients. Reproduction is where different researchers get the same results in a different place. This is one of the true bedrocks of science and it enforces the idea that the original positive study wasn’t just a fluke or plain good luck. If there is anyone out there thinking about a reflexology research project, then Tracey and the AoR would cordially invite them to reproduce a previously positive study; the methodology has already been thought out and it is just waiting to prove a point - that reflexology does work.

Consultant Gynaecologist Observes that Reflexology is far Superior to the Surgical Procedure to Alleviate Painful Periods.

The following report illustrates the real benefits of complementary medicine when the medical profession are open-minded in looking for an holistic approach to helping their patients regain health. This report is exceptional as reflexology gave better and non-invasive results. In this conventional medical reflexology trial on patients with severe period pain (dysmenorrhea) at Whipps Cross Hospital[4] in London, consultant gynaecological surgeon, Mr Lindsay McMillan, FRCOG describes how his year long trial was not completed as “it became blatantly obvious that Reflexology was far superior to the then current surgical treatment for severe dysmenorrhea and I felt that it was unethical for me to continue the trial”.  This trial was not published because it was discontinued due to the success of reflexology.  Mr McMillan gave Lynne Booth permission to publish it for the first time in her book Vertical Reflexology for Hands in 2003.

Mr McMillan worked closely throughout the trial with Anthony Porter who is an outstanding reflexologist and founder of Advanced Reflexology Training (ART) for post-graduate study. Mr McMillan outlines the aim of the trial and the results below.

“In 1994 I took a number of young women who all suffered refractory dysmenorrhea and complained of very severe pain at the time of their periods (menses). Many of the women would be hospitalized due to their extreme discomfort. All these patients had had conventional treatment such as combined oral contraceptives, steroidals and analgesia at the time of their periods with little or no effect on their pain.

“At that time there was a theory that if one transected the nerve fibres that run on the medial aspect of both utero-sacral ligaments this would cure the pain experienced at the time of the period.  Although it is true that a large percentage of the nerve fibres run in the medial aspect of the utero-sacral surgery, the approach was to laparoscope a patient and to use a laser or cutting diathermy needle to transect the utero-sacral ligaments close to their attachment to the cervix.

“The theory was that this would then cure the severe dysmenorrhea. A number of papers were published at the time but unfortunately I do not have these to hand. They indicated that this procedure was successful but I had serious doubts from personal experience.  Knowing Anthony Porter’s skill as a reflexologist could often alleviate dysmenorrhea we set up a trial which involved me choosing the patients and randomly selecting them either for surgery, laparoscopic surgery or a course of reflexology.

“The course of reflexology we set out for the patients was: To have a session of reflexology once a week for the four weeks leading up to their menstrual bleed. In the second month two treatments were applied in the two weeks prior to their menses. The third month comprised two weekly treatments in the two weeks prior to their menses and thereafter a single treatment in the week before the onset of their menses.

“The aim of the trial was that the patients were laparoscoped. Other pathology was excluded from their pelvis such as endometriosis and if there was no obvious evidence of other pathology, the utero-sacral ligaments were transected using a laser scalpel.

“By the end of nine to ten months, when we began to correlate the figures, it became plainly obvious that Anthony’s success in alleviating severe dysmenorrhea in these young women was in the region of 85% - 90%, whereas in surgical treatment it was probably less than half that figure.

It was at this point that I made the difficult decision that I could not submit women for a potentially dangerous procedure under a general anaesthesia when it seemed the results were so unfavourable compared to a treatment such as reflexology”.

Researchers found that people felt about 40 per cent less pain, and were able to stand pain for about 45 per cent longer, when they used Reflexology as a Method of Pain Relief.[5]   

Dr Carol Samuel, a trained reflexologist, who carried out the experimental procedures at the University of Portsmouth as part of her PhD, said “As we predicted, reflexology decreased pain sensations. It is likely that reflexology works in a similar manner to acupuncture by causing the brain to release chemicals that lessen pain signals.” The researchers found that when the participants received reflexology prior to the session they were able to keep their hand in the ice water for longer before they felt pain, and that they could also tolerate the pain for a longer period of time.

Although Reflexology is often associated with the feet, the participants attended two sessions, in which they were asked to submerge their non-dominant hand in ice water. In one of the sessions they were given reflexology before they submerged their hand, and in the other session they believed they were receiving pain relief from a TENS machine, that was not actually switched on.

Dr Ebenezer from the Department of Pharmacy and Biomedical Sciences, co-author of the study, said: “We are pleased with these results. Although this is a small study, we hope it will be the basis for future research into the use of reflexology”

Dr Samuel used a small study of 15 people to determine whether foot reflexology would be more effective than no pain relief at all. Dr Ebenezer said: “Complementary and alternative therapies come in for a lot of criticism, and many have never been properly tested scientifically. One of the common criticisms by the scientific community is that these therapies are often not tested under properly controlled conditions. When a new drug is tested, its effects are compared with a sugar pill. If the drug produces a similar response to the sugar pill, then it is likely that the drug’s effect on the medical condition is due to a placebo effect. In order to avoid such criticism in this study, we compared the effects of reflexology to a sham TENS control that the participants believed produced pain relief. This was the equivalent of a sugar pill in drug trials.”

Dr Samuel added: “This is an early study, and more work will need to be done to find out about the way reflexology works. However it looks like it may be used to complement conventional drug therapy in the treatment of conditions that are associated with pain, such as osteoarthritis, backache and cancer“.

References

1. Tracey Smith, Reflexology and Research Manager, The Association of Reflexologists www.aor.org.uk
2. Pain reduction and increased mobility in older people (1997) Lynne Booth published in Vertical Reflexology Publ Piatkus Books, London.  ISBN: 0-7499-2132-3  2000.
3. VRT self-help in the work place (2002) Lynne Booth Publ Piatkus Books (2003). Paperback  ISBN: 0-7499-2319-9 2003. Published in Vertical Reflexology for Hands
4. Medical reflexology trial on patients with severe period pain (dysmenorrhea) at Whipps Cross Hospital  Mr Lindsay McMillan FRCOG.  Published in Reflexology for Hands.
5. Reflexology reduces feelings of pain: University of Portsmouth Press Office Research news. April 9 2013.