How does reflexology work?

There are several different schools of thought as to why reflexology works. Frustratingly, it is not easy to design experiments or studies which test these theories and so understanding proceeds slowly. It is perhaps helpful to look at the treatment that we know as reflexology in two ways.

Aspects not necessarily unique to reflexology:

Firstly, reflexology is a touch therapy. It involves physical contact between the therapist and the client in a manner which is intended to bring about a therapeutic or beneficial effect.   It is known that physical touch can help reduce stress levels, for example pet animals can help to lower blood pressure and other stress indicators and babies are known to fail to thrive without regular physical contact. Many people find the experience of foot massage and manipulation to be deeply relaxing and, as with other kinds of body massage it can assist in reducing muscle tension, stimulating the release of endorphins and decreasing the levels of body stress hormones. Stress is both a physical and a psychological response to everyday life which becomes problematic if continued for too long or too acutely and is now recognised to play a large part in our susceptibility to illness and hinder our ability to heal and become well. Therefore any touch therapy which has the benefits mentioned above will assist the mind and body in becoming and remaining healthy.

As well as the benefits of physical contact, reflexology (in common with most other complementary therapies) also involves the client spending a quite considerable amount of time in the therapeutic setting with the undivided attention of the therapist. During the consultation part of the session the client is encouraged to talk about things that matter to them which may be physical health concerns, anxieties, other stressful problems or more general matters to do with their situation and lifestyle such as family matters or diet. This very necessary discussion can act as a basic talking therapy, enabling the client to face things that may be worrying them and receive advice and help for these problems as far as the therapist is able to give. The very act of providing time and sharing problems gives a space for the client to confront them and begin healing if they are able to do so.

Aspects that are unique to reflexology.

Reflexology involves the therapist applying pressure and manipulating points or zones, generally on the feet or hands, which are thought to relate to other organs or areas of the body. It is thought that this manipulation can somehow feed back to the related organ or area of the body and encourage a healing process if there is imbalance or abnormal functioning of that part. Many reflexologists and clients who have benefited from reflexology believe this to be a powerful intervention and there is a great deal of anecdotal evidence as to its efficacy although, as mentioned before, investigations which fulfil more conventionally accepted scientific criteria are difficult to design and have not been carried out to a great extent.

The crux of “how reflexology works” might therefore be seen as the question of exactly how specific areas – reflex points – on the feet or hands do somehow feed back to other areas or organs of the body.

The nervous system seems to answer the role very well. It transfers information by electro-chemical means around the body and connects all parts of the body and organs. It connects with the other major signaling system of the body, the endocrine system, via the hypothalamus and pituitary gland. The fact that we do not yet know exactly how the nervous system might transfer information from, e.g. the liver reflex point to the liver, does not necessarily mean that it does not do so. Internal organs do not, for example, transmit pain in the same way that skin pain receptors do and sometimes malfunction in an organ is felt as pain somewhere else in the body, called referred pain, as in the case of a heart attack causing pain in the left jaw and arm. It could well be that by manipulating a reflex point on the foot, nerve impulses are sent back to a discrete area of the body which conveys a signal to that organ to change its function. For example; manipulating the foot’s reflex point for the uterus might send a nerve signal to the uterus to relax if its muscles are abnormally contracted and causing intense period pains.

Other theories that try to explain reflexology include the lactic acid/U-bend theory which compares the body to a plumbing system where debris in the form of lactic acid crystals ends up in the feet and hands as the most distal parts of the body.   Indeed sensations of “grittiness” and “sharpness” can often be felt both by reflexologist and client in certain areas and the dispersion of these by manipulation is thought to bring relief to the organ or body area associated with the reflex point where the crystal is identified.  However, research including biopsies undertaken by Dr José Manzanares suggests that these gritty “deposits” are actually made up largely by nerve fibers which points back to the nervous system model again.

Another theory with its roots in traditional Chinese medicine is that energy or “Qi” (chi) flows along pathways through the body and can be disrupted by imbalance or disease. Many of these pathways, or meridians, end in the feet and hands and it is thought that by manipulating the points which relate to the ends of the pathways the energy flow is restored and the body can heal the imbalance which caused the disruption.  Reflexologists who have developed techniques utilising this model include John Cross with his Light Touch Reflextherapy and Jan Williamson’s Precision reflexology.  Both of these methods use very little pressure if any – indeed Cross suggests that working just off the body is at least as effective if not even more so.

These theories, whether or not they explain the action of reflexology, provide useful models for looking more deeply at the question. What is the body’s “plumbing”? Is there “energy” which flows along preordained pathways? In Western medicine we are used to considering only physical systems of the body that might answer these roles: the nervous system; the lymph system; the circulatory system and the many and varied roles of adenosine triphosphate (ATP), which transfers energy at molecular level between cells.

While we do not know what forms the exact mechanism of reflexology, all of these theories and disciplines help to give us models to which we can work and with which to structure our use and understanding of the practice of reflexology.


Hull, R., 2011. The complete guide to reflexology. Cambridge: The Write Idea Ltd.
Tiran, D., 2011. The physiological basis of reflexology. In D Tiran and P Mackereth, eds. 2011 Clinical reflexology: a guide for integrated practice. 2nd edition. Edinburgh: Elsevier. Ch.1.
Manzanares, J., 2012. Reflexology (Dr Manzanares reflexologic method). Barcelona: Manzanares.
Cross, J., 2012. Light touch reflextherapy; a new way forward for reflexologists. Bloomington IN:
Williamson, J., 2010. Precision reflexology. 2nd edition. London: Quay books.


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