Reflexology research

Does reflexology work? While the benefits have been experienced for thousands of years, there is growing scientific evidence of the affects of this ancient modality. Explore the main research studies so far, together with links to the full papers where available.

About the research studies

Listed below are all the major studies so far, including brief summaries of the methodologies used, results and authors' conclusions.

What many these studies highlight is that statistically significant changes are reported in the reflexology groups, often following a series of regular sessions. 

It's important to note that some of these studies are limited in their approach and more research is needed. We're lucky to have some research specialists in the industry who are diligently carrying out more detailed studies.

Other reflexology research

There's an exhaustive list of worldwide research studies on reflexologycanada.org, listing many other trials not mentioned here. Summaries of more recent research, that hasn't yet made it to a published paper, are in News & Blog.

Quick links

Anxiety, depression & stress

Also see: Cancer care | Cardiovascular issues | Menopause | Pain relief | Pregnancy

Effect of foot reflexology intervention on depression, anxiety and sleep quality in adults (2020)
A meta-analysis and metaregression of randomised controlled trials

Method: The authors critically appraised 26 eligible studies involving randomised controlled trials comparing foot reflexology groups with control groups for adult depression, anxiety and sleep quality. The trials involved a total of 2,366 participants.

Results: Through the meta-analysis, it was found that foot reflexology significant improved adult depression, anxiety and sleep quality.

Conclusion: The authors concluded, "Foot reflexology may provide additional nonpharmacotherapy intervention for adults suffering from depression, anxiety, or sleep disturbance." However, high quality trials – with a larger group of participants and more long-term follow-ups – are recommended for the future.
"Foot reflexology may provide additional nonpharmacotherapy intervention for adults suffering from depression, anxiety, or sleep disturbance."

Wei-Li Wang et al, 2020

Foot reflexology on pain and anxiety severity during dressing change in burn patients (2021)
A randomised controlled trial

Method: 66 patients with burn injuries were randomly divided into the control group (receiving standard care) and the intervention group (receiving standard care and reflexology). Reflexology was performed three times every other day in one week, for 30 minutes each time. Severity of pain and anxiety was measured using a visual analog scale, twice a day for six days, before and after dressing changes.

Results: While there was no significant difference in pain and anxiety for the first few days, there was a marked difference in the reflexology group on the fourth, fifth and sixth days.

Conclusion: Pain and anxiety was statistically relieved when comparing reflexology to a control group in burns patients. Reductions in pain and anxiety reduced on the fourth, fifth and sixth days after intervention.

Breastfeeding

Investigating the effect of reflexology on the breast milk volume of preterm infants’ mothers (2018)
A clinical trial

Method: 50 mothers with premature infants were selected through convenience sampling and randomly allocated into a reflexology group and control group. The reflexology group received six sessions of foot reflexology. The control group received regular breastfeeding training.

Results: There were significant differences in the volume of breast milk between the two groups at different times. Women in the reflexology group produced significantly more breast milk (mean) after intervention.

Conclusion: The results indicate that reflexology is an effective therapy for increasing the volume of milk. As a low-cost and easy procedure, it can be used along with regular lactation training.

The effect of reflexology on lactation in women who had cesarean section (2021)
A randomised controlled pilot study

Method: 60 post-partum women were selected and split into a reflexology group and control group. Interventions for both groups began once the mothers had recovered from the effects of anesthesia from the C-section. Mothers in the control group were given around three hours of routine nursing care. The reflexology group received 20 minutes of reflexology twice a day on the first and second days after the C-section, at eight-hour intervals.

Results: The breastfeeding scores among the reflexology group on both days were significantly higher than the control group.

Conclusion: Although this was a small, randomised controlled study, when compared to no intervention, reflexology enabled higher breast feeding scores in the mothers who received reflexology after cesarean section.

Cancer care

Complementary therapies for patients with cancer:  Reflexology and relaxation in integrative palliative care (2020)
A randomised controlled comparative study

Method: 88 patients with cancer at a palliative care out-patient unit were randomly divided into two equal groups: a reflexology and relaxation group. Each group received six 30-minute weekly session of either reflexology or relaxation therapy.

Results: While there was a stastically significant decrease in anxiety and depression during the observation period, there was a more significant decrease in the reflexology group during the sixth week. Also, quality of life physical and mental measurements were significantly greater for the group receiving reflexology.

Conclusion: Although the two interventions – relaxation practice and reflexology – both showed a significant decrease in anxiety and depression in patients living with cancer, reflexology was found to be more effective in improving quality of life and had a greater effect on pain management than relaxation alone.

The effect of foot reflexology on fatigue, pain, and sleep quality in lymphoma patients (2019)
A clinical trial

Method: 72 lymphoma patients were randomly assigned to a foot reflexology group and control group. Patients in the reflexology group received foot reflexology for five consecutive days, while the control group received usual care.

Results: While the starting point for both groups' fatigue, pain and sleep quality was the same, there was a significant difference in the reflexology group after the full intervention.

Conclusion: When compared with usual cancer care, the results showed that reflexology could reduce fatigue and pain and improve the quality of sleep in patients with lymphoma.

The effect of reflexology on the Pain-Insomnia-Fatigue Disturbance Cluster of breast cancer patients during adjuvant radiation therapy (2018)
Method: 72 women with breast cancer (stages 1-3) who were scheduled for radiation therapy were allocated based upon their preference to a reflexology group or control group. The reflexology group received reflexology once a week concurrently with radiotherapy, and continued for 10 weeks afterwards.

Results: The reflexology group showed significant lower levels of fatigue after five weeks of radiation therapy compared with the control group. Also, the quality of life in the control group deteriorated after five and ten weeks of radiotherapy, while it was preserved in the reflexology group. The reflexology group also demonstrated a significant improvement in sleep quality after ten weeks. The final analysis included 58 women.

Conclusion: Reflexology may have a positive effect on fatigue, quality of sleep, pain, and quality of life in breast cancer patients during radiation therapy. The authors said, "Reflexology prevented the decline in quality of life and significantly ameliorated the fatigue and quality of sleep of these patients. An encouraging trend was also noted in amelioration of pain levels."
"Reflexology prevented the decline in quality of life and significantly ameliorated the fatigue and quality of sleep of these patients. An encouraging trend was also noted in amelioration of pain levels."

Riccardo Tarrasch et al, 2018

The effects of reflexology on anxiety, depression and quality of life in patients with gynaecological cancers with reference to Watson’s theory of human caring (2021)
A randomised controlled trial

Method: 62 women were split between an intervention group (reflexology) and control group.

Results: Anxiety and depression levels were lower in the group receiving reflexology. The reflexology group also demonstrated improved quality of life scores and significantly reduced symptoms due to chemo, such as fatigue, pain, insomnia and loss of appetite.

Conclusion: The results showed that reflexology is effective in reducing anxiety and depression in women with gynaecological cancers and improves quality of life during chemotherapy. The study suggests that offering reflexology at certain intervals during chemotherapy will increase the duration of its effect.

Cardiovascular issues

Effect of foot reflexology on chest pain and anxiety in patients with acute myocardial infarction (AMI) (2021)
A double-blind randomised clinical trial

Method: 90 patients with AMI were split into three groups: a reflexology, placebo and control group. Foot reflexology was carried out for three consecutive days (20 minutes each treatment). Chest pain and anxiety were evaluated immediately afterwards and again 20 minutes later.

Results: The severity of chest pain in the reflexology group was significantly lower than the control and placebo groups 20 minutes after intervention. The difference in anxiety levels across the three groups was not significant.

Conclusion: Foot reflexology was effective in relieving chest pain. The most effect was recorded 20 minutes after intervention, compared with both a placebo and a no intervention control group. Reflexology can be used to relieve chest pain in patients with AMI.

The effects of foot reflexology on blood pressure and heart rate in stage-2 hypertensive patients (2021)
A randomised clinical trial

Method: 94 patients with stage-2 hypertension were split into a reflexology group and control group. Foot reflexology was performed for five minutes in a sitting position. The control group received conventional treatment including anti-hypertension drugs, plus diet, exercise and lifestyle advice. Blood pressure and heart rates were measured at set periods.

Results: Blood presure (systolic and diastolic) and heart rate decreased significantly from the baseline levels at 15 minutes and 30 minutes after reflexology.

Conclusion: When using a specific reflexology technique, heart rate significantly reduced in patients with high blood pressure as compared to the control group. Blood pressure was reduced too, but the researchers say it was not to a statistical level.

Chronic obstructive pulmonary disease (COPD)

The effect of reflexology applied to patients with chronic obstructive pulmonary disease on dyspnea and fatigue (2017)
A pre test - post test experimental design

Conclusion: The study determined that reflexology reduced dyspnea (shortness of breath) and fatigue in patients with living with COPD. The study consisted of 60 patients: 30 in the experimental group and 30 in the control group. The authors summarised the clinical relavance of reflexology by stating that "Complementary methods such as reflexology should be used with pharmacological methods to reduce dyspnea and fatigue in COPD patients".
"Complementary methods such as reflexology should be used with pharmacological methods to reduce dyspnea and fatigue in COPD patients."

Hatice Polat & Seher Erguney, 2017

Fatigue

See: Cancer care | COPD | Multiple sclerosis | Rheumatoid arthritis

Menopause

The effect of foot reflexology applied to women aged between 40 and 60 on vasomotor complaints and quality of life (2016)
A randomised controlled study involving 120 women

Method: 120 women were split into two groups: one receiving foot reflexology and the other non-specific foot massage.

Results: Following the treatments, the mean scores of hot flushes, sweats and night sweats were significantly lower in the reflexology group.

Conclusion:  Reflexology can be effective in decreasing hot flushes, sweats and night sweats (vasomotor complaints) and improving a woman's quality of life during menopause.

The effects of foot reflexology on depression during menopause (2019)
A randomised controlled clinical trial

Conclusion:  The study indicates that foot reflexology can be an effective complementary therapy for reducing levels of depression during menopause. However, due to the small sample size and no intervention in the control group, more studies are needed to verify the findings.

The effects of reflexology on sleep disorder in menopausal women (2011)
A randomised controlled trial study

Method: The trial study involved 100 retired menopausal women, aged from 45 to 60, who were randomly divided into two groups: one who received reflexology for 15 minutes each day for 21 days, and the other with no intervention. There were no significant differences in demographics and menopausal complications between the two groups.

Conclusion:  Using the Pittsurgh Sleep Quality index, the results showed a significant reduction in sleep disorder in the group receiving regular reflexology treatments. The authors concluded: "Reflexology is an effective therapy for sleep disorder."
"Reflexology is an effective therapy for sleep disorder."

Maryam Asltoghiri, 2011

Migraines

Effect of applying reflexology massage on nitroglycerin-induced migraine-type headache (2018)
A placebo-controlled clinical trial

Conclusion: When comparing reflexology, control and placebo groups, there was a statistically significant reduction in the intensity of migraine in the reflexology group. The study was based on nitrate-induced headaches experienced by inpatients in a coronary care unit.

Effects of feet reflexology versus segmental massage in reducing pain and its intensity, frequency and duration of the attacks in females with migraine (2017)
A pilot study

Method: 48 women who had been suffering from migraine for 2-10 years were split into two groups: a reflexology group and segmental massage group. The reflexology group received a series of 10 treatments over five weeks (twice per week), while the massage group received 15 treatments over five weeks (three times per week).

Results: There was a marked decrease in the intensity, frequency and duration of migraines within both groups at three months following the treatments. There were also stastically significant differences between the two groups.

Conclusion: The results showed that reflexology and segmental massage were both effective in reducing the intensity, frequency and duration of migraines. The authors noted a significant statistical difference between both groups: "The patients with migraine obtain significant health benefits with feet reflexology."
"The patients with migraine obtain significant health benefits with reflexology."

Kobza Wojceich et al, 2017

Multiple sclerosis

A comparison of the effects of reflexology and relaxation on the psychological symptoms in women with multiple sclerosis (2017)

A randomised clinical trial

Method: 75 women with MS were randomly assigned to three groups: reflexology, relaxation and control. For the groups receiving reflexology and relaxation, they received interventions twice a week for four week (40 mins each session). The control group only received routine treatment as directed by a doctor.

Conclusion:  Along with relaxation techniques, reflexology is effective in relieving anxiety, stress and depression in women with MS. The results highlighted a significant reduction in the severity of anxiety, stress and depression when compared with the control group.

Comparing the effects of reflexology and relaxation on fatigue in women with multiple sclerosi (2015)
A single-blinded randomised clinical trial

Method:  The study aimed to compare the impacts of reflexology and relaxation on fatigue in women with MS. Seventy-five patients were randomly assigned to three groups. While the foot reflexology and relaxation therapy group received weekly treatments for four weeks (40 mins per session), the control group received care and routine medical treatment by a physician.

Results: Although both interventions (reflexology and relaxation) were effective in reducing fatigue, reflexology had an increased effect over relaxation techniques.

Conclusion: The authors recommended both reflexology and relaxation as effective and affordable techniques in reducing fatigue in women with multiple sclerosis. 

Reflexology treatment relieves symptoms of multiple sclerosis (2003)
A randomised sham-controlled clinical trial

Method: 71 patients with MS were randomised to receive an 11-week treatment of either reflexology or non-specific massage. The trial evaluated the intensity of paresthesias (tingling and numbness), urinary symptoms, muscle strength and spasticity at the start of the study, after 6 weeks, at the end of the study and at a three-month follow-up.

Results: The reflexology group showed significant improvement in tingling and numbness, urinary symptoms and spasticity. The improvements in tingling and numbness among the reflexology group continued at the three-month follow-up. In terms of muscle strength, the improvements were termed as 'borderline significance'.

Conclusion:  The trials authors stated, "Specific reflexology treatment was of benefit in alleviating motor; sensory and urinary symptoms in multiple sclerosis patients."
"Specific reflexology treatment was of benefit in alleviating motor; sensory and urinary symptoms in multiple sclerosis patients."

I. Siev-Ner et al, 2003

Pain relief

Also see: Migraines | Premenstrual syndrome | Pregnancy

An investigation into the efficacy of reflexology on acute pain in healthy human subjects (2011)
Method: Participants attended two sessions, during which they were asked to submerge their hand in ice water. In one of the sessions, they were given reflexology beforehand. In the other, they believed they were receiving pain relief from Tens machine (which was not switched on).

Results: Following reflexology, participants felt 40 percent less pain and were able to stand pain for 45 percent longer.

Conclusion: "As we predicted, reflexology decreased pain sensations," said the study's author, Dr Carol Samuel. "This is an early study... However, it looks like [reflexology] may be used to complement conventional drug therapy in the treatment of conditions that are associated with pain, such as osteoarthritis, backache and cancers."

The effect of reflexology on low back pain in operating room nurses (2022)
A quasiexperimental study

Method: 38 operating room nurses were split into two groups. The experimental group received 30 minutes of reflexology for four weeks, while the control group did not receive any intervention. When monitored during the first week, there was no statisical difference in pain score between the two groups of participants (measured using the visual analog scale).

Results: The nurses in the reflexology group reported significantly lower pain scores than the control group after five weeks.

Conclusion: The author concluded, "In this study, reflexology significantly reduced the pain of nurses who had low back pain. Therefore, reflexology might be useful in controlling low back pain of operating room nurses."

Parkinson's disease

Can reflexology maintain or improve the well-being of people with Parkinson’s Disease? (2010)
Method: 16 people with varying levels of Parkinson's disease were recruited to take part in the study. One group received eight sessions of reflexology, twice weekly for four weeks, followed by once ever three weeks.

Results: While paricipants' symptoms deteriorated over time, reflecting the progressive nature of Parkinson's Disease, there were improvements in wellbeing during the active therapy phase.

Conclusion: The results suggest that continuous reflexology sessions ever two or three weeks may limit further deteroration or maintain improvement of wellbeing. The author recommends a further study to investigate this hypothesis.

Premenstrual syndrome (PMS)

Also see: Pain relief

Comparing the effects of reflexology methods and Ibuprofen administration on dysmenorrhea (2010)

A quasi-experimental clinical trial study

Method: 68 university students experiencing primary dysmenorrhea (spasmodic and painful cramps in the lower abdomen before or at the onset of their bleed) were randomly divided into two groups. The reflexology group received 10 reflexology sessions (40 minutes each) over two consecutive menstrual cycles. The Ibuprofen group received 400mg of Ibuprofen once every eight hours for three days during three consectutive menstrual cycles.

Results: Reflexology was superior to Ibuprofen on reducing painful periods in this study. Remarkably, the effects of the treatments even continued into the participants' third cycle, well after the sessions had been discontinued.

Conclusion: The study concluded that as a non-invasive, easy and cheap technique, reflexology can replace anti-inflammatory drugs (NSAIDS) so women can avoid their adverse side effects.

Effects of reflexology on premenstrual syndrome (PMS) (2019)
A systematic review and meta-analysis

Conclusion: Based on a joint analysis of several studies between 1993 and 2018, reflexology relieves both somatic (physical) and psychological (emotional) symptoms of PMS. The study's results revealed that longer treatment sessions of reflexology had a greater effect. 

Pregnancy

The effectiveness of using foot reflexology to improve quality of sleep amongst post partum women (2009)
A randomised controlled trial

Method: 65 postpartum women who reported poor quality of sleep were recruited to the trial. Participants were assigned randomly to a reflexology (intervention group) and a control group. The group receiving reflexology received a 30-minute reflexology session at the same time each evening for five consecutive days. Results were measured using the Pittsburgh sleep quality index.

Results: The reflexology group reported significant improvements in their quality of sleep.

Conclusion: The authors of the study concluded: "An intervention involving foot reflexology in the postnatal period significantly improved the quality of sleep".
"An intervention involving foot reflexology in the postnatal period significantly improved the quality of sleep."

Chia-Yen Li et al, 2009

Investigating the effects of beta-endorphin, cortisol and pregnancy related stress (2018)
A three-armed pilot, randomised controlled trial

Method: The study involved 90 pregnant volunteers who had all given birth before, and who were all experiencing lower back pain and/or pelvic girdle pain. They were split into three groups: one group received six reflexology treatments, another group received six footbath treatments, and the final control group received usual care. Pain intensity and frequency were monitored using the visual analog scale, as were salivary beta-endorphin and cortisol levels.

Results: Of clinical note, the frequency of pain reduced following reflexology. Beta-endorphin levels (released from the pituitary gland during stress) decreased among the group receiving reflexology, while increased in the other two groups. Also, cortisol levels experienced by the other two groups were almost double that recorded in the reflexology group. 

Conclusion: Reflexology during pregnancy may help reduce low back and/or pelvic girdle pain and associated stress. The authors stated that antenatal reflexology is under research and needs further investigation.

The effects of foot reflexology on the anxiety levels of women in labour (2018)
A semi-experimental study

Method: 154 pregnant women who had not given birth before. The reflexology group received foot reflexology when cervical dilation was 3–4 cm for 30 minutes. Anxiety scores were measured four times: before reflexology, in the latent and active phases of labour, and soon after childbirth.

Results: While the mean anxiety scores were higher in the reflexology group before intervention, after reflexology their scores were lower than the control group. The mean anxiety scores after childbirth were similar across both groups.

Conclusion: It was found that foot reflexology had a positive effect in lowering the total anxiety scores of pregnant women in the study. As a non-invasive and economical treatment, reflexology can be used by health professionals to reduce problems during labour. The authors also noted that decreased anxiety levels at birth helps to improve a woman's birth experience, promote a secure mother-baby attachment and protect postpartum mental health.

Rheumatoid arthritis

The effects of reflexology on pain and sleep deprivation in patients with rheumatoid arthritis (2018)
A randomised controlled trial

Method: 60 patients were recruited from the Rheumatology Follow-up Polyclinic in Turkey. Foot reflexology was given to the experimental group over six weeks. Results were monitored using the Pittsburgh Sleep Quality Index and the visual analog scale.

Results: The group receiving reflexology reported reduced average pain levels after six weeks of treatments. Similarly, the reflexology group's sleep quality was lowered during the study.

Conclusion: The study's authors concluded, "Foot reflexology is a non-pharmacological nursing intervention that may reduce the pain and sleep deprivation symptoms of patients with rheumatoid arthritis."
"Foot reflexology is a non-pharmacological nursing intervention that may reduce the pain and sleep deprivation symptoms of patients with rheumatoid arthritis."

Ercan Bakir et al, 2018

The role of non-pharmacological interventions in the management of rheumatoid-arthritis-related fatigue (2019)
A narrative review

Method: Seven studies were reviewed. Four of them focused on physical activity, two on psychosocial interventions and one that investigated aromatherapy and reflexology.

Results: Physical activity and psychosocial interventions offer small to moderate reductions in fatigue. Reflexology and aromatherapy also appear promising.

Conclusion: Non-pharmacological interventions may be beneficial in managing fatigue related to rheumatoid arthritis. The authors concluded that due to the complexity of fatigue, further research is recommended.

Sleep problems

See: Anxiety | Cancer care | Menopause | Pregnancy | Rhematoid arthritis