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Reflexology, or zone therapy, is an alternative medicine or pseudoscience involving the physical act of applying pressure to the feet, hands, or ears with specific thumb, finger, and hand techniques without the use of oil or lotion. It is based on what reflexologists claim to be a system of zones and reflex areas that they say reflect an image of the body on the feet and hands, with the premise that such work affects a physical change to the body. A 2009 systematic review of randomised controlled trials concludes that
"The best evidence available to date does not demonstrate convincingly that reflexology is an effective treatment for any medical condition."
There is no consensus among reflexologists on how reflexology is supposed to work; a unifying theme is the idea that areas on the foot correspond to areas of the body, and that by manipulating these one can improve health through one's qi. Reflexologists divide the body into ten equal vertical zones, five on the right and five on the left. Concerns have been raised by medical professionals that treating potentially serious illnesses with reflexology, which has no proven efficacy, could delay the seeking of appropriate medical treatment.
The Reflexology Association of Canada defines reflexology as:
Reflexologists posit that the blockage of an energy field, invisible life force, or Qi, can prevent healing. Another tenet of reflexology is the belief that practitioners can relieve stress and pain in other parts of the body through the manipulation of the feet. One claimed explanation is that the pressure received in the feet may send signals that 'balance' the nervous system or release chemicals such as endorphins that reduce stress and pain. These hypotheses are rejected by the general medical community, who cite a lack of scientific evidence and the well-tested germ theory of disease.
Reflexology's claim to manipulate energy (Qi) has been highly controversial, as there is no scientific evidence for the existence of life energy (Qi), 'energy balance', 'crystalline structures,' or 'pathways' in the body.
In Trick or Treatment? Alternative Medicine on Trial, Simon Singh argues that if indeed the hands and feet "reflect" the internal organs, reflexology might be expected to explain how such "reflection" was derived from the process of Darwinian natural selection; but Singh observes that no argument or evidence has been adduced.
Reflexology is one of the most used alternative therapies in Denmark. A national survey from 2005 showed that 21.4% of the Danish population had used reflexology at some point in life and 6.1% had used reflexology within the previous year.
A study from Norway showed that 5.6% of the Norwegian population in 2007 had used reflexology within the last 12 months.
In the United Kingdom, reflexology is coordinated on a voluntary basis by the Complementary and Natural Healthcare Council (CNHC). Registrants are required to meet Standards of Proficiency outlined by Profession Specific Boards, as CNHC is voluntary anyone practising can describe themselves as reflexologists. When the CNHC began admitting reflexologists, a skeptic searched for and found 14 of them claiming efficacy on illnesses. Once pointed out, the CNHC had the claims retracted as it conflicted with their Advertising Standards Authority.
Practices resembling reflexology may have existed in previous historical periods. Similar practices have been documented in the histories of China and Egypt.
Reflexology was introduced to the United States in 1913 by William H. Fitzgerald, M.D. (1872–1942), an ear, nose, and throat specialist, and Dr. Edwin Bowers. Fitzgerald claimed that applying pressure had an anesthetic effect on other areas of the body.
Reflexology was modified in the 1930s and 1940s by Eunice D. Ingham (1889–1974), a nurse and physiotherapist. Ingham claimed that the feet and hands were especially sensitive, and mapped the entire body into "reflexes" on the feet renaming "zone therapy" to reflexology. Ingham's procedure and related practices developed by Laura Norman are used by modern reflexologists.
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Reflexology has had several clinical trials dedicated to it over the years with mixed results. One systematic review found, "The best evidence available to date does not demonstrate convincingly that reflexology is an effective treatment for any medical condition."