Effects of foot reflexology on disease

Abstract

In this article, we review a recently published article to explore the significance of foot reflexology in modern medical practice. With the advancement of modern medicine, we are increasingly committed to finding the specific physiological mechanisms of foot reflexes to treat diseases, thereby better proving the therapy’s effectiveness. It has been reported that foot reflexes can activate the cerebral cortex and organs corresponding to the feet, stimulating blood flow, nutrition and nerves through neural and endocrine regulation to achieve the purpose of treating and preventing diseases and promoting health. The therapy shows unique potential and value, and provides a new perspective on integrating traditional medicine and modern medicine.

Key Words: Foot; Reflexology; Sense-hearing loss; Alternative medicine; Massage therapy

Core Tip: Most of the previous studies on foot reflexology have been systematic reviews, with mixed results. There has been one case report that foot reflexology can treat sensory-hearing loss, which provides objective imaging evidence to increase its credibility. However, the number of included studies is too small, and a large sample randomized controlled trial is needed to further study the mechanism of foot reflexology to prove its effectiveness.

TO THE EDITOR

Foot reflexology, also known as zone therapy or reflexology massage, is based on the principle that specific areas on the soles of the feet correspond to other parts of the body and organs. By applying appropriate pressure and stimulation to these areas, it is believed that these reflex zones can be activated, promoting therapeutic effects by stimulating blood flow, nutrients, nerves, etc. According to research, foot reflexology can help alleviate pain, exhaustion, cancer symptoms, sleep disturbances, and other health problems[1]. This low-cost, side-effects-free, simple and non-invasive complementary therapy is becoming popular in the general population.

DISCUSSION

A review of clinical randomized controlled trials (RCTs) on foot reflexology therapy for various conditions concluded that foot reflexology therapy is effective in treating premenstrual syndrome[2]. A systematic review and meta-analysis of 44 relevant studies on the effects of foot reflexology on fatigue, sleep, and pain was conducted in 2011. Of these, 15 studies investigated fatigue, 18 sleep, and 11 pain. The study concluded that while foot reflexology can help with fatigue and sleep promotion, it is less successful with pain[3]. Foot reflexology was shown to be effective in treating fecal incontinence and chronic constipation in 50 children aged 3 to 14 years who participated in an observational study. The majority of the children improved without experiencing any side effects, and 72% of the parents expressed high satisfaction with the children's treatment[4]. In 2010, a study found that foot massage effectively reduced postoperative pain intensity in Turkish pregnant women, in contrast to a control observation group, indicating its potential in pain management[5]. In a clinical study comparing the effects of foot and palm reflexology on respiratory distress in infants with noninvasive ventilation, statistically significant differences in mean oxygen saturation percentage, respiratory rate and respiratory distress score were found between the two intervention and control groups (P < 0.05). Both types of reflexology effectively alleviated respiratory distress in preterm infants receiving noninvasive ventilation[6]. In a systematic review of the impact of foot reflexology on patients with multiple sclerosis (MS), which included nine studies with a total of 545 patients, it was found that foot reflexology can help reduce physical symptoms such as fatigue, pain, muscle spasms and stiffness, as well as alleviate psychological symptoms and improve quality of life in patients with MS. However, larger, high-quality studies are needed to further validate the efficacy of this therapy[7]. In 2009, a systematic review was conducted on reflexology for a variety of conditions including anovulation, asthma, back pain, dementia, diabetes, gestational foot edema, irritable bowel syndrome, and MS. Although reflexology was found to have positive therapeutic benefits, most RCTs were of poor quality, did not adequately control for non-specific effects, and most had small sample sizes. Two large RCTs (n = 130 and 243) yielded negative results, with most having one RCT and lacking independent replication, indicating insufficient evidence on the effectiveness of reflexology in treating diseases[8]. Does foot reflexology have any therapeutic effects? We found that previous studies were mainly clinical case reports and systematic reviews, which lacked relevant mechanistic studies and other objective evidence to support the effectiveness of this treatment. This makes it difficult to convince people of the benefits of foot reflexology. Encouragingly, recent literature conclusively shows that foot reflexology stimulation activates somatosensory responses to the stimulated reflexology area. Three reflexology areas in the left foot associated with the eye, shoulder, and small intestine were identified. Reflexology stimulation of these areas not only activates the somatosensory region corresponding to the foot, but also the somatosensory region corresponding to neighboring body parts. This process was verified using functional magnetic resonance imaging (fMRI), which captures signals from active brain areas due to increased neuronal activity and blood flow, allowing a better understanding of surrounding tissues[9]. The report supports the Chinese conjecture that specific areas of the soles of the feet correspond to other parts and organs of the body. Foot massage therapy also accelerates the maturation of electroencephalography activity and visual function (including vision) in human infants and rat pups, mediated by upregulation of insulin-like growth factor-1-positive neurons. This study confirmed the efficacy of foot reflexology in treating diseases, thereby enhancing our confidence in this therapy[10]. Foot reflexology can improve vagus nerve function, reduce sympathetic nerve regulation, lower blood pressure, decrease depression and stress responses, and enhance the immune system in middle-aged women[11]. A recent case report, “Effect of foot reflexology on an infant with sensorineural hearing loss: A case report”, which found that foot reflexology can treat sensorineural deafness, which is caused by damage or dysfunction of the cochlear or auditory nerves. This type of hearing loss usually cannot be restored with medical or surgical treatment, but hearing can be improved with assistive devices such as hearing aids or cochlear implants. We recorded the changes of functional connectivity in the brain of children with sensorineural hearing loss after receiving foot reflexology massage. The regional synchronicity of the upper frontal lobe, the lower frontal lobe and the right middle temporal lobe of the treated children increased. These brain regions are mainly involved in language processing and speech perception, which indicates that foot reflexology can promote the improvement of these functions, thus improving hearing and language development in children. The objective physiological basis of fMRI is supported in this paper, and the language level of children at the later stage of follow-up was comparable to that of normal children of the same age. The scientific basis for the clinical application of foot reflexology in treating sensorineural deafness has been demonstrated[12]. The successful treatment of sensorineural hearing loss in infants with foot reflexology is promising, but the small sample size in the study is insufficient to prove its universal applicability. A larger sample size is needed to verify the reliability of the treatment results. Combining fMRI with other imaging techniques such as diffuse tensor imaging and positron emission tomography can provide a better understanding of changes in brain functional connectivity and structure. Studies should consider individual differences, age groups, and disease severity which could provide better results. Foot reflexology can improve prognosis, reduce the costs associated with hearing aids, and enhance patient welfare.

Foot massage can be traced back to the ancient Egyptian civilization. In traditional Chinese culture, foot massage is often closely linked with health and health care. In Southeast Asian countries, foot reflexology and the application of local herbs has become a characteristic cultural practice. In Europe and the United States is also favored by many people treated by professional reflexology therapists. Across different social cultures, foot reflexology is widespread and accepted by the public worldwide. To further enhance the scientific credibility and efficacy of foot reflexology, future research should focus on the following aspects: (1) Conduct large sample randomized controlled experiments to ensure the stability and repeatability of the results; (2) Examine the mechanism of action of foot reflexology therapy, including, but not limited to, nerve conduction, blood circulation improvement, endocrine regulation, immune response, etc., and observe the physiological changes during treatment with modern biological techniques and imaging methods to provide objective evidence on the therapeutic effect; Conduct basic experimental studies such as animal models to further validate and clarify the biological basis; (3) Conduct research on patients from different populations, different disease types and disease courses to determine the potential of foot reflexology in the treatment and prevention of diseases; (4) Long-term follow-up of patients treated with foot reflexology therapy should be performed to observe the continuity and stability of its efficacy; (5) Strengthen multidisciplinary cooperation and exchanges in medicine, biology, psychology, sociology, etc., and jointly promote the in-depth development of foot reflexology research; and (6) Develop standardized procedures and efficacy evaluation criteria for foot reflexology therapy to ensure comparability between studies.

CONCLUSION

Foot reflexology is a potentially effective healthcare intervention therapy. Foot massage can promote blood circulation throughout the body, relieve stress and anxiety, relieve chronic pain, regulate the endocrine system, etc. It shows great potential as a safe, effective and side-effect-free healthcare complementary therapy to promote overall health. However, current research on the effectiveness of foot reflexology has some limitations, including primarily focusing on systematic reviews and Meta-analyses with limited sample sizes, a lack of mechanistic studies, and insufficient supporting evidence. Further in-depth research is needed to uncover the scientific principles behind foot reflexology, to clarify its efficacy and credibility. As foot reflexology finds its unique place in modern healthcare practice as part of alternative medicine, it may hold promise for patients seeking low-cost, non-invasive treatment options. How much can foot reflexology contribute to chronic pain management, stress relief, and overall health? We encourage readers to explore these issues in depth. Perhaps it is through our efforts to determine the effects of foot reflexology that it may become an integral part of modern healthcare in the future.

ACKNOWLEDGEMENTS

Thanks to the relevant authors of the main study, who focused on foot reflexology to treat the disease, and gave me the opportunity to comment on this issue.