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The Role of Reflexology in Integrative Medicine

I think we will find that integrative approaches to pain management during the hospital stay will improve patient satisfaction and outcomes, and we will see cost savings from patients using fewer drugs and experiencing fewer adverse events.” - Lori Knutson, RN, BSN, HN-BC  

Knutson is the executive director of the Penny George Institute for Health and Healing at Abbott Northwestern Hospital in Minneapolis, the largest integrative health hospital of its kind in the country. A study completed at the Institute in 2009 with over 1,800 hospitalized patients receiving complementary therapies, that included reflexology, showed reduced pain by as much as 50%.  

There are other well-designed studies, funded by the National Cancer Institute and the National Institutes of Health, that indicate reflexology’s promise as an integrative intervention to enhance relaxation and sleep, and reduce pain, depression and other psychological symptoms as well as help with the symptoms of fibromyalgia. 

As complementary and alternative medicine (CAM) practices go mainstream, more hospitals are implementing integrative medicine programs that include reflexology. Hospitals like St. Rita’s Medical Center in Lima, Ohio, Cleveland Clinic Taussig Cancer Institute and Maine Medical Center in Portland, Maine.

CAM refers to a broad category of therapies that are not generally recognized by the medical community as standard or conventional. Examples are acupuncture, massage therapy, reflexology, homeopathy, herbal medicine, reiki, meditation and yoga.  

Integrative medicine (IM) or integrative healthcare is the combination of conventional and complementary medicine and is based on a physician-patient partnership in which both conventional and alternative modalities are used to stimulate the body’s natural healing potential.  

The integrative model is used for assisting the body in alleviating illness and pain. While conventional medicine is preferred in the treatment of disease, emergencies and trauma, CAM therapies excel when it comes to preventive healthcare, the treatment of chronic disease, pain or anxiety. Studies by J. Manzanares, MD, have shown that reflexology induces the relaxation response which enhances healing.

In the U.S., CAM is defined by The National Center for Complementary and Alternative Medicine (NCCAM). They break down CAM therapies into 5 categories: biologically-based, energy medicine, manipulative and body-based, mind-body medicine and whole medical systems (like Eastern medicine).

Reflexology, a therapy primarily applied to the feet, is listed under ‘body-based’ therapies that rely on the structures and systems of the body, making adjustments to them to heal symptoms and medical problems. Growing research shows the benefits of reflexology for a wide variety of health concerns that include cancer, high blood pressure, phantom limb pain, migraines, fibromyalgia, PMS, menopause, anxiety and use in nursing and palliative care.

Hospital-based institutes, like Penny George, with a vision to blend the art of healing with the science of medicine, are causing a transformation in health care. The goals of alternative and complementary therapies such as reflexology have always been to optimize the health of the whole person – mind, body and spirit.  

NCCAM’s 2007 health survey showed that 38% of Americans used some form of complementary medicine and were most likely to use it for pain. Since pain reduction is a hallmark result of reflexology, it is certain to be a CAM therapy that will increase within the integrative medicine model.  


Williamson et al (2002). Randomized controlled trial of reflexology for menopausal symptoms. International Journal of Obstetrics and Gynecology, 109 (9) p 1050-1055.

Testa, G.W. (2000). A study on the effects of reflexology on migraine headaches. Accessed on May 24, 2007, from

Hodgson, H. (2000). Reflexology and cancer patients’ quality of life. Nursing Standard, 14(31), 33-38.

Complement Ther Clin Pract. 2008 May;14(2):124-31. Epub 2008 Mar 4. 

Ketz AK. Arch Phys Med Rehab. 2008 Jun; 89(6):1127-32. 

Oleson, T & Flocco, W. (1993). Randomized controlled study of premenstrual symptoms treated with ear, hand, and foot reflexology. Obstetrics and Gynecology, 82(6), 906-11. 

Wilkinson S, Lockhart K, Gambles M, Storey L. Cancer Nurs. 2008 Sep-Oct; 31(5):354-60; quiz 361-2. 

Stephenson NL, Swanson M, Dalton J, Keefe FJ, Engelke M. Oncol Nurs Forum. 2007 Jan; 34(1):127-32. 

Jeffery A. Dusek, Ph.D., Michael Finch, Ph.D., Dr. Gregory Plotnikoff, MD, and Lori Knutson, RN, “The Impact of Integrative Medicine on Pain Management in a Tertiary Care Hospital,” Journal of Patient Safety, Vol. 6, No. i, March 2010

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