Intended for healthcare professionals

Clinical Review ABC of complementary medicine

Massage therapies

BMJ 1999; 319 doi: (Published 06 November 1999) Cite this as: BMJ 1999;319:1254

Evidence that reflexology may work

Massage therapies - Evidence that reflexology may work

Editor - In their ABC on massage therapies (1) Vickers and Zollman
state that 'Practitioners of reflexology claim that ... they can bring
about more specific changes in health', but also that 'There are very few
clinical trials showing that any massage technique can have specific
effects'. I therefore wish to bring an unpublished trial (2) to your

In 1992 a single-blinded, concealed, randomised trial supported by
the Danish Health Insurance Fund was carried out by two Danish midwives
and reflexologists. Some 99 pregnant women with diagnosed primary inertia
during labour were randomised to receive either reflexology in two
sessions each of 30 minutes or to receive general supportive care for the
same amount of time. Either type of randomised care was carried out by the
research midwife on duty, whereas the assessment of dilatation of the
cervix was carried out before and after treatment by a third midwife who
were meticulously kept blinded to the actual treatment. If there was still
no progress the woman would be entitled to usual care, i.e. augmentation,
whereas the randomised care would continue in case of progress. The
observed outcomes were tabled in the photocopied research report. A later
statistical analysis of the data shows that lack of progress assessed by
the blinded midwife (OR=0.27; 95%CI 0.12-0.62) and augmentation with
oxytocin (OR=0,42, 95%CI 0,42-0,95) was significantly less common in the
group treated with reflexology.

The trial shows that a large fraction of women (38%), who would have
been offered augmentation under usual care, actually makes progress when
they are offered extra supportive midwifery care, and that an even larger
fraction (70%) makes progress when they are additionally treated with
reflexology. If these findings can be confirmed in a larger, equally well
conducted, three armed trial (usual care vs. midwife support vs.
reflexology), high rates of unpleasant and painful oxytocin augmentation
(3) practiced in many hospitals can be dramatically reduced.

1. Vickers A, Zollman C. ABC of complementary medicine - Massage
therapies. BMJ 1999;319:1254-1257.

2. Clausen J, Møller E. En randomiseret undersøgelse af zoneterapi
ved inerti og retentio placentae (A randomised trial of reflexology in
inertia). Århus Kommunehospital Afd Y8.

3. Enkin M, Keirse MJNC, Renfrew MJ, Neilson JP. A Guide to
Effective Care in Pregnancy and Childbirth. Oxford: Oxford University
Press 1994.

Competing interests: No competing interests

19 November 1999
Ole Olsen
senior researcher
The Nordic Cochrane Centre