Stiletto Heals? 

I had the weirdest thing happen to me when I was home recovering from emergency abdominal surgery. I was on bed rest, and I felt a terrible, deep pain under the ball of my foot, running down the center. This lasted for days and days. The funny thing was, as my abdomen healed, the foot pain got better. Is this a stomach reflexology point that I was feeling? It just seems like too much of a coincidence.

--Anna

Reflexologists believe that stimulation of certain spots on your hands and feet can directly affect your body's organs. These areas are depicted on wall charts as little shapes conveniently mimicking the contour of, say, your kidney or liver. Some wireless connection, they propose, joins each bodily function to a very specific reflex point. So tell me this: wouldn't it follow that squeezing into a narrow pair of Manolo Blahniks might backup a person's bowels? I only ask because, as much as I love her, Sarah Jessica Parker always seemed a bit fidgety on Sex and the City.

The scientifically unsupported theory that our organ systems can be controlled by certain spots on the foot (or hand) has inevitably led to claims of disease diagnosis and therapy. Some practitioners of reflexology believe they can identify present illness or predict future disorders by locating tender points on the underside of the foot. By stimulating these "reflex zones," numerous diseases can be treated or avoided. It's a relief to know that getting a pebble in my shoe will soon be covered by insurance.

Proponents claim that this system has ancient roots, based mainly on an oft-referenced Egyptian wall painting allegedly showing reflexology performed on royalty. A brief glance at the painting makes clear the depiction could just as easily be a foot massage, splinter removal, or ointment application to an unfortunate pyramid-building injury. Our modern version of reflexology began with a theory put forth in the early 1900s by an ear, nose and throat physician named William Fitzgerald. His "zone therapy" was a credible attempt to find a point that could be manually stimulated as a surgical anesthetic. The work resulted in a division of the body into 10 long zones, each beginning and ending with a finger and toe.

One of Fitzgerald's therapists, Eunice Ingham, greatly expanded his method and changed the main focus to the feet. She postulated that by removing "congestion"--grinding out the painful spots--one could cleanse toxins, repair organs and heal disease. Ingham ultimately became the main promoter of zone therapy during the late 1930s and '40s. In 1961, physiotherapists raised a kerfuffle about the use of the word "therapy" in the name, thus reflexology was born.

Evidence of reflexology's ability to detect or treat disease is more difficult to find than a rent-controlled apartment in Parker's Manhattan. The few studies showing any positive effect are either poorly controlled or published in non-mainstream journals. One very good paper is a 2005 review article in the American Journal of Medicine, the prestigious chronicle of internal medicine. This study analyzed all prior research related to this therapy for, in this case, menopausal hot flashes and could find no evidence of benefit. In another investigation, Dr. William Jarvis of Loma Linda University challenged an experienced reflexologist to identify past or current medical conditions among 70 subjects. Not only were the results little better than random guessing, the reflexologist ultimately decided to change his practice to basic foot massage.

So why do thousands of people, both in this country and overseas, swear by the therapy (and swear at me in angry letters)? In my opinion, the likely explanation is that compression of tender areas under the foot releases the same natural painkillers (endorphins) as a deep tissue massage elsewhere in the body. For that reason, reflexology can be beneficial for reduction of stress in the same way as a full body massage. However, the belief that underlying disease processes will be detected can too easily lead to unnecessary worry and expense--or worse, a delay in obtaining a proper medical evaluation.

Anna, as much as it seems like your abdominal surgery and foot pain were related, it was probably nothing more than a foot cramp from being bed bound. In fact, a relaxing reflexology treatment might actually be just the thing to rejuvenate you, as long as the therapist offers no medical advice. Fashion advice? That'd be fine, with one caution: Best avoid the Manolo Blahniks until you get your final hospital bill -- for now, you'll just have to make due with a slightly cheaper pair of Jimmy Choo's.

Dr. Ed Rabin is a chiropractor practicing at Life Chiropractic Center in Boise. Send pumice stones and health-related questions to theantidote@edrabin.com (on the Web at www.edrabin.com).

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