Reflexology

williamgrogan

The Irish Times of the 15-12-03 carried the following article which is a copyright of the Irish Times:-

Healing from the feet up

Reflexology is widely used for stress and other ailments, and some hospitals now offer treatments, writes Iva Pocock.

...The therapy is considered excellent for promoting wellbeing, boosting the immune system and beating stress...

...It is also now available in two maternity hospitals - the Coombe and Holles Street. Since 1997, mothers in the Coombe can avail of reflexologist Catherine Chambers, who has visiting rights from the hospital to advertise and give treatments there, although she's not a member of staff.

"If the midwifery staff believe someone has had a very dramatic delivery or a mother's baby has died she \ is available," explains Dr Sean Daly, Master of the Coombe. "The service provided in the hospital is patient-driven, not midwifery- or obstetrics-driven," he explains. "There are no clinical trials that I know of that show it'll improve any particular problem but if reflexology makes a woman feel better that's fine."...

...Over in Holles Street, reflexology is just one of a number of therapies available from the complementary therapy unit...

...Maura Murray, chairperson of Ireland's largest governing and examining body, the Irish Reflexologists' Institute (IRI), this year attended the European reflexologists' gathering, as well as a worldwide conference in Jamaica. In 2006, the institute will host the European event in Limerick University...

For further information, visit the website of the Irish Reflexologists' Institute at www.reflexology.ie

To see another opinion of Reflexology see

http://www.quackwatch.org/01QuackeryRelatedTopics/reflex.html



[Edited because the article is both copyrighted by The Irish Times and subscription only - davros]

Myksyk

I think the media are particularly poor at providing any level of critical analysis of these practices. Nowhere in the piece are the extraordinary claims of the practice mentioned and tellingly, what seems to matter is that it is 'popular'. This seems to be the AM equivalent of the clinical trial!

It might be worth starting a 'Media Watch' thread to discuss coverage of questionable practices.

williamgrogan

What is also amazing is that these people seem to be allowed to operate in the hospital buildings. Allowing this is giving people the impression that it is acknowledged by the Doctors as a valid treatment.

ecksor

It's one thing to object to the lack of evidence when someone makes a bold claim about the benefits of something, but considering this:

"If the midwifery staff believe someone has had a very dramatic delivery or a mother's baby has died she \ is available," explains Dr Sean Daly, Master of the Coombe. "The service provided in the hospital is patient-driven, not midwifery- or obstetrics-driven," he explains. "There are no clinical trials that I know of that show it'll improve any particular problem but if reflexology makes a woman feel better that's fine."...

I think it's hard to object to it being available in hospitals (there are plenty of things in hospitals that are there just to make people feel better, and that's pretty important if you're there for a while). I know nothing about reflexology, but even if it only has the medical effect that a chat and a cup of tea has, then it's not exactly something that we need to drive away from our hospitals as if it was some sort of scourge.

Calibos

I know nothing about reflexology, but even if it only has the medical effect that a chat and a cup of tea has, then it's not exactly something that we need to drive away from our hospitals as if it was some sort of scourge.

mothers in the Coombe can avail of reflexologist Catherine Chambers, who has visiting rights from the hospital to advertise and give treatments there

"Hello dear, I hear your feeling down after your operation. Would you like a reflexology foot massage, its all the rage these days.........You do? You wont be sorry dear. These massage balances the bodies life force energies and promote a state of calm and wellbeing......I'll get started then.......oh and it'll be €80 a session dear....."

:rolleyes: :rolleyes: :rolleyes:

ecksor

Yeah, her details are on the coombe website.

'life force energies' and the value of €80 aren't mentioned anywhere I saw. A brief scan over the reflexology site reveals a detailed explanation that it is not an alternative therapy and doesn't profess to do the job of your doctor. Does anyone know if a similar caveat must be given within the hospital on any literature provided?

Barnowl

Reflexology is one of a range of therapies that claim that organs of the body are mapped onto handy pocket sized anatomy charts. In reflexology it's the foot, in iridology it's the iris and in auricular therapy it's the ear etc. There is no evidence whatever (aside from the usual anecdotes) that any such relationships exist. Anatomy, neurology and physiology are pretty well understood and there is no known mechanism to facilitate diagnosis and treatment via these routes. Despite the caveats that occasionally appear in order to defy possible accusations of practising medicine without a license, diagnosis and treatment is precisely what these people regularly claim to provide. They will diagnose problems in various areas of the body and will suggest a wide range of alternative treatments.

One of the common arguments they mount when it is demonstrated that no disease exists in a person they have diagnosed goes something like this..."Oh, we don't diagnose organic disease, we diagnose energy imbalances in organs which precede organic pathology and if we treat you such pathology will not arise. BEAT THAT FOR A POSITION!:ninja: :ninja: :ninja:

Myksyk

A brief scan over the reflexology site reveals a detailed explanation that it is not an alternative therapy

But it is an alternative therapy... i.e. it hasn't been shown to work beyond placebo and it's underlying theories are completely unvalidated and lie outside, and in opposition to, existing scientific knowledge. If that's 'alternative' to 'traditional' what is?

ecksor

Originally posted by Myksyk
But it is an alternative therapy... i.e. it hasn't been shown to work beyond placebo and it's underlying theories are completely unvalidated and lie outside, and in opposition to, existing scientific knowledge. If that's 'alternative' to 'traditional' what is?

My understanding of 'alternative medicine' is roughly "Don't go to your doctor, come to us instead and we'll fix you up better than they ever could", which strikes me as dangerous. Reflexology is specifically described on the reflexology.ie site as 'complementary', which advocates the use of the therapy along with the appropriate medical care. Now, this obviously is more to do with how the actual techniques are practiced than the techniques themselves, which is why I asked if they are required to supply the appropriate caveat within the hospitals.

Are the terms "Complementary therapy" and "alternative medicine" being used interchangeably? It would be helpful to agree on the terms. I believe it would be more helpful in the context of actual medical practice to separate out practices that are dangerous and practices which merely may not be as helpful as they are claimed to be, and not press the matter too forcefully beyond that. Medical research on the other hand must be more ruthless in its quest to figure out the effects and mechanisms of treatments based on a proper process involving evidence and review.

davros

Originally posted by ecksor
I believe it would be more helpful in the context of actual medical practice to separate out practices that are dangerous and practices which merely may not be as helpful as they are claimed to be, and not press the matter too forcefully beyond that.

I don't think we can say that reflexology and its ilk are harmless. As I might have mentioned before, a reflexologist on Newstalk (and she was not just an ordinary reflexolgist but the head of some professional grouping of complementary medical practitioners) recently stated "we don't claim to cure cancer but reflexology has been known to reduce the size of tumours". This (and every other statement) went completely unchallenged by the presenter, George Hook.

These people do like to call their brand of medicine "complementary" rather than "alternative". But I believe that is to cover themselves legally, i.e. they didn't tell any seriously ill people not to consult a real doctor. But at the same time they are putting out the strong message that, yes indeed, they can compete with real medicine on its own terms.

If I had cancer and I had never heard reflexology forcefully challenged in the media, I might be quite taken by that woman's claim on the radio. "Hey, maybe I don't need these expensive and debilitating chemical and radiation treatments."

It's just not possible to ignore the small claims because, as small as they start out, they always lead to massive confusion and ignorance and to sick people not receiving the treatment they badly need.

ecksor

Ok, I accept that, but that just leads me to think that it's better to have them practicing in the hospitals than anywhere else. I'm very specifically trying to make the distinction between the harmless and the not harmless practice, as I said. Whether we believe that there is anything in reflexology or not, I don't think it is constructive to go around with a big black dismissive brush painting anything that moves without clear and discerning arguments.

williamgrogan

Eeh! I thought we were Skeptics?

If someone is charging money to people for a treatment that has no basis in fact then its wrong and should be opposed. The people who pay for this service believe that it does something that it doesn't. They are being fooled. In my opinion the hospital is helping validate the "sting".

Whether they are being fooled by something major or minor, whether they are loosing a small amount of money or a lot is not relevant. It is wrong and those of us who know it is wrong should try and stop it.

The knee may be connected to the shin bone and the shin bone connected to the ankle bone, but the foot is not connected to the stomach!

davros

Originally posted by ecksor
Ok, I accept that, but that just leads me to think that it's better to have them practicing in the hospitals than anywhere else.

But allowing them in hospitals is to, in effect, give them the establishment seal of approval. We are then saying that these practices are legitimate and effective and on a par with the fruits of modern medical research.

Are we ready to do that? I remain to be convinced that this is a positive (or at least neutral) step. I don't want to be seen as tarring things with big brushes but the modern drugs and treatments supplied in hospitals only got there after proving their worth in rigorously-designed trials costing tens or hundreds of millions of dollars. Reflexology (or whatever) has snuck in the back door without proof of the convincing sort and is gaining credibility by association.

Calibos

'life force energies' and the value of €80 aren't mentioned anywhere I saw

Hypothetical conversation between practitioner and 'victim'. ie Tongue in cheek

Talliesin

1. It's pretty bloody easy (and enjoyable) to prove that reflexology is relaxing
2. There is a large body or evidence to show that being relaxed is good for your well-being (hey, many sceptical arguments against believing in various alternative medical practices boil down to "it just relaxes you, hence you get better").

Sure, from a sceptical viewpoint there is no difference between a reflexology foot massage and a foot massage (except perhaps in the cost, but a foot massage is expensive enough anyway), but if we accept that view point its hard to see why foot masages shouldn't be available in hospitals. A thread on episiotomy might be more worthwhile.

Calibos' implication that the reflexologist is badgering women into using the service on the other hand has even less evidence to back it up than the strongest claims made for reflexology, and is hard to justify.

Talliesin

There are no clinical trials that I know of that show it'll improve any particular problem

There, how is that an "uncritical" article?

So lets see, you start with short emotive language, then you have a longer explanation which when read carefully shows that you don't really mean what the earlier emotive langauge claimed - so you can't be accused of making false claims.
Where have I come across that rhetorical technique before?…

williamgrogan

Reflexologists are not supplying foot message. They don’t even say that’s what they are doing. They advertise Reflexology!

They are claiming a lot more. It’s the extra claims that earn them the money and therefore it’s those unproven claims that we attack.

I have even heard the same type of tangential arguments for other CAM treatments and they are equally invalid, e.g. Acupuncture & chiropractic are relaxing, Homeopathy has no side effects, religion is a crutch, water diviners can find water anyway because they spend a lot of time doing it, psychics help people get over bereavement even if they cannot contact the dead, the placebo effect cures people etc.

Do I have to go into details or do you see my point?

Talliesin

Originally posted by williamgrogan
I have even heard the same type of tangential[I/] arguments for other CAM treatments and they are equally invalid, e.g. Acupuncture & chiropractic are relaxing, Homeopathy has no side effects,

Those are arguments for using such treatments, but against their efficacy. You won't find many homœopathists claiming it has no side-effects (though some would point out that if those who doubt it are correct then there is no reason to believe that it does).

religion is a crutch

That's an argument against religion's validity, and against its practice by all except the most dependent.

water diviners can find water anyway because they spend a lot of time doing it

Well that is really all water diviners claim to be able to do when you hire them. Since some work on a no-well no-fee basis what does it matter? Any claims about how it works (and there are a few diviners who are deeply sceptical about those claims, and say it most likely has a scientific explanation that'll appear rather obvious in hindsight once we discover it) are beside the point. A well is a pretty simple thing to prove scientificly (is it a big hole? is there water at the bottom?) whatever claims are made about how it was found.

You might as well argue you shouldn't buy butter at farm markets because one or two still leave the paddles out for the fairies.

My point though isn't about whether reflexology works or not. It's about the freedom of those who believe it works (or who think it's a lot of rubbish, but that reflexologists give the best foot massages - personally I lean towards the second) to have them.

Of course you should argue against its efficacy, but to say "What is also amazing is that these people seem to be allowed to operate in the hospital buildings" is only justifiable if you can show it is harmful in and of itself (whereas there is a large body of scientific literature to show that prophylactic episiotomy, and at least some other cases in which episiotomy may be performed is harmful and that occurs in a lot of maternity hospitals too).

williamgrogan

So in summary, you are arguing that if someone claims to be able to treat a person for a specific illness for a substantial fee (e.g. the reflexology treatment was recommended in Holles St for vomiting) by evoking a mechanism that in itself does not work that it is OK, provided there may be a small side effect that is beneficial in some other area?

I could open a clinic at the top of a hill selling snake oil and boast that while the snake oil doesn’t work, the people whose money I con from them at least get some exercise walking up the hill!

As regards water divining, tests show they cannot find water any more often than chance. In fact James Randi has said the most common applicants for his $1,000,000 prize are Water Diviners. Most of the applicants are surprised that Water Diviners can even apply. Needless to say none of them has succeeded.

There are cons based on this concept. You email 1,000,000 people month one and predict to half of them that say the dollar will strengthen and to the other half that it will weaken. Next month you email the 500, 000 you got right , half to say it will weaken and half it will strengthen, ditto until after 6 months those that are left will feel that as you predicted correctly 6 months on the trot that they should invest with you.

No foal no fee. Great idea. The water diviner only gets paid say, €500 for finding a well when he accidentally finds one. Dig a hole in most fields in Ireland and you will probably find water.

Your logic is bizarre to say the least of it.

ecksor

Originally posted by Calibos
Hypothetical conversation between practitioner and 'victim'. ie Tongue in cheek

Just making sure.

Originally posted by davros
But allowing them in hospitals is to, in effect, give them the establishment seal of approval. We are then saying that these practices are legitimate and effective and on a par with the fruits of modern medical research.

If we're sure that that is exactly what is being said, then why has nobody answered my question about the caveats (if any) supplied within the hospitals?

My standpoint is that if something is harmless and can make someone feel better (for whatever reason), then perhaps it does have a place within a hospital. Once you've done everything you can do for a patient medically, then I think any practicing doctor won't forbid anything that will make the patient more relaxed or comfortable, as long as it does no actual harm to the patient. I don't want to get bogged down in an emotive argument, but if someone close to me had a difficult childbirth, I'd see no harm in paying a reflexologist to make the mother feel better, if it might in fact make her feel better.

Reflexology (or whatever) has snuck in the back door without proof of the convincing sort and is gaining credibility by association.

I see the credibility issue as separate and far more relevant to sceptics than advocating to get rid of it from hospitals. Making clear and strong arguments to debunk the extraordinary beliefs in such practices is good. Ridiculing (tongue in cheek or not) doesn't really hep matters. Surely the point is to equip people to make good decisions for themselves rather than to make the decisions for them.

davros

Originally posted by ecksor
If we're sure that that is exactly what is being said, then why has nobody answered my question about the caveats (if any) supplied within the hospitals?

What are caveats worth? On the reflexology.ie site you mentioned, it says within the space of a few lines: a qualified practitioner can alleviate or treat a range of conditions - stress, sinus problems, back pain, irritable bowel syndrome, migraine etc. ... Reflexologists do not ... treat medical conditions. Legally, these people cannot make medical claims. In practice, verbally, they do.

My standpoint is that if something is harmless and can make someone feel better (for whatever reason), then perhaps it does have a place within a hospital.

There are lots of things that can make people feel better in hospitals, including tranquil garden views outside windows and sound-absorbing roof panels that let patients get a better night's sleep. Positive effects can be achieved without fooling patients into believing in fake sciences or forking over wads of cash.

I'd see no harm in paying a reflexologist to make the mother feel better, if it might in fact make her feel better.

This is the best argument for alternative/complementary medicine and all I can say is that hospitals should hurry up and steal the quacks' clothes. Provide the sympathetic ear, the quality time, the physical contact and whatever else it is that makes people feel better after an alternative consultation.

Surely the point is to equip people to make good decisions for themselves rather than to make the decisions for them.

Only up to a point. It's one of the huge benefits of living in a society that we don't have to ponder over every decision for ourselves. If I buy a kids' toy, I can reasonably expect that it is not covered in toxic paint. We have standards, regulations and stiff penalties that ensure such a product doesn't get to market. I don't need to test it myself or understand the biological effects of lead poisoning.

In medicine, the protections are much stronger again. Claims are severely circumscribed and must be backed up by irrefutable research. Lengthy information leaflets come with each prescribed drug. Only highly trained doctors may prescribe. This is the society we grow up in. We assume we have built strong protections, in medical and general consumer legislation against being sold a dud or something harmful.

Somehow, alternative medicine has been able to circumvent much of that protection. They can make claims and provide services without qualification or certification by any authority. The public does not know this. They reasonably assume that such services would not be widely advertised and made available if they were bogus. They expect society to make many decisions on their behalf, and not to be forced to sift the real from the phoney. Who has time for that?

williamgrogan

This is the best argument for alternative/complementary medicine and all I can say is that hospitals should hurry up and steal the quacks' clothes. Provide the sympathetic ear, the quality time, the physical contact and whatever else it is that makes people feel better after an alternative consultation

Very good point and obviously people are prepared to pay for this extra "hands on" quality time.

Health Direct 2000 is an orgnisation in the UK that seems to be doing this. So maybe it will catch on.

ecksor

Originally posted by davros
What are caveats worth?

To my mind they represent a rather large difference in how these treatments are presented. If people choose to ignore them, then that is their problem. If the caveats are not there, then
(a) - It seems like an omission on the part of the hospital to not make some sort of statement of that nature.
(b) - It might be a good activity for the Skeptics society to provide a balanced alternative viewpoint in hospitals, via flyers/leaflets etc that can be placed alongside advertisements for these treatments.

If people do not pay attention to any caveats there, then they're unlikely to pay attention to the caveats anywhere else or be swayed at all.

On the reflexology.ie site you mentioned, it says within the space of a few lines: a qualified practitioner can alleviate or treat a range of conditions - stress, sinus problems, back pain, irritable bowel syndrome, migraine etc. ... Reflexologists do not ... treat medical conditions. Legally, these people cannot make medical claims. In practice, verbally, they do.

Understood, but this is why I would like to make the distinction between the different ways of practicing separately to the actual issue of the effectiveness or mechanism by which a treatment is effective. Between harmful and harmless (physically/mentally I mean, not economically).

This is the best argument for alternative/complementary medicine and all I can say is that hospitals should hurry up and steal the quacks' clothes. Provide the sympathetic ear, the quality time, the physical contact and whatever else it is that makes people feel better after an alternative consultation.

Makes sense. This does happen in various forms though, nurses can pay attention to someone's emotional wellbeing, some patients will feel better because they can attend chapel services, there are chaplain services, etc etc.

Perhaps recognised forms of physical therapy should be provided more widely.

But, with this doubt in mind, can you still say there is definitely no place for this therapy within a hospital? Actually, what did Dr. Hughes have to say on the subject regarding filling in this gap through conventional medicine?

ecksor

One other point about the lack of information about the caveats is that this discussion is very much disconnected from actual practice, since if we're not able to answer that question then how can any of us claim to have made a proper study of the situation?

davros

Originally posted by ecksor
It might be a good activity for the Skeptics society to provide a balanced alternative viewpoint in hospitals, via flyers/leaflets etc that can be placed alongside advertisements for these treatments.

That's a very good idea indeed. In a similar vein, I've also thought it would be fun to take a booth at the annual Mind Body Spirit show at the RDS. Or would that be inviting a lynching?

But, with this doubt in mind, can you still say there is definitely no place for this therapy within a hospital?

I'm afraid that if I admit there is a place for any particular nutty idea within a hospital that I will have to accept all other equally useful ideas that come along. How about animal sacrifice? It has a long tradition. It makes some people feel better.

I'm exaggerating just a tad but if I'm asked to draw a line between what should and should not be offered within a hospital, then I will choose to exclude reflexology until it gets some solid research behind it. It's just easier. Treatments that do what they claim - come on in. Treatments that don't (and side-effects of relaxation are not justification enough) - stay away. There are thousands of these alternative medical systems. Without a clear standard, how would I choose between them?

ecksor

I accept your point of view, and when we have conventional treatments or forms of physical therapy (perhaps we do?) that can achieve the same feelings of well-being (misguided or not), I'll agree completely!

williamgrogan

I've also thought it would be fun to take a booth at the annual Mind Body Spirit show at the RDS. Or would that be inviting a lynching?

Great idea. I'll help man it. If nothing else it would be a serious laugh. It may get a great deal of publicity. Which if us isn’t prepared to be lynched in pursuit of the truth?

We would have to apply to the organisers under some nutty sounding name, say "Healing by Empirical Reasoning"

Myksyk

I remember that at the first Irish Skeptics lecture a man said that his daughter had begun a course in reflexology and was thumbing through her course book. Being a skeptic he enquired as to the research backing behind the quite extraordinary claims made by reflexology. She said they were well backed up, but he wasn't convinced. He was reading Steven Pinker's 'How the Mind Works' and suggested they compare the reference pages in the backs of their respective books. His daughter's reflexology handbook had no references; Pinker provided 30 or 40 pages of them. His daughter didn't seem particularly phazed by this. He felt this demonstrated the difference between those who base their thinking, theories and practices on evidence, however tentative, and those who don't...or won't.