The proper design, control, and intervention protocols of research on reflexology remain debatable. The use of randomized controlled trials (RCTs) is the golden standard in assessing the efficacy of complementary therapies such as reflexology.34 Verhoef et al. have described the challenges when researching complementary therapies: standardization of regimented treatment that limit the individualization of treatment; client's focus on health with restricted roles for disease treatment; ethical issues involving the recruitment and randomization due to participants pre-conceived belief on reflexology; practicality of applying sham reflexology; interference of psychological influence on rapport between patient-provider.35
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Some reflexologists who deny that they diagnose or treat disease claim that the majority of health problems are stress-related and that they can help people by relieving the "stress" associated with various diseases or body organs [1]. This type of double-talk is similar to chiropractic claims that "subluxations" lower resistance to disease and that "adjusting" the spine to correct subluxations will improve health. All ten of the books I have inspected mention scores of health problems that reflexology has supposedly helped.

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