The UK's Advertising Standards Authority (ASA) has upheld complaints concerning the Reflex Clinic online portal. The website's text stated
“As well as being used to assist in a wide variety of conditions, Reflexology techniques may be used in cases where there are fertility issues (Fertility Reflexology) ... Whilst reflexology does not claim to diagnose, treat or cure a disorder, it is thought that some disorders, detailed below, may respond well to reflexology. This is based mainly on anecdotal evidence and some limited scientific research: - Nervous system - Headaches, Migraines, Insomnia, Stress, Emotional Stress, ADHD, Anxiety, Panic Attacks and Depression; Glandular System - Reproductive - Hormone Imbalances, Menstrual Problems, Menopausal Concerns, PMT, Perimenopause, Fertility Issues, Pregnancy Issues, Prostate Problems; Glandular System - Metabolic - Hormone Imbalances, Thyroid Imbalance, and Adrenal Stress; Circulatory System - Hypertension, Stress, Poor Circulation and Oedema; Respiratory System - Asthma, Hay Fever and Sinusitis; Immune System - Viruses (M.E., glandular fever, Epstein Barr), Cancer, Fatigue, Stress and Auto-immune Disorders such as Rheumatoid Arthritis and Lupus; Urinary System - Hypertension, Water Retention and Backpain; Structural System - Sciatica, Stiff Neck, Muscle Cramps, Tennis Elbow, Toothache and Frozen Shoulder; Digestive System - Indigestion, Heartburn and Stomach Cramps; Intestinal System - Constipation, Poor Appetite and Irritable Bowel Syndrome (IBS); Post operative recovery; Palliative Care and more ...”.
The ASA examined claims made for reflexology on the site and testimonials provided there. It also noted a disclaimer posted on the site.
We have done everything possible to make this website compliant with the ASA. We have however, for the purposes of your convenience, left in some medical terms where appropriate as these are the terms that you the user would be searching on and we are therefore unable to remove them because you would no longer be able to find the website using those terms in your google or yahoo search criteria. (We have no control of terminology used by searches). All material on this website is subject to this disclaimer. See the footer link on each page. Reflexology is not intended to replace the relationship with your primary health care providers and the consultation is not intended as medical advice. The consultation is intended as a sharing of knowledge and information from education, research and experience. The information and service provided is not used to prescribe, recommend, diagnose or treat a health problem or a disease. It is not a substitute for medical care. If you have or suspect you have a health problem, you should consult your GP ...”.
The complainant challenged the efficacy claims, which it alleged were misleading; the disclaimer, which it said contradicted the text on the website; and the website itself, which the complainant alleged discouraged visitors from visiting mainstream medical practitioners in cases in which mainstream medical treatment was a preferable alternative. The ASA challenged the claims made for efficacy with regard to the testimonials.
Said the ASA:
The ASA noted that four of the six studies submitted (both of the stress reduction studies and two of the pain management studies) were pilot studies, designed as preliminary studies to test methodologies before larger quantitative studies took place. A number of the studies acknowledged the limitations of their findings for that reason, such as a pain reduction study that concluded “Reflexology appears to offer promise as a treatment in the management of LBP (lower back pain); however, an adequately powered trial is required before any more definitive pronouncements are possible”. We therefore considered that we would need to see the results of the larger quantitative studies, and not just the results of the pilot studies, before we could conclude that reflexology was able to assist with stress, anxiety and pain management.
We noted the third pain management study provided was not a pilot study, but also noted it stated that reflexology had no statistically significant effect after three or 24 hours. We therefore considered the study did not provide evidence that reflexology could assist with pain management.
We noted the PMT study was small, with 18 women undergoing reflexology treatment and 17 women undergoing a placebo reflexology treatment as a comparison. We noted the study found a positive link between reflexology and PMT, stating that it found a “significantly greater decrease in premenstrual symptoms for the women given true reflexology treatment than for the women in the placebo group” and “The primary benefit reported by the women receiving true reflexology was the experience of profound relaxation”. We also noted the study stated that it looked at 38 symptoms of PMT and stated that reflexology could benefit both somatic and psychological symptoms, but that it did not specify which of those symptoms reflexology was able to benefit.
We noted that the ASA and CAP had accepted previously that reflexology might help with relaxation, mood improvement, tension reduction and an improved sense of well-being. Those benefits were relevant to PMT symptoms such as poor mood and tension, and we therefore considered that claims that reflexology could have those benefits were acceptable. However, because the study was very small, involved self-reporting by subjects rather than objective measures, and did not specify whether reflexology could benefit symptoms beyond the general benefits we found acceptable, we considered we were unable to accept the study as sufficient substantiation that PMT responded well to reflexology. We considered that stating reflexology could benefit PMT implied it could benefit the more specific or serious symptoms of PMT that women might experience such as depression, anxiety, breast tenderness or cramps, when we had not seen evidence for that.
Because we had not seen evidence that reflexology could provide benefits beyond relaxation, mood improvement, tension reduction and an improved sense of well-being, we considered the efficacy claims for reflexology listed had not been substantiated and were misleading.
The claims breached CAP Code (Edition 12) rules 3.1 (Misleading advertising), 3.7 (Substantiation) and 12.1, 12.2 and 12.6 (Medicines, medical devices, health-related products and beauty products).
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While we noted the disclaimers clearly stated that the site was not intended to prescribe, recommend, diagnose or treat a health problem or disease, we considered they directly contrasted with the claims in the main text of the site, which outlined a large number of serious medical conditions that the site stated reflexology might be able to assist with. We therefore concluded the disclaimers contradicted rather than clarified the main text of the website.
The claims breached CAP Code (Edition 12) rules 3.1 (Misleading advertising), and 3.7 (Substantiation).
We noted The Reflex Clinic had ensured the site contained a number of disclaimers and replaced “can” with “may”. We considered that the term “may” still implied reflexology could have some benefit on the conditions listed, when we had not seen evidence that that was the case. We noted a number of the conditions listed in the ad were serious conditions that medical supervision should be sought for such as cancer, depression and auto-immune disorders. We were concerned that by stating reflexology could assist with those conditions, the site might discourage some individuals from seeking medical advice when it was required. As noted in (2) above, we considered the disclaimers on the site contradicted rather than clarified the text, and therefore did not consider the disclaimers were sufficient to ensure individuals were not discouraged from seeking medical advice.
The claims breached CAP Code (Edition 12) rules 3.1 (Misleading advertising), 3.7 (Substantiation) and 12.1, 12.2 and 12.6 (Medicines, medical devices, health-related products and beauty products).
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While we noted the testimonials may have been genuine opinions from clients, we noted we had not seen objective evidence that reflexology was able to have the benefits those clients claimed it could, such as treating depression or anxiety. We therefore concluded that the efficacy claims in the testimonials had not been substantiated.
The claims breached CAP Code (Edition 12) rules 3.1 (Misleading advertising), 3.7 (Substantiation), 3.47 (Testimonials), 12.1, 12.2 and 12.6 (Medicines, medical devices, health-related products and beauty products).
The ASA ruled that the Reflex Clinic could not publish the claims again "in their current form" and told the Clinic not to repeat the claims that had not been "substantiated."
Reflexology is a non-intrusive complementary health therapy, based on the theory that different points on the feet, lower leg, hands, face or ears correspond with different areas of the body.
Reflexology is a non-invasive complementary practice involving the use of alternating pressure applied to reflexes within reflex maps of the body located on the feet, hands and outer ears.
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