Cortisol and reflexology

As the professional body, the Association of Reflexologists (AoR) continues to invest in research to strengthen the evidence base and credibility of reflexology practice. A recent pilot study explored whether reflexology has a measurable impact on physiological stress by analysing cortisol levels in hair follicles before and after treatment. Preliminary findings were presented at the RCCM Conference in September 2025 by Tracey Smith (AoR), Dr Ru Jian (Nuffield Department of Primary Health Care Sciences, University of Oxford)  and Dr Adam Massey (Cortigenix).

The pilot study involved 11 participants and found that whilst measured cortisol levels showed a reduction following treatment, the results were not statistically significant which is unsurprising given the small sample size.  However, participants also reported subjective perceived stress levels, and here the findings were statistically significant which a reduction of 62%.  Funding is now being sought to support a larger-scale study. 

In my own clinic, I regularly observe improvements in stress-related symptoms. For example, one client experiencing chronic insomnia began with weekly treatments for one month, then moved to fortnightly sessions, and now attends monthly. They report deeper, more restorative sleep stating they wake up less frequently,  an increase of approximately 90 minutes per night and sustained improvements over time. This is anecdotal but consistent with the type of feedback many reflexologists hear daily.  So, when objective biomarkers do not yet show statistical significance, but subjective well-being measures do, how should we interpret that?  Self-reported outcomes matter. If individuals experience meaningful reductions in stress and improvements in sleep, that has real-world benefits, even as the science to prove this continues to evolve. 

If you’re struggling with stress or poor sleep, it may be worth carrying out your own research by exploring reflexology and evaluating the impact for yourself.