Fact Sheet: Massage Regulation of Reflexology

Current Laws

Current Status (June 2003)

Since 1998, reflexology has been removed from massage regulation in the states of Washington, Texas, Tennessee, New Mexico, North Carolina, Maryland, Arizona, and the city of Chicago. Should pending massage licensing legislation be enacted this year in Idaho, Montana, and Pennsylvania, reflexology will be excluded in the resulting laws. The City Council of San Diego is poised to license reflexology separately from massage.


Massage licensing requirements continue for reflexologists in the states of Oregon, Delaware, Hawaii, Alabama, Nebraska, New York, and Florida as well as under anti-prostitution ordinances in the cities of Los Angeles, Denver, and Colorado Springs.

Reflexology is Clearly Different than Massage

Reflexology is clearly different from massage in its origins, technique applications, safety issues, and assessment. The modern-day practice of reflexology is a direct descendant of medical research into the reflex at the end of the nineteenth century in Europe. A variety of therapeutic methods was created to influence the body through the reflexes. One resulting therapy was the work of Dr. William Fitzgerald of Connecticut who created zone therapy, application of pressure to all parts of the body, following a visit to England. His work was gradually developed by Dr. Riley and Eunice Ingham into the foot work known today in America as reflexology.


An established standard of practice has been accepted by the reflexology profession as represented by the professionals organizations, Reflexology Association of America and the American Reflexology Certification Board. It is: "Reflexology is the physical act of applying pressure to feet and hands with specific thumb, finger, and hand techniques that do not utilize cream, lotion of oil, assessed on the basis of zones and reiterative areas with the premise that such work effects a physical change in the body."

Ramifications of Massage Regulation of Reflexology

· Abridgment of Reflexologist's Fourteenth Amendment Rights

Massage laws are arbitrary and unconstitutional, failing to demonstrate that restraining reflexologists from entry into their profession is rationally related to legitimate public health and safety objectives.


While the national standard of the reflexology profession is 200 hours of education, no reflexology education is required of massage licensees. Over-regulation becomes no regulation as massage licensees with little or no reflexology training provide reflexology services. As a result, consumers are mislead as to the competency of state-approved reflexologists. In addition, reflexologists are required to obtain education that is not relevant to their profession.


As noted in case law: "California law used to require that African hair braiders spend 1,600 hours in classes, costing at least $5,000, at state-approved cosmetology schools and pass a licensing examination in order to legally practice their craft. California's cosmetology schools teach hair-straightening and chemical use but absolutely nothing about braiding. ...The federal court held in Cornwell v. California Board of Barbering and Cosmetology that the licensing law was arbitrary and unconstitutional. This was an important victory for economic liberty -- the right to earn an honest living free from excessive government regulation."1

· Prejudicial treatment

Massage laws and their enforcement are arbitrary and prejudicial. Of the many alternative health practices where pressure is applied, not all are required to obtain massage licensing.


Existing laws are not enforced for other professionals. "Massage" is offered by clerks selling make-up at counters in department stores with no penalty. Licensed massage therapists offer services tantamount to the practice of medicine with impunity. For example, providing reflexology services and selling herbs in a single session to a client, raises the issue of diagnosing a problem with reflexology and then prescribing an herbal remedy.

· Public Safety

Public safety issues are met by the assurance that, when licensed, practitioners practice within the legally defined, legislatively-mandated and licensed scope of practice, "confining their work to those (activities) that they are trained to do."2

· Fair Practices Act

Fair Practice Acts in each state maintain that the consumer receive goods or services as promised. No massage law, ordinance or rules includes a definition or scope of practice for reflexology. Consumers cannot be assured of what services are to be received or if reflexology services provided are within professional boundaries.

· Abridgment of Consumers' and Reflexologists' First Amendment Rights

The Constitutional, First Amendment Rights of reflexologists have been abridged by massage regulation of their profession. Under such laws, individuals are not allowed to provide or receive health services or their belief choice.3 In order for such abridgement to take place, it must be shown that there is an over-riding public safety issue.


1. "Celebrating 10 Years of Excellence at the Institute for Justice," Walter Williams, Human Events

The Week of December 10, 2001 (http://www.humaneventsonline.com/articles/12-10-01/williams.html)

2. Durnoff, Michael, ed. Michael H. Cohen, "Malpractice Liability of Alternative / Complementary Health Care Providers, A View from the Trenches," Alternative & Complementary Therapies Journal, June/July, 1995, pp. 248-253

3. Board of Medical Quality Assurance Report, State of California, 1982, p. 17

ŠKunz and Kunz 2003
button chart

Visit Our Bookstore

Call Toll Free 1-877-344-9392 or email us Click Here


Register for Reflexology Research Project free email updates