Reflexology, acupressure, acupuncture – how do they differ?
Acupressure and acupuncture are both Eastern treatment methods that target energy points on the human body: acupressure applies manual pressure, while acupuncture involves the insertion of needles.
Acupuncture is regarded as a subtler and more complex method, typically practiced in specialized clinics of Chinese medicine. In contrast, acupressure and its Western equivalent, reflexology, are categorized as massage techniques and can be administered in massage parlors.
Reflexology and acupressure are two terms that get thrown around a lot in massage and spa treatment descriptions and are often treated like they’re interchangeable. Most people, though, have little idea what they mean. Many confuse acupressure with acupuncture, while some generally consider such “esoteric” practices as useless and dubious.
A typical storefront of a Chinese massage parlor. San Francisco, USA
Indeed, all these treatments fall back on roots from a finding made by humans in time immemorial – pressure in a certain way on certain areas of the body, especially on the extremities, can somehow affect distant internal organs and systems and promote the body’s natural healing process! Traditional curing practices based on manipulation of the feet or hands have been found in many indigenous cultures, from Native Americans to Australian aborigines.
Evidence-based modern medicine only recognizes that stimulation of specific points on the body can reduce or eliminate pain in places remote from these points, as well as calm the nerves and even put a person into a trance. However, it’s not able to scientifically explain this phenomenon yet, despite the fact that these remarkably similar concepts of Folk medicine evidently reflect some general fundamental principles of human anatomy and physiology.
Massaging the ball of the foot just below the big toe might (or might not) reduce heart rate
On the other hand, there is Eastern medicine, also called Alternative medicine, that comprises traditional health systems and practices from India, Thailand, China, Japan, and other Asian countries. The most known and sophisticated of them is traditional Chinese medicine. Eastern medicine describes the phenomenon of the “biologically active points” on the human body in a way entirely different from Western medicine.
Energy pathways and acupoints
Eastern medicine posits that vital energy, called Qi by the Chinese, Prana by the Indians, and Lom Pran by the Thais, surrounds and courses through our bodies to support life. This essential life force travels by a network of invisible pathways, similar to a circulatory network of blood vessels. The major highways are termed Meridians, Nadi, and Sen, respectively.
The life force enters the physical body and further gets distributed through the doorways commonly called acupoints. There are hundreds of acupoints located on the body’s surface in specific areas such as the hands, feet, legs, arms, abdomen, back, and head. Each acupoint has its unique name and is associated with a specific organ, system, and physiological function.
Traditional Chinese medicine identifies 20 major meridians, each containing over 400 acupoints. These meridians feature various types of points, including Alarm, Proactive, Calming, and Harmonizing, as well as special points designated for particular conditions and treatments.
The basic principle of Eastern medicine is that when the flow of energy is blocked or insufficient at a certain point in the energy network, it causes health problems along certain pathways. Stimulating the related acupuncture points can help restore proper energy flow and promote physical, mental, and emotional well-being.
Acutherapy is a broad term that encompasses various alternative healing practices based on stimulating specific points on the body:
1. ACUPRESSURE: it’s not a needling!
This method refers to the manual stimulation of acupoints throughout the body. Besides the direct pressure itself, these points can also be activated by kneading, stroking, rubbing, tapping, and grasping motions with the fingertips, especially the thumbs, in the areas around them.
Acupoint massage is commonly performed with the fingertips, especially the thumbs, although the palms, elbows, feet, knees, or even wooden sticks, stones, or herbal compresses sometimes may also be employed.
While originating in China, acupressure techniques spread and were adopted in other East and Southeast Asian countries, where local variations developed, such as Japanese shiatsu and Thai massage. Nevertheless, the specific point locations, hand techniques, and theoretical foundations remain rooted in the traditional Chinese system.
Due to its relative simplicity and painlessness, acupressure is often incorporated into regular Eastern massages, alternating with other techniques. For example, in conventional Thai massage, which generally focuses on overall wellness rather than being specifically therapeutic, acupressure is usually used to stimulate just several points associated with promoting emotional balance and lowering blood pressure.
Quick guide to main Eastern modalities of acupressure massage
However, the Eastern massage modalities which are targeted at treating particular health conditions, including therapeutic Thai massages, utilize unique and complex protocols and require considerable experience and skills. Typical acupressure protocol specifies the points or their combinations to stimulate for a given condition, the hand part to use, and the order, pattern, intensity, and duration of the manual manipulation techniques.
2. REFLEXOLOGY: it’s often a bit of a misnomer!
In European languages, “reflexology” is commonly used to refer to any manual pressure points technique applied to the extremities. You can see this word on the signs and service menus of Chinese, Thai, and Ayurvedic massage establishments everywhere worldwide – simply because it’s more familiar and understandable to a Western audience. Agree, that “Thai pressure point massage of the feet” won’t be as concise and catchy as “Thai foot reflexology“!
In fact, the reflexology itself, also known as Zone therapy, or the Ingham method, is unrelated to Eastern energy points therapy. Originated in America in the 20th century, the study of reflexes explains through a Western medicine lens why stimulation of specific areas on the human feet, hands, and ears can induce physiological effects in other parts of the body: these all are reflexes, i.e. responses of the body inflicted on irritation.
Reflexology relies on 10 longitudinal zones running from the top of the head to the tips of the toes and fingers. Each reflex zone connects particular organs or body parts with specific reflex areas located on the extremities. The reflex areas mirror their associated parts of the body in miniature – and, when pressed, transmit nerve impulses there, causing reflex reactions (for example, reducing pain) in the corresponding places.
Reflexology charts are visual representations of the reflex areas corresponding to specific body parts through the nervous system. For example, the toes are associated with the head and neck, the foot ball corresponds to the chest and lungs, the arch relates to the spine, and the heel connects to the pelvic area. Reflexologists use these charts as guides during reflexology sessions.
While Western reflexology and Eastern acupressure therapies may appear similar as they both involve applying pressure on specific points, they differ in their underlying principles and expected outcomes. Thus when some Zone practitioners claim that the foot, hand, or ear massage they provide is rooted in ancient Chinese medical knowledge rediscovered 100 years ago, this is not entirely true.
In Chinese and Thai languages, the traditional pressure point massages of the feet, hands, or head are never called “reflexology”. There is no such word in the Thai language at all, and the Chinese term Fǎnshè Liáofǎ (反射疗法) refers to “outlandish” Ingham method. In China, Thailand, and other Asian countries, these treatments are considered a fast but effective form of acutherapy, focused on locations with a high concentration of energy pathways and points. Limb massages are ideal for people on the go and are widely practiced in an Asian daily routine for relaxation and quick body energy balance recovery.
Pressure point for Foot Massage: locations, functions, and benefits
While acupressure massage has commonalities across many Asian cultures and traditional medicine systems, there are also several quite elaborate acutherapy practices unique to traditional Chinese medicine (TCM):
3. ACUPUNCTURE: you won’t find it in a massage parlor!
This method is to stimulate the energy points with the tip of filiform needles inserted through the skin to a depth of 2 to 15 mm, depending on the point locations. As with acupressure, acupuncture uses points throughout the body, however, some acupuncturists may also focus specifically on the ears, hands, or feet. Because of the similarity of names, these two practices are constantly confused, and since people tend to be afraid of needles, “needle phobia” somewhat extends to pressure point massage.
The number of needles can vary from 1-3 per session for very focused, localized treatment to more than 20 when addressing complex or whole-body conditions. The session usually lasts about 20 minutes.
But the needles are so thin, ranging from about the thickness of a human hair to slightly thicker, that the patients often don’t feel the insertion of the needles at all. Rather than pain, they tend to experience heaviness, numbness, tingling, or warmth around the needled area.
This sensation is called the “Arrival of Qi” (De Qi, 得气 ) and indicates that the point has been properly activated and Qi energy is being moved at that location. If the De Qi sensation doesn’t immediately after the needle penetrates, the practitioner will twirl and move the needle up and down at different speeds and depths.
Acupuncture in China is usually performed in conjunction with moxibustion, in which dried mugwort sticks (moxa) are burned to warm the meridians and hasten the “Arrival of Qi”. The Chinese term for acupuncture (Zhēn Jiū, 鍼灸) is actually composed of “needling” (Zhēn) and “burning” (Jiū) because this treatment often involves placing an ignited moxa onto inserted needles, allowing the heat to travel to the chosen acupoints through them.
Despite the frightening name, moxibustion doesn’t usually involve literal contact of the burning stick with the skin surface. If the needles are not used as a conductor of heat, the moxa just holds for a few minutes very close to the skin surface until the acupoint area turns red.
In Chinese medical books, one finds assertions that the most skilled acupuncturists can elicit the “Arrival of Qi” even through finger pressure, and then feel the De Qi response by their fingertips as a sort of throbbing or pulsating, or very weak electrical discharge. However, Qi massage manuals generally do not cover the De Qi reaction because acupressure is a way less subtle healing method than acupuncture.
“Acupuncture-moxibustion” requires more advanced training – usually a Bachelor’s degree with medical school prerequisites, clinical and diagnostic skills based on traditional Chinese medicine principles, and a medical license due to the invasive nature of needle insertion and associated risks of nerve damage or organ puncture. For this reason, this practice is regulated as a medical care service in most countries, including Thailand, and must be provided in healthcare facilities, but not in spa and massage parlors.
However, there is another, less well-known method of acutherapy in the arsenal of Chinese medicine, which, because of its relative simplicity and safety, does not require special certification and can be provided in wellness venues:
4. CUPPING: it can be found in a massage parlor!
This form of acutherapy in a sense is the opposite of pressure point massage for limbs. Firstly, acupoints are not stimulated by pressure but rather by vacuum suction. This suction, created by special cups placed along the body’s meridians, lifts stagnant blood to the surface and stimulates the tissues beneath the cups to receive fresh, oxygen-rich blood. As blood is believed in TCM to be a denser form of Qi, its increased circulation means revitalizing vital energy flow.
Traditionally, the vacuum is created by placing a flame inside the cup for a few seconds; when the air in the cup cools, it contracts back in volume, and negative pressure arises. In recent years, handheld manual and even electric pumps have been increasingly used in cupping therapy.
Next, due to the ease with which it can be performed there, Cupping is mostly applied to the acupoints on the back, but not on the arms, legs, or head. These points, located parallel to the vertebra, are the back points of the 12 main internal organs and transport Qi to them; thus they are called Back Shu points where Shu (俞) means transportation. Each of the 12 Back Shu acupoints is located on the same level as the related organ and named after it, e.g. point BL-15 Xin Shu is “Heart-Shu”.
For this reason, the standard Chinese cupping set is always a multiple of 12, although the real number of cups may vary depending on the purpose of the treatment. For example, in the picture above, the cups in the top row are used to relieve muscle tension in the shoulders, not for acutherapy, while the other 4 rows are expected to affect the acupoints regulating the function of Lungs, Pericardium, Liver, and Gall Bladder.
Chinese cupping therapy (Báguàn, 拔罐) along with acupuncture-moxibustion were once established across hospitals in China as the official principal treatment for many chronic diseases. There is even a Chinese saying that goes: “Cupping and acupuncture cure more than half of illnesses.”
