In South Africa, massage is regulated, but enforcement is poor. The minimum legal requirement to be able to practice as a professional massage therapist is a 2-year diploma in Therapeutic Massage and registration with The Allied Health Professions Council of SA (AHPCSA). The 2 year qualification includes 240 credits, about 80 case studies, and about 100 hours community service.
The findings by a recent study have confirmed the efficacy of reflexology by recording 31% of pain reduction among the patients with back pain. Quinn et al. reported that the pain intensity score decreased to an average extent in the experimental group.23 Poole et al. demonstrated that there was a significant difference between the control and experimental groups before and after the reflexology treatment.24
Reflexology is an alternative medicine system that claims to treat internal organs by pressing on designated spots on the feet and hands; there is no anatomical connection between those organs and those spots. Systematic reviews in 2009 and 2011 found no convincing evidence that reflexology is an effective treatment for any medical condition. Quackwatch and the NCAHF agree that reflexology is a form of massage that may help patients relax and feel better temporarily, but that has no other health benefits. Our own Mark Crislip said, “The great majority of studies demonstrate reflexology had no effects that could not be replicated by picking fleas off your mate…And it has no anatomic or physiologic justification.”
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Before you go, check with the spa about what you should wear: the spa may provide disposable underwear. If the thought of removing all your clothes makes you blush, don't worry: your therapist will be an artist of professional draping techniques. The oils and lotions used in massage can stain fabrics, so it's a good idea to opt for something old if you're wearing your own clothes.
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A 2004 systematic review found single applications of massage therapy "reduced state anxiety, blood pressure, and heart rate but not negative mood, immediate assessment of pain, and cortisol level", while "multiple applications reduced delayed assessment of pain", and found improvements in anxiety and depression similar to effects of psychotherapy. A subsequent systematic review published in 2008 found that there is little evidence supporting the use of massage therapy for depression in high quality studies from randomized controlled trials.