Nico Pauly
Tell us how Nerve Reflexology began.

Walter Froneberg, a German chiropractor, got in touch with the school of Hanne Marquardt and learned her approach of classic foot reflexology. In his clinic, he altered the spinal reflex zones techniques by applying instead a static direct pressure on the bones of the feet - as opposed to “walking” in the soft tissue. He noticed that the paravertebral muscles were responding much quicker than with the classic zone technique. Given that these points were responding so quickly, he became convinced that they must have a direct relationship with the corresponding nerves. So he called these points “nerve reflex points”. He elaborated in a period of 20 years of experience nerve reflex points for the whole peripheral, autonomous and central nervous systems.

Walter Froneberg also adapted special techniques for the spine like: “specific muscle and nerve massage” and “modified joint mobilisations”. He combined these manual techniques with the nerve reflex points and called this new approach: “Manual Neurotherapy.”

How is it different from more classical reflexology, such as the Ingham Method, for instance?

The techniques of nerve reflexology are completely different from the classic zone techniques.

1°. The pressure is given with the outside side of the top of the thumb to small parts on the bones of the foot. Meaning: the bone of the thumb is touching the bone of the foot (see picture).

2°. If the corresponding nerve is overloaded, the nerve reflex point will be painful. The therapist holds the point, without moving until the pain decreases.

3°: The nerve reflex points can be combined with classic zone therapy. You can first treat the nerve of the affected structure by pressing the nerve reflex points and then treat the structure by zone therapy. The effects are much better and quicker, a normal innervation being the first important thing for a good function of structures.

What is your part in the evolution of Nerve Reflexology and Manual Neurotherapy?

I learned Nerve Reflexology (NR) and Manual Neurotherapy (MNT) from Walter Froneberg himself, and later, together with his son in law Norbert Gosch, I became teacher in Belgium, teaching MNT and NR to physiotherapists. My personal touches in MNT and NR are:

1°. The science based approach.
Very soon, I felt the need for a scientific and didactic approach, as this was completely missing in the trainings of Walter Froneberg's school. While MNT and NR are working deeply into the nervous system, you must have a consistent knowledge of how the nervous system works and certainly, how the nervous system is reacting on pain.
I elaborated a “pain clinical reasoning and handling model”. In this model, students learn to analyse the pain of a client to find out where the dysfunctions are in the peripheral, autonomous and central nervous system and how the psycho-emotional behaviour of the client is influencing the nervous system and the pain (See diagram).

This model gives students a clear and good structure to deal with nerve reflex points. The whole approach is built on the research in the pathophysiology of pain.

2°. Developing new nerve reflex points and refining the manual techniques of MNT.
In my 24 years of experience and teaching NR and MNT, I discovered new nerve reflex points for the sympathetic nervous system, for nerve plexi around organs and for muscles. I also modulated the original spine mobilisations of Walter Froneberg in more precise and safer techniques, which I call “spine tuning”.

3°. Research.
Together with my teaching colleague, Rian Lasonder, I published a large study on the effects of nerve reflex points on paravertebral muscles.

In collaboration of well trained nerve reflexologists of the Netherlands, I performed a study on the effects of nerve reflexology on chronic lumbar pain.
Both studies can be downloaded from our website:

4°. The evolution of MNT and NR with more precise visceral approaches for organs, hormones and the immune system.
For this part, I attracted Griet Rondel, a Belgian physiotherapist, certified in MNT and NR. She developed a manual mobilisation technique for the digestive tract and a special approach combining NR and zone therapy for the whole visceral system. Both of us gave this approach a scientific and well structured form.

5°. Foundation of MNT-NR International.
Together with Griet Rondel, Norbert Gosch (son in law of Walter Froneberg), I founded MNT-NR International. This foundation was needed for spreading out and protecting our concept. MNT-NR International stands for high quality and science based teaching and developing of MNT and NR.

Where on the foot are the Nerve Reflex Points related to the back?

We have several NR-points related to the spine:
• points for the spinal nerves: dorsal and ventral ramus,
• points for the sympathetic innervation part like paravertebral ganglia,
• points for paravertebral muscles.

In the figures below you see spinal nerve and paravertebral ganglia points.

However, in NR or MNT, we never use these points as single standing approach to back pain. The back is part of a large movement system, including spine, surrounding muscles but also internal organs. All these structures have to move in a harmonious relationship. A chain of nerves is linking all these structures. The NR and MNT therapist will first find out where the dysfunctions in all these structures are located and then try to restore these by interfering in the nervous chain and in the movement chain.

In your experience, how effective is Nerve Reflexology for back pain?

In the research on low back pain, as mentioned earlier, NR has the same result as the evidence-based physiotherapy approach (exercise program). So, it would be very interesting to combine these two approaches in the hope that the result is much better.

Many reflexologists are very frustrated that there are too few studies validating reflexology as an effective therapy. Why in your opinion and given the fact that, as reflexologists, we see constantly how effective our work is on our patients, is it taking so long to prove with randomized controlled studies that reflexology really does work for this or that condition?

There a many reasons for the lack on RCTs (randomized controlled trials).

1°. Reflexologists must learn in their education and in their work to speak the same language as the western medicine world. It's like when a Greek and an Englishman meet and speak in their own language about the beautiful weather and sun. They talk about the same thing but they don’t understand each other. Reflexologists are talking about energy, yin and yang, meridians and so on….Let’s translate these valuable concepts into the medical western language of physiology, sympathetic and parasympathetic system, hormones etc…Then we have already the same language.

2°. The responsability of big reflexology organizations like RIEN and ICR. They should rally professional reflexologists on a financial annual contribution. They should work together and create with these finances a scientific committee. This committee could sponsor well designed RCT’s or other science based research. I know an English reflexologist, Carol Samual, who is now finishing a PhD with a research on reflexology and pain. These studies are very valuable, however, she had to fund her own research over more than 5 years, without any help from the reflexology world. There is a big responsibility of ICR and RIEN to help these idealistic researchers.

3°. In large world conferences like ICR and RIEN conferences, there is a big lack of scientific approach. Lectures should be focusing on research, discussion groups should be focusing on hypotheses and on a scientific approach in daily work, and workshops should demonstrate new approaches.
How can you expect interest of scientists when reflexologists do not show any interest in the science approach of their work?

More and more doctors are looking to integrate complementary therapies in their practice. According to you, is integrated medicine going to be the trademark of the coming decades?

There are very interesting signs going on in the medicine world. Certainly the new sciences of energy and epigenetics are very promising for the future. They will slowly convince the medical world of the holistic approach.
I think that in the future reflexology, homeopathy, and allopathy will really operate in integrated teams. Changing minds goes slowly. Let’s see in about 50 years from now, I believe that medicine will by then be completely different from the narrow symptomatic approach of today.

For more information on Nico Pauly, Nerve Reflexology, and Manual Neurotherapy visit:


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