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Quinn F, Hughes CM, Baxter GD. Reflexology in the management of low

back pain: a pilot randomised controlled trial. Complementary Therapies

in Medicine 2008;16:3-8.

Aim Of This Study



This pilot study was conducted to assess whether reflexology

treatments are clinically effective in the management of lower back

pain.



Method



Fifteen participants diagnosed with non-specific lower back pain

were randomised into two groups: seven in the reflexology group (six

females and one male) and eight in the sham group (four females and four

males).



Both groups were given 40-minute weekly treatments for six

consecutive weeks. Those in the reflexology group received precision

treatments that focused on reflex points on the feet associated with

body organs, the spine and the spine's surrounding muscular

structures.



The sham group received foot massages that used less pressure than

that used in the reflexology group. The same reflex points for body

organs were massaged but points associated with the spine and

surrounding musculature were avoided.



Three experienced reflexologists performed all the treatments for

this study. Each participant received treatments from a single therapist

throughout the intervention. To test for blinding, in weeks 2 and 12,

participants were asked to indicate which group they believed they had

been assigned to.



Measurements



Measurements were taken before the first treatment, after the last

treatment at six weeks, and for follow-ups at 12 and 18 weeks. A 10 cm

visual analog scale (VAS) was used to measure pain intensity, whereby 0

cm represents 'no pain' and 10 cm represents 'worst

possible pain'. Participants were asked to make a mark on the scale

to indicate their pain level.



Three questionnaires were also used to assess pain and disability.

The McGill pain questionnaire assessed what the pain felt like, how it

changed over time, and its intensity. The Roland-Morris disability

questionnaire assessed the impact of pain on daily activity. And the

SF-36 health survey was used to assess the participants' perceived

health status. It covers mental and physical functioning, mental and

physical role limitations, vitality, bodily pain and general health

perceptions.

Results



VAS scores in the reflexology group reduced by an average of 2.5 cm

at the 18-week follow-up. Of the seven participants in this group, three

showed a clinically relevant improvement, three showed a small

improvement and one felt that their pain had worsened at the end of six

weeks intervention. Four participants in the sham group felt that their

pain had increased after six weeks and four had a small improvement.



Scores in the Roland-Morris disability questionnaire decreased by

one point in the reflexology group and three points in the sham group at

18 weeks. These results indicate relevant improvements in the sham

group. Both groups showed a reduced score in the McGill pain

questionnaire. At six weeks, the reflexology group decreased their score

by 18 points and the sham group by 11.5 points. These improvements

tapered off by week 18 to 6 points and 7.5 respectively.



The SF-36 scales showed improvements in both groups for vitality,

social functioning, role-emotional and mental health. Only the

reflexology group showed improvements for role-physical and bodily pain

scores. This result shows that although both groups improved in the

mental summary scale, only those in the reflexology group improved in

the physical summary scale. Blinding tests indicated that 53.3% of

participants wrongly guessed their group allocation.



Conclusion



The researchers concluded that:





these results suggest that reflexology may be of benefit

in the treatment of lower back pain, and may also have

some wider benefits in terms of quality of life. A suitably

powered randomised controlled trial would be required

to draw any definitive conclusions.

Limitations Of This Study



As acknowledged by the researchers, the small sample size in this

study does not allow for any statistically significant results to be

calculated.