“The use of complementary and alternative medicine (CAM) for the management of chronic low back pain (CLBP) continues to rise. However questions regarding the efficacy of many CAM therapies for CLBP remain unresolved. This study is designed to evaluate the effectiveness of reflexology in this domain. “Design: Pragmatic RCT. N=243 participants randomised to one of three groups: reflexology, relaxation, or non-intervention (usual care by GP). “Method: All participants completed a questionnaire booklet before and after the treatment phase. This measured their general health status, pain, functioning, coping strategies, mood and satisfaction with social support. In addition post treatment semi-structured interviews were conducted with a subsample of 22 participants. These were designed to elicit details of participants experience of treatment and its outcome. “Results: Repeated measures ANOVA found no significant differences between the groups pre and post treatment on the primary outcome measures of pain (F(4, 310)=1.152, p=.332) and functioning (F(4, 318)=2.039, p=.132). There was a main effect of pain reduction, irrespective of group (F(2, 310)=8.185, p=.0005). Conversely thematic analysis of the interview data revealed that the majority of participants reported treatment led to reduction in pain, increased relaxation and an enhanced ability to cope. “Conclusion: The quantitative data suggest that reflexology is ineffective for managing CLBP, while the qualitative data suggest otherwise. This incongruence between results raises important questions for the design of research studies into the efficacy of CAMs. Should the patients view of efficacy be negated because ‘objective’ measures showed no effect? or the appropriateness of the scientific parameters questioned because they are in conflict with patients notion of efficacy? Whatever the verdict it is apparent that studies which consider treatment outcome need to define that outcome in terms that have currency for providers and consumers alike.”
“Evaluating the efficacy of reflexology for the management of chronic low back pain,” Authors:Helen Poole, Peter Murphy, Sheila Glenn, Presented at the Annual Meeting of the American Pain Society (Treatment Approaches (Physical) E03 - Holistic/Alternative Medicine Poster #807 ), Published as Poole, H. M., Murphy, P., & Glenn, S. (2001) “Evaluating the efficacy of reflexology for chronic back pain,” The Journal of Pain, 2(2), 47 (http://www.ampainsoc.org/abstract/2001/data/221/)
“Physiological responses to pain create harmful effects that prolong the body's recovery after surgery. Patients routinely report mild to moderate pain even though pain medications have been administered. Complementary strategies based on sound research findings are needed to supplement postoperative pain relief using pharmacologic management. Foot and hand massage has the potential to assist in pain relief. Massaging the feet and hands stimulates the mechanoreceptors that activate the "nonpainful" nerve fibers, preventing pain transmission from reaching consciousness. The purpose of this pretest-posttest design study was to investigate whether a 20-minute foot and hand massage (5 minutes to each extremity), which was provided 1 to 4 hours after a dose of pain medication, would reduce pain perception and sympathetic responses among postoperative patients. A convenience sample of 18 patients rated pain intensity and pain distress using a 0 to 10 numeric rating scale. They reported decreases in pain intensity from 4.65 to 2.35 (t = 8.154, p <.001) and in pain distress from 4.00 to 1.88 (t = 5.683, p <.001). Statistically significant decreases in sympathetic responses to pain (i.e., heart rate and respiratory rate) were observed although blood pressure remained unchanged. The changes in heart rate and respiratory rate were not clinically significant. The patients experienced moderate pain after they received pain medications. This pain was reduced by the intervention, thus supporting the effectiveness of massage in postoperative pain management. Foot and hand massage appears to be an effective, inexpensive, low-risk, flexible, and easily applied strategy for postoperative pain management.”
Wang HL, Keck JF., “Foot and hand massage as an intervention for postoperative pain,” Foot and hand massage as an intervention for postoperative pain,” Pain Manag Nurs. 2004 Jun;5(2):59-65.; PMID: 15297952; Clarian Health Partners, Methodist Hospital, Indiana University School of Nursing, Indianapolis, IN 46202, USA. hswang@iupui.edu
“Objectives: To determine the 12-month prevalence of hand dermatitis among massage therapists, to investigate a potential association between hand dermatitis and the use of aromatherapy products, and to study potential associations with other known risk factors for hand dermatitis. Design: Mailed survey. Setting: Philadelphia, Pa.; Participants: Members of a national massage therapy organization who live in the greater Philadelphia region; Main Outcome Measures: Self-reported and symptom-based prevalences of hand dermatitis. Results: The number of respondents was 350 (57%). The 12-month prevalence of hand dermatitis in subjects was 15% by self-reported criteria and 23% by a symptom-based method. In multivariate analysis, statistically significant independent risk factors for self-reported hand dermatitis included use of aromatherapy products in massage oils, lotions, or creams (odds ratio, 3.27; 95% confidence interval, 1.53-7.02; P =.002) and history of atopic dermatitis (odds ratio, 8.06; 95% confidence interval, 3.39-19.17; P<.001). conclusions: the prevalence of hand dermatitis in massage therapists is high. significant independent risk factors include use of aromatherapy products in massage oils, creams, or lotions and history of atopic dermatitis.”
Crawford GH, Katz KA, Ellis E, James WD., “Use of aromatherapy products and increased risk of hand dermatitis in massage therapist.,” Arch Dermatol. 2004 Aug;140(8):991-6; PMID: 15313817; Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, USA. glen.crawford@uphs.upenn.edu
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