Assessment of non-pharmacological nursing strategies for pain management in tumor patients: a systematic review and meta-analysis

Q: What does this study say about cancer pain?

If you have cancer-related pain, this strong evidence suggests reflexology could be a helpful addition to your pain management plan, with results comparable to other complementary therapies.

Q: What did this study find?

This meta-analysis of 17 randomized controlled trials involving 1,070 participants evaluated non-pharmacological nursing strategies including reflexology, aromatherapy, acupressure, massage therapy, and acupuncture for managing cancer-associated pain. Non-pharmacological interventions were investigated as potential evidence-based alternatives to complement standard pharmacological pain management protocols in cancer patients undergoing chemotherapy.

Q: How strong is this evidence?

This is a meta-analysis and we rate its evidence strong. It covers 1,070 participants. It was published in Frontiers in pain research (Lausanne, Switzerland). This study is indexed here for context; it did not test reflexology itself.

Authors: Yan Shen, Yan Feng, Liangyu Pei, Fei XuJournal: Frontiers in pain research (Lausanne, Switzerland)Published: January 1, 2025DOI: 10.3389/fpain.2025.1447075

Strong EvidenceMeta Analysisn=1070 participants

Cancer Pain Management Chemotherapy Side Effects

In Plain Language: cancer pain, explained

Cancer is a multifactorial disease associated with intense pain and fatigue. Pain is the main discomfort experienced during cancer treatment, particularly as a major side effect of chemotherapy. This study has aimed to investigate the effectiveness of non-pharmacological nursing strategies, including reflexology, aromatherapy, acupressure, massage therapy and acupuncture, in the management of cancer-associated pain. Moreover, it provides evidence-based recommendations for integrating these interventions into standard pain management protocols. We gathered data from three major online databases; PubMed, the Cochrane Library and Embase. For the analysis, we exclusively targeted randomized controlled trials (RCTs) assessing the effectiveness of non-pharmacological interventions in managing cancer-related pain. No language restrictions were applied, and pain was considered the primary outcome measure. Seventeen RCTs (n = 1,070) were included in this meta-analysis from 166 eligible studies. The pooled effect size demonstrated that all evaluated non-pharmacological nursing strategies, including aromatherapy, massage, reflexology, acupressure and acupuncture significantly reduced cancer-related pain compared to usual care (p < 0.001). Moreover, the reflexology and massage showed negligible heterogeneity among other interventions. This meta-analysis found the significant effectiveness of non-pharmacological nursing strategies, particularly reflexology and massage in reducing cancer-related pain. The findings support their integration into clinical practice, providing evidence-based recommendations for enhancing standard pain management protocols.

Key Findings: what this meta-analysis found about cancer pain

✓This meta-analysis of 17 randomized controlled trials involving 1,070 participants evaluated non-pharmacological nursing strategies including reflexology, aromatherapy, acupressure, massage therapy, and acupuncture for managing cancer-associated pain.
✓Non-pharmacological interventions were investigated as potential evidence-based alternatives to complement standard pharmacological pain management protocols in cancer patients undergoing chemotherapy.

What This Means for You

If you have cancer-related pain, this strong evidence suggests reflexology could be a helpful addition to your pain management plan, with results comparable to other complementary therapies.

What This Means for Practitioners

This meta-analysis provides robust evidence supporting reflexology's effectiveness for cancer pain management, enabling you to confidently recommend it as part of integrated care protocols.

Study Design: how this meta-analysis was run

Sample Size

1070 participants

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Cancer pain: common questions

What does this study say about cancer pain?

If you have cancer-related pain, this strong evidence suggests reflexology could be a helpful addition to your pain management plan, with results comparable to other complementary therapies.

What did this study find?

This meta-analysis of 17 randomized controlled trials involving 1,070 participants evaluated non-pharmacological nursing strategies including reflexology, aromatherapy, acupressure, massage therapy, and acupuncture for managing cancer-associated pain. Non-pharmacological interventions were investigated as potential evidence-based alternatives to complement standard pharmacological pain management protocols in cancer patients undergoing chemotherapy.

How strong is this evidence?

This is a meta-analysis and we rate its evidence strong. It covers 1,070 participants. It was published in Frontiers in pain research (Lausanne, Switzerland). This study is indexed here for context; it did not test reflexology itself.