Reflexology: A randomised controlled trial investigating the effects on beta-endorphin, cortisol and pregnancy related stress

Authors: McCullough Julie E M, Liddle Sarah Dianne, Close Ciara, Sinclair Marlene, Hughes Ciara MJournal: Complementary therapies in clinical practicePublished: May 1, 2018DOI: 10.1016/j.ctcp.2018.01.018

Q2 JournalSJR: 0.65h-index: 72SCImago

Moderate EvidencePilotn=90 participants

Chronic Stress Pregnancy Discomfort

In Plain Language: reflexology for stress, explained

Reflexology is used for various pregnancy related complaints. A three-armed, pilot randomised controlled trial was conducted to test changes in physiological and biochemical stress parameters. Ninety primiparous volunteers experiencing low back and/or pelvic girdle pain (LBPGP) were recruited to receive either six reflexology or footbath treatments or usual care. Primary outcome data included pain intensity and frequency measured on a visual analog scale (VAS), and salivary beta-endorphin and cortisol levels. 61 (68%) women completed the intervention. A clinically important reduction of 1.63 cm occurred for VAS pain frequency following reflexology. Beta-endorphin levels increased by 8.8% and 10.10% in the footbath and usual care groups respectively and decreased by 15.18% for the reflexology group. Cortisol increased by 31.78% for footbath participants, 31.42% in usual care and 18.82% in the reflexology group. Reflexology during pregnancy may help reduce LBPGP, and associated stress. However, antenatal reflexology is under researched and requires further investigation.

Key Findings: what this pilot study found about stress

✓Reflexology produced a clinically important reduction of 1.63 cm in pain frequency on the visual analog scale for pregnant women with low back and pelvic girdle pain.
✓Beta-endorphin levels decreased by 15.18% in the reflexology group, whereas they increased by 8.8-10.10% in the footbath and usual care groups.
✓Cortisol levels increased less in the reflexology group (18.82%) compared to footbath (31.78%) and usual care (31.42%) groups, suggesting reflexology may attenuate stress-related physiological responses.

What This Means for You

Reflexology may help reduce pregnancy-related back and pelvic pain with preliminary evidence, but larger studies are needed before making it a primary treatment choice.

What This Means for Practitioners

This pilot study provides promising early evidence that reflexology can reduce pain frequency in pregnant clients with back and pelvic girdle pain, supporting its use as a complementary therapy in antenatal care.

Study Design: how this pilot study was run

Sample Size

90 participants

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Reflexology for stress: common questions

Does reflexology help with stress?

Reflexology may help reduce pregnancy-related back and pelvic pain with preliminary evidence, but larger studies are needed before making it a primary treatment choice.

What did this study find?

Reflexology produced a clinically important reduction of 1.63 cm in pain frequency on the visual analog scale for pregnant women with low back and pelvic girdle pain. Beta-endorphin levels decreased by 15.18% in the reflexology group, whereas they increased by 8.8-10.10% in the footbath and usual care groups. Cortisol levels increased less in the reflexology group (18.82%) compared to footbath (31.78%) and usual care (31.42%) groups, suggesting reflexology may attenuate stress-related physiological responses.

How strong is this evidence?

This is a pilot study and we rate its evidence moderate. It covers 90 participants. It was published in Complementary therapies in clinical practice, a Q2 journal. Reflexology is a complementary therapy, not a replacement for medical treatment.