30/04/2025
A new piece of research indicates that reflexology is beneficial for pain following total knee replacement surgery (TKR).
TKR can be an extremely painful experience post surgery and high doses of pain relieving medication is usually given to control it.
In this study there were 50 patients in each group - reflexology vs control. Both groups were administered pain relieving medications, although the intake of those meds were not directly measured for the individuals during the experimental procedure.
Rather interestingly the researchers suggests that, the right foot decreases activation of the sympathetic nervous system whilst the left foot activates the parasympathetic nervous system, thus affecting the patient's pain and anxiety levels. An interesting suggestion, but do remember that we have no evidence to that effect in the research literature.
As a result of their assumption, they provided 20 minutes of reflexology to the right foot and 10 minutes to the left foot. Five minutes was dedicated to massage of the foot, pre and post reflexology, whilst the remaining time was given to stimulating the reflex points related to pain and anxiety.
Let's take a closer look.
a). there is no evidence that the left/right feet differ in terms of sympathetic/parasympathetic activity.
b). the researcher suggests there are points for pain and anxiety, but again, there is no evidence of specific points in the literature and we should bear in mind that we are all different in terms of our perception of pain, which is a very subjective experience.
c). it would be helpful for any ongoing research and replication, if the researchers had indicated where on the feet they applied the reflexology stimulus.
d). the natural course of events suggests that the farther away from a surgical procedure one is, the more likely it is that pain will decrease and mobility will increase.
e). there may be non-specific effects from the additional care and concern provided by the attending reflexologist/nursing staff which may have had an impact on improving anxiety levels.
Overall this is an interesting piece of research that suggests a beneficial effect on pain, but more importantly on mobility. Early mobilisation following TKR is important for the greater long term benefit of the patient.
Dr Jackie James recently completed her DProf on reporting research in reflexology which adds more structure. Without knowing the protocol involved, the points reflected through the feet, we cannot replicate this research or progress it further.
So, as a researcher and a patient who has experienced a TKR, I would suggest you err on the side of caution.
We are a long way from agreeing on what impacts pain in reflexology. We know we can alleviate that pain in 'some' individuals and that ongoing support with reflexology will bring about changes in the nervous system, but pain is very much a personal experience and we would do well to remember, there is 'no one size fits all approach'.
A good paper, with some good evidence, but not necessarily strong evidence.
https://dergipark.org.tr/en/download/article-file/4324912
