Open Access Opinion

Alternative Therapies in Pain Management: A Brief Review

Tammy Mullins*, Alicia Bradley, Jessica Kehl, Elizabeth Logsdon, Tabatha Scherer and Jonathan Thomas

School of Nursing, Spalding University, Louisville, USA.

Corresponding Author

Received Date: June 12, 2020;  Published Date: June 30, 2020


The purpose of this paper was to bring awareness to use of Reflexology as an effective therapy in managing pain especially in the post-operative setting. This paper was completed in conjunction with the authors and their faculty member as a requirement for completion of a master’s of science in nursing degree program.

The oxford dictionary [1], defines reflexology as a system of massage used to relieve tension and treat illness, based on the theory that there are reflex points in the feet, hands, and head linked to every part of the body. Sensors in each body part are stimulated by applying the reflexology technique in order to improve the blood flow and energy circulation, giving a sense of relaxation to a specific body part or area [1]. A total of 12 articles were reviewed from the MEDLINE database for this paper. Reflexology has proven to be non-invasive, nonpharmacological, and is easy to use as a complimentary therapy. Training is required of providers to insure the consistency of the therapy provided.

Keywords:Reflexology, Non-invasive and nonpharmacological, Pain management, Complementary and alternative medicine


Inadequate pain management with post-operative patients can impose poor outcomes for patients. In the midst of the ongoing opioid epidemic there is an urgency to seek alternative pain control, especially in the management of postoperative pain in surgical patients [2]. The focus of this paper is to review alternative therapies that include reflexology, with the intention of reducing the use opioid analgesics in the management of postoperative pain. Based on the latest research available, reflexology seems to be effective in helping the body return to its natural state [3]. Reflexology can give benefits to certain groups of patients generally without any harmful side effects. Reflexology techniques have been around for a significant time period and now with the increase in evidence-based research these techniques have shown benefit in patients’ recovery with the management of their pain.


Attias S, et al. [4] completed a randomized control trial with the use of reflexology, that reported improved pain control using the visual analog scale in postoperative setting. They concluded adding reflexology to standard analgesic care is effective in reducing postoperative pain both at rest and in motion for patients with moderate to severe pain [4].

Khorsand A, et al. [5], completed a double-blind randomized control trail and reported decreased pain intensity and decreased use of opioids in postoperative time frame using the visual analog scale, when reflexology was implemented in the plan of care [5].

Cotton S, et al. [6], conducted a retrospective chart review revealing the use of massage therapy and healing touch improved pain score by as much as 50% in pediatric patients [6].

Öztürk R, et al. [7], concluded after a randomized control trial that foot reflexology may serve as an effective intervention to decrease pain and anxiety in females after abdominal hysterectomy [7].

Matsota P, et al. [8], concluded the use of music therapy in the perioperative and postoperative setting showed reduction in stress levels and decreased pain results [8].

Other studies reviewed included alternative holistic approaches such as acupuncture, leech therapy, cyroanalgesia, and intramuscular stimulation that reported improved outcomes as well [9-13].


After reviewing the literature, it can be concluded that reflexology in conjunction with current practices decreases the frequency and duration of needed opioids post-operatively, while successfully managing pain. In order to integrate reflexology into practice increased awareness and training on alternative therapies should be implemented [14]. A continued education class is recommended for health care providers.

With the implementation of reflexology, we have the potential to improve patient outcomes and decrease opioid use. Anticipated improvements include decreased hospital stays following surgery, increased mobility early on, and less negative side effects related to opioids which could prolong or complicate recovery.

Limitations may include the acceptance of the alternative therapy by the provider and the patient. Providers may have varying techniques that change or decrease the benefits of treatment. Cost or insurance carrier coverage may also be a limitations, as many alternative therapies are costly and not covered by insurance.

More research on reflexology and its effects on pain is encouraged to address these limitations. Research, education, and increased utilization are the keys in implementing this therapy with success.


As a group we would like to acknowledge the entire graduating class from Spalding University and the faculty, staff, family, and friends that supported the class of 2020 from the MSN Family Nurse Practitioner Program.

Conflict of Interest

The authors declare no competing interest


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