Preventive Care in Nursing and Midwifery Journal
Volume 16, Issue 2 (4-2026)
Prev Care Nurs Midwifery J 2026, 16(2): 3-12 |
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Ethics code: IR.IUMS.REC.1403.1154
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Hosseini S E, Amirpour M, Javadi M. The Effect of Foot Reflexology Massage on Pain and Fatigue after Lumbar Spine Surgery: A Randomized Controlled Trial. Prev Care Nurs Midwifery J 2026; 16 (2) :3-12
URL: http://nmcjournal.zums.ac.ir/article-1-1027-en.html
URL: http://nmcjournal.zums.ac.ir/article-1-1027-en.html
Nursing and Midwifery Care Research Center, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran , esmat.hosseini.110@yahoo.com
Abstract: (361 Views)
Background: Pain and fatigue control after spinal surgery is a significant concern. Foot reflexology massage has a comprehensive effect on reducing pain and fatigue in patients.
Objectives: This study aimed to determine the effect of foot reflexology massage on postoperative pain and fatigue trajectory after lumbar spine surgery.
Methods: This randomized, parallel-group controlled trial was conducted on 68 patients undergoing lumbar spine surgery at Ayatollah Beheshti Hospital in Yasuj, Iran. Participants were randomly allocated to either the experimental or control group using a computer-generated randomization sequence. The experimental group received a standardized 30-minute foot reflexology massage session at least 4 hours after analgesic administration, while the control group received routine postoperative care without therapeutic massage. Data were collected using a demographic information form and a Visual Analog Scale (VAS). Pain, fatigue, and hemodynamic indicators were measured in both groups at 30, 60, 90 minutes, and 24 hours post intervention. Data were analyzed using Repeated Measures Analysis of Variance (ANOVA) in SPSS software, version 20.
Results: The study results indicated that the experimental group had lower pain and fatigue scores compared with the control group (p < 0.001). Significant group, time, and group × time interaction effects were observed (p < 0.01, η² = 0.07–0.15), while no significant differences were found at 24 hours.
Conclusion: Foot reflexology massage may help reduce pain and fatigue in the early postoperative period after spinal surgery, but its effect does not seem to last up to 24 hours.
Objectives: This study aimed to determine the effect of foot reflexology massage on postoperative pain and fatigue trajectory after lumbar spine surgery.
Methods: This randomized, parallel-group controlled trial was conducted on 68 patients undergoing lumbar spine surgery at Ayatollah Beheshti Hospital in Yasuj, Iran. Participants were randomly allocated to either the experimental or control group using a computer-generated randomization sequence. The experimental group received a standardized 30-minute foot reflexology massage session at least 4 hours after analgesic administration, while the control group received routine postoperative care without therapeutic massage. Data were collected using a demographic information form and a Visual Analog Scale (VAS). Pain, fatigue, and hemodynamic indicators were measured in both groups at 30, 60, 90 minutes, and 24 hours post intervention. Data were analyzed using Repeated Measures Analysis of Variance (ANOVA) in SPSS software, version 20.
Results: The study results indicated that the experimental group had lower pain and fatigue scores compared with the control group (p < 0.001). Significant group, time, and group × time interaction effects were observed (p < 0.01, η² = 0.07–0.15), while no significant differences were found at 24 hours.
Conclusion: Foot reflexology massage may help reduce pain and fatigue in the early postoperative period after spinal surgery, but its effect does not seem to last up to 24 hours.
Type of Study: Orginal research |
Subject:
Nursing
References
1. Mosabbir A. Mechanisms behind the development of chronic low back pain and its neurodegenerative features. Life (Basel). 2022;13(1):1-15. [https://doi.org/10.3390/life13010084] [PMID]
2. Alshammari HS, Alshammari AS, Alshammari SA, Ahamed SS. Prevalence of ihronic pain after spinal surgery: a systematic review and meta-analysis. Cureus. 2023;15(7):1-11. [https://doi.org/10.7759/cureus.41841]
3. Särkilahti I, Reponen E, Skants N. Patient-reported pain, satisfaction, adverse effects, and deviations from ambulatory surgery pain medication. Scandinavian Journal of Pain. 2024;24(1):1-10. [https://doi.org/10.1515/sjpain-2023-0133] [PMID]
4. Reme SE, Munk A, Holter MTS, Falk RS, Jacobsen HB. Pre- and post-operative psychological interventions to prevent pain and fatigue after breast cancer surgery (PREVENT): Protocol for a randomized controlled trial. PLoS One. 2022;17(7):1-25. [https://doi.org/10.1371/journal.pone.0268606] [PMID]
5. Chinnusamy S, Subbarayalu AV, Mani P, Purushothaman VK, Vasanthi RK, Muralidharan CK, et al. Combined efficacy of foot reflexology and back massage on pain and fatigue in patients undergoing hemodialysis. International Journal of Therapeutic Massage and Bodywork. 2025;18(2):19-27. [https://doi.org/10.3822/ijtmb.v18i2.1097] [PMID]
6. Keskin AY, Molu B. Nurses' attitudes toward holistic and complementary medicine in pain management. Pain Manag Nursing. 2025;26(3):298-305. [https://doi.org/10.1016/j.pmn.2024.11.008] [PMID]
7. Ouda MM, Al Ghadeer H, Hussein MF, Elfeshawy R, Mahmoud NF, Elsayed AIIJTMJoN. Effect of foot reflexology on pain and fatigue levels regarding insulin injection among diabetic children. The Malaysian Journal of Nursing. 2025;16(4):274-285. [https://doi.org/10.31674/mjn.2025.v16i04.027]
8. Levin J, Bradshaw M. Prevalence and determinants of massage therapy use in the U.S.: Findings from the 2022 National Health Interview Survey. Explore (NY). 2024;20(6):103-115. [https://doi.org/10.1016/j.explore.2024.05.013] [PMID]
9. Zhuang Q, Yin Y, Liu Z, Zhang L, Li H. Effect of music therapy on relieving the pain and distress of children undergoing venipuncture: a systematic review and meta-analysis. Complementary Therapies in Clinical Practice. 2025;60(10):1-18. [https://doi.org/10.1016/j.ctcp.2025.101994] [PMID]
10. Hull R. The Complete guide to reflexology. 3th ed: Simon and Schuster; 2023. [https://www.simonandschuster.co.uk/books/The-Complete-Guide-to-Reflexology/Ruth-Hull/9781644116258]
11. Sluka KA. Mechanisms and management of pain for the physical therapist-E-BOOK. 3th ed: Elsevier Health Sciences; 2025. [https://pubhtml5.com/ylgr/cudv/Mechanisms_and_Management_of_Pain_for_the_Physical_Therapist_Second_E]
12. Lee J, Han M, Chung Y, Kim J, Choi J. Effects of foot reflexology on fatigue, sleep and pain: a systematic review and meta-analysis. Journal of Korean Academy of Nursing. 2011;41(6):821-833. [https://doi.org/10.4040/jkan.2011.41.6.821] [PMID]
13. Zhang Y, Qin X, Li Q, Ma J, Rao L, Zhou J. Hand and foot massage on pain management after cesarean section: a meta-analysis. Pain Management Nursing. 2025;26(2):237-244. [https://doi.org/10.1016/j.pmn.2024.10.017] [PMID]
14. Mohamed Elghareeb Allam S, Ahmed Mohammed Elmetwaly A, Mokhtar Mokhtar I. Impact of the finger handheld relaxation technique on pain intensity and stress among post appendectomy patients. Egyptian Journal of Health Care. 2023;14(3):103-115. [https://doi.org/10.21608/ejhc.2023.313529]
15. Özkan E, Bayrak NG. Efficacy of massage therapy in alleviating pain and anxiety post-cardiac surgery: A systematic review and meta-analysis. Perioperative Care and Operating Room Management. 2025;38:1-13. [https://doi.org/10.1016/j.pcorm.2025.100465]
16. Almutairi BNA, Almutary SA. Nursing interventions for managing chronic pain in older adults: a comprehensive review. The Review of Diabetic Studies. 2024;20(s5):261-275. [https://doi.org/10.70082/zeqzps79]
17. Ajari EE. Mindfulness meditation as a complementary health therapy: a useful import into aarica? European Journal of Environment and Public Health. 2020;4(2):1-10. [https://doi.org/10.29333/ejeph/8328]
18. Poyyamozhi M, Ravichandran PT, Bharathidass K, Murugesan B, Vadivelan K, Alsafyani M, et al. Investigating the use of luminous capsule bubble tiles in smart structures to improve reflexology. Buildings. 2025;15(7):1-15. [https://doi.org/10.3390/buildings15071092]
19. Shibasaki WM, Martins RP. Simple randomization may lead to unequal group sizes. Is that a problem? American Journal of Orthodontics and Dentofacial Orthopedics. 2018;154(4):600-605. [https://doi.org/10.1016/j.ajodo.2018.07.005] [PMID]
20. Sayari S, Ghorbani R, Nobahar M. Effect of foot reflexology on sleep quality and severity of fatigue in patients with acute myocardial infarction: A double-blind randomized clinical trial. Koomesh. 2021;23(23):327-337. [https://brieflands.com/journals/koomesh/articles/149951]
21. Begum MR, Hossain MA. validity and reliability of visual analogue scale (VAS) for pain measurement. Journal of Medical Case Reports and Reviews. 2019;2(11):1153-1157. [https://doi.org/10.1111/j.1553-2712.2001.tb01132.x] [PMID]
22. Goudman L, Pilitsis J, Billet B, De Vos R, Hanssens K, Billot M, et al. The level of agreement between the numerical rating scale and visual analogue scale for assessing pain intensity in adults with chronic pain. Anaesthesia. 2024;79(2):128-138. [https://doi.org/10.1111/anae.16151] [PMID]
23. Liu C, Chen X, Wu S. The effect of massage therapy on pain after surgery: A comprehensive meta-analysis. Complementary Therapies in Medicine. 2022;71(102892.):1-18. [https://doi.org/10.1016/j.ctim.2022.102892] [PMID]
24. Cole JS, Olson AD, Dupont-Versteegden EE. The Effects of massage therapy in decreasing pain and anxiety in post-surgicalpatients with breast cancer: a systematic review and meta-analysis. Global Aadvances in Integrative Medicine and Health. 2024;13(II):1-13. [https://doi.org/10.1177/27536130241245099] [PMID]
25. Yang JM, Li ZQ, Ye H, Wu YL, Long Y, Zhong YB, et al. Effects of foot reflexology massage on pregnant women: a systematic review and meta-analysis of randomized controlled studies. Scientific Reports. 2024;14(1):1-12. [https://doi.org/10.1038/s41598-023-51107-y] [PMID]
26. Shan S, Lin L, Fang Q, Tian F, Guo D, Zhou Y, et al. Massage therapy significantly improves cancer-related fatigue in cancer patients: a meta-analysis of randomized controlled trials. Supportive Care in Cancer. 2023;31(8):1-16. [https://doi.org/10.1007/s00520-023-07926-w] [PMID]
27. Cai DC, Chen CY, Lo TY. Foot reflexology: recent research trends and prospects. Healthcare (Basel). 2022;11(1):1-18. [https://doi.org/10.3390/healthcare11010009] [PMID]
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