Complementary and alternative medicine in the treatment of low back pain, with a focus on reflexology

Abstract

This thesis aimed to ascertain the amount of evidence available investigating the use ofcomplementary and alternative medicine (CAM) in the treatment of low back pain (LBP),and to investigate the current use of CAM among reflexologists, physiotherapists, and LBPpatients. A systematic review was performed to assess the current evidence base availablefor CAM in the management of LBP.

This review highlighted the lack of evidenceavailable in this area, particularly concerning reflexology in the management of LBP. The surveys of reflexologists, physiotherapists, and LBP patients produced a number of keyfindings. Views obtained from reflexologists relating to potential benefits of reflexologytreatment concur with current evidence from randomised controlled trials (RCTs) andanecdotal evidence. Findings from the surveys of physiotherapists and LBP patientssuggest that although acupuncture, massage, and chiropractic are commonly used amongboth physiotherapists and patients, the limiting factor of a more widespread use of otherCAM therapies, such as reflexology, is a lack of knowledge of its effectiveness in themanagement of LBP.The pilot RCT investigating the effectiveness of reflexology in the management of LBPproduced encouraging results. Visual analogue scale (VAS) scores decreased in thereflexology group, with minimal or no change in the sham reflexology group. However,improvements were observed in both groups with secondary outcome measures therefore itis not clear whether even sham reflexology produces a therapeutic effect or ifimprovements were due to a placebo effect. This thesis has added to the limited evidencebase investigating reflexology treatment for LBP and suggested improvements to informthe design of a larger trial of reflexology in the management of LBP.

Date of Award	Apr 2006
Original language	English
Supervisor	David Baxter (Supervisor) & Ciara Hughes (Supervisor)