Last Updated on February 11, 2026 by MASSAGE Magazine
Reflexology may reduce both physical and mental symptoms of low back pain, according to a pilot randomized controlled trial conducted at the University of Ulster in Newtownabbey, United Kingdom.
Low-back pain (LBP) remains one of the most common musculoskeletal complaints worldwide. Researchers sought to determine whether reflexology, a foot-based therapy targeting specific reflex points, could help manage nonspecific low back pain. The findings suggest potential benefits, though the authors emphasize the need for larger studies before drawing firm conclusions.
Who Participated in the Study?
Fifteen staff members from the University of Ulster with nonspecific low-back pain were selected to participate.
Before inclusion, each participant was diagnosed with nonspecific LBP by an experienced physiotherapist. Additional inclusion criteria required that:
- Any physiotherapy, medication, or other treatment for LBP had been stabilized for at least three months
- Participants had not taken part in other research within the past three months
- They had no detailed knowledge of reflexology
- They were not pregnant
Of the 15 participants, 10 were female and five were male. The median age in the reflexology group was 42, while in the sham-treatment group it was 45. Participants were randomly assigned using a computer-generated random number table and were not aware of which group they were in.
What Was the Difference Between Reflexology and Sham Treatment?
The reflexology group received treatments focused on key reflex points on the feet that correspond to the spine and its surrounding musculature.
The sham group received a gentle foot massage that followed the sequence of a standard reflexology session but used less pressure and deliberately avoided reflex points associated with the spine and surrounding muscles.
Both groups received:
- 40-minute sessions
- Once weekly
- For six consecutive weeks
Treatments were administered by experienced reflexologists. Three therapists were involved, with each participant treated by the same therapist throughout the study. One of the study’s authors, also an experienced reflexologist, monitored treatment validity during the trial.
How Was Pain Measured?
The primary outcome measure was the Visual Analogue Scale (VAS), a widely used tool for assessing pain intensity.
Participants marked their average pain level from the previous week along a 10-centimeter line ranging from “no pain” to “worst pain ever.” This provided a measurable indicator of perceived pain over time.
Researchers also used three secondary outcome measures:
- The McGill Pain Questionnaire, which evaluates both intensity and characteristics of pain
- The Roland-Morris Disability Questionnaire, which measures how much low-back pain affects daily life
- The SF-36 Health Survey, which assesses general quality of life, including physical and mental health components
Data collection occurred at four time points:
- Before treatment began (week one)
- After the final treatment (week six)
- At 12 weeks
- At 18 weeks
- At the start of the study, levels of low-back pain and disability were comparable between both groups.
Did Reflexology Reduce Low-Back Pain?
Yes, the reflexology group showed a steady decrease in pain scores over time.
VAS pain scores in the reflexology group declined from the start of the study through the 18-week follow-up. In contrast, the sham-treatment group showed no clinically significant changes in VAS pain scores over the same period.
Secondary measures revealed more nuanced findings.
Both groups showed decreased scores on the McGill Pain Questionnaire and the Roland-Morris Disability Questionnaire. Mental health components of the SF-36 improved in both groups as well.
However, only the reflexology group demonstrated improvements in the physical aspects of quality of life as measured by the SF-36.
Why Did the Sham Group Also Improve in Some Areas?
The authors noted that improvements in the sham group may have been influenced by factors beyond simple pain intensity.
Because the secondary outcome measures assess broader aspects of well-being, and because the sham treatment followed the sequence of a standard reflexology session, it is possible that general therapeutic touch, relaxation or nonspecific effects contributed to improvements.
The researchers cautioned that the small sample size limits definitive conclusions and emphasized that further research with a larger participant group is necessary.
What Did the Researchers Conclude?
“These results suggest that reflexology may be of benefit in the treatment of LBP, and may also have some wider benefits in terms of quality of life,” the authors stated.
Originally published in Complementary Therapies in Medicine (2008, 16, 3–8), this pilot study provides preliminary evidence that reflexology may reduce perceived low-back pain and improve physical quality-of-life measures over time.
While additional research is needed to confirm these findings, the study offers insight into how reflexology might fit into a broader approach to managing nonspecific low-back pain.