The Effect of Foot Reflexology Massage on Neuropathic Pain in Women With Type 2 Diabetes: A Randomized Controlled Trial.

BACKGROUND

Diabetic peripheral neuropathy is a significant cause of chronic pain in patients with type 2 diabetes. Although pharmacological treatments are available, complementary therapies such as reflexology massage may offer additional symptomatic relief. However, evidence on the efficacy of reflexology massage in this context remains limited, particularly among women with type 2 diabetes.

AIM: This study aimed to evaluate the effect of foot reflexology massage on neuropathic pain in women with type 2 diabetes.

METHODS

This study was conducted between April 2023 and March 2024. The study was conducted as a randomized controlled trial and included 65 women diagnosed with type 2 diabetes and neuropathic pain, randomized into intervention (n = 33) and control groups (n = 32) using a computerized randomization program managed by an independent researcher. The intervention group received routine treatment plus foot reflexology massage administered by trained nurses, while the control group received routine treatment only. Outcomes were assessed using validated instruments for neuropathic pain and sensory function: Douleur Neuropathique 4 Questions (DN4), a 10-item questionnaire identifying neuropathic pain; Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), differentiating neuropathic from nociceptive pain; Visual Analog Scale (VAS), measuring pain intensity on a 0-10 scale; Monofilament test (SWM), evaluating peripheral touch sensation; and Neurothesiometer, assessing vibration perception thresholds. Effect sizes (Cohen's d) and 95% confidence intervals were calculated.

RESULTS

Preintervention measurement characteristics and pain scores did not differ significantly between groups (p > .05). Postintervention, the intervention group demonstrated significant reductions in DNQ4 (p = .001, d = 3.55), LANSS (p = .001, d = 2.34), and VAS scores (p = .001, d = 2.26) compared to the control group. No adverse events related to the intervention were reported.

CONCLUSION

Foot reflexology massage administered by trained nurses effectively reduces neuropathic pain in women with type 2 diabetes. As a low-cost and accessible therapy, it can serve as a valuable adjunct to routine care and is recommended to be incorporated and maintained in nursing practices for the management of neuropathic pain in individuals with diabetes.