By A.H. Retief

Literature Study

Osteoarthritis is the degeneration of the cartilage in the joints. It often manifests after an injury or from repetitive physical tasks that place excess stress upon joints. It predominately afflicts the weight-bearing joints, such as the knees, hips, and spine, but can also manifest in areas of general wear and tear, such as finger and thumb joints, and shoulder joints.

About 60% of the British population has used, or is using, some form of complementary medicine to treat their arthritis. Some claim great benefit, but as with all arthritic treatments it is often difficult to know if an individual’s improvement is due to the illness waxing and waning naturally or because of if improvement is direct result of the treatment being used. (Philipsen, C. Healthy Way Magazine, Issue 21, Article 7) Even so, reflexology can play an important role in encouraging positive changes in a person’s lifestyle and outlook, such as increased self-reliance, a positive attitude, learning relaxation techniques and appropriate exercises. Lifestyle changes such as these may help to improve or stabilize your arthritis. There is often no cure for arthritis, but these changes in a person’s psychological well-being and lifestyle can be as important as the more conventional treatments in coping with the pain associated with osteoarthritis.

According to Dr. Goldberg (http://goldberg.getwebspace.com/arthritis.htm), the key to treating Osteoarthritis is to work with the patient’s entire health picture. He also states that it is necessary for a patient to adopt a whole new way of living, even to the point where they may need to change jobs, lifestyles, etc. if necessary. Rest and relaxation are essential in the treatment of Osteoarthritis. This leads one to question the role that stress might play in aggravating Osteoarthritis. Dr. Goldberg sates that when a person who is predisposed to Osteoarthritis is exposed to extensive and long-term emotional stress, the disease process can be triggered. Unrelenting emotional stress negatively influences the immune, endocrine, nervous, and gastrointestinal systems particularly, which in turn influence the muscles and joints. Reflexology can be an effective relaxation tool and can greatly reduce stress. It also approaches the individual as a holistic being and promotes rest and relaxation.

Cortisone is a common medication used for relieving arthritic pain and inflammation. Research has found that the body can be stimulated to produce it’s own natural cortisone by applying pressure to certain reflex points, namely the adrenal glands. (http://www. holistic-online.com) According to Cobi Philipsen (Healthy Way Magazine, Issue 21, Article 7), most people will obtain a degree of relief from pain through regular reflexology treatments, regardless of the type and location of the arthritis. It has also been found that not only is reflexology potentially beneficial for pain relief, but it can add quality to a person’s life by means of touch and communication.

Even though conventional treatments are safe and effective for most people, drugs and surgery are not suitable for all patients and these treatments cannot always fully control the symptoms of arthritis. Reflexology, on the other hand, is a safe and effective form of therapy for all which cannot harm the individual. The emphasis here is that the person’s body must “heal” itself with the help of a practitioner. Instead of merely treating the symptoms, reflexology treats the whole body and aids in the maintenance of health, not only in the achievement of health.

Due to the growing number of studies linking reflexology with successful pain management and reduction as well as the large number of people suffering from Osteoarthritic related pain it would therefore appear feasible to conduct a study to determine the effectiveness of reflexology in reducing pain and joint immobility associated with Osteoarthritis.

Aim

The aim of this research study was to investigate the possible impact of Therapeutic Reflexology on the pain experienced in the joints of individuals suffering from Osteoarthritis as well as the possible reduction of joint inflammation and immobility associated with osteoarthritis. Ten research subjects were selected from a group of volunteers to participate in the study. The composition of the research subject group was as follows: age - ranged from 35 to 68; Gender - 3 males, 7 females; location of arthritis - ankles, knees, hip, back, hands, and shoulder. Each patient received a total of ten, one hour Therapeutic Reflexology treatments, administered twice weekly with a break of at least 2 days between successive treatments, spanning a period of 5 to 7 weeks. Subjects were treated at their own residences at the same time each day. The following parameters were recorded at each treatment: subjective experience of pain according to the Brief Pain Inventory (Short Form), feedback regarding any negative and positive responses and changes, general condition of research subject, pain intensity and sensitivity of reflex responses, stress levels and general psychological well-being.

Conclusion

Although all research subjects noted a positive correlation between the reflexology treatments and a reduction in the inflammation of arthritic joints, improvement in joint mobility, reduced stress levels and general improvement of overall well-being, the results of this study are inconclusive as it was not possible to prove with any degree of statistical reliability that a correlation exists between therapeutic reflexology and a reduction in the pain associated with Osteoarthritis as only four of the research subjects treated claimed to experience a significant reduction in pain in the area afflicted with arthritis. There was also not enough evidence present to suggest that these four research subjects had achieved a reduction in arthritic pain solely by means of the reflexology treatments received and not perhaps by other contributing factors, such as medication and lifestyle changes.

The following limitations where also found to have a negative impact on the reliability and validity of the results obtained:

The sample population was not drawn randomly from the general population but was selected from a group of volunteers.

The arthritic conditions presented by the 10 research subjects were not the same in terms of severity and location.

The research subjects differed in age, gender and socio-economic status.

There was no uniformity with regards to other treatments being received.

The number of research subjects was too small to be able to draw any definite conclusions.

Pain is a subjective experience and can be affected by fatigue, mood and individual sensitivity.

The BPI (Short Form) is completed by the patient and cannot therefore be seen as an objective and statistically reliable measurement instrument.

Research subjects were free to continue with individual daily activities (such as sports) which would mean that there was no control over additional stressors which could hinder or delay improvements.

It is therefore not possible to prove that therapeutic reflexology directly reduces or cures the pain associated with Osteoarthritis by means of this study alone. There is, however, significant evidence present to suggest that reflexology greatly reduces joint inflammation and can therefore potentially improve joint mobility. However, as there was a significant reduction of Arthritic pain noted among four of the research subjects, it would be beneficial to investigate this topic further.

It is therefore recommended that a more intensive research study is undertaken making use of a larger sample group and eliminating the above limitations and subjective factors in order to further investigate the possibility that therapeutic reflexology can indeed be beneficial in the reduction of pain and other symptoms associated with Osteoarthritis.

References

DOUGANS, I. 1998. Reflexology— A Practical Introduction. Melbourne : Element

DOUGANS, I. 2002. Complete Illustrated Guide to Reflexology. London : Element

JACKSON, C. & JACKSON J. 2002. Modem Reflexology. London : Caxton Editions

OXENFORD, R. 2001. Healing with Reflexology. London : Southwater

PHILIPSEN, C. Healthy Way Magazine, Issue 21, Article 7

STORMER, C. 1995. Reflexology — The Definitive Guide. London Hodder & Stoughton

VONER, V. 2003. The Everything Reflexology Book. Avon, Massachusetts : Adams Media Corporation

WAUGH, A. & GRANT, A. Ross & Wilson: Anatomy & Physiology in Health and llness. Edinburgh Churchill Livingstone

The British Medical Association — Complete Family Health Encyclopedia. 1990. London Dorling Kindersley

The Merck Manual of Medical Information — Second Home Edition. 2003. Whitehouse Station, New Jersey: Merck Research Laboratories

INTERNET:

www.positivehealth.com/permit/Articles/CaseStudies/CaseStudies.htm 2004/11/10

www.scottishreflexology.org/research/publications/general.html 2004/11/10

www.pacificreflexology.com/pacrflx2004/muscle.htm 2004/11/10

www.holistichealthtools.com/reflexology.html 2004/12/14

www.complimentarymedicine.upmc.com/Reftexology.htm 2004/12/14

www.internethealthlibrary.com/Therapies/Reflexology-Research20.htm 2005/01/05 www.holistic-online.com 2005/01/05

http://goldberg.getwebspace.com/arthritis.htm - PAUL A. GOLDBERG 2005/01/05

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