Focus on Alternative and Complementary Therapies
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Focus Alternat Complement Ther©2005 Pharmaceutical Press
Focus Altern Complement Ther 2002; 7: 105–6
The use of complementary and alternative medicine (CAM) for the management of chronic low back pain (CLBP) continues to rise. However, questions regarding the efficacy of many CAM therapies for CLBP remain unresolved. This study was designed to evaluate the effectiveness of reflexology in this domain.
Pragmatic, randomised controlled trial. A total of 243 participants randomised to one of three groups: reflexology, relaxation, or non-intervention (usual care by GP). All participants completed a questionnaire booklet before and after the treatment phase. This measured their general health status, pain, functioning, coping strategies, mood and satisfaction with social support. In addition, 22 participants were interviewed at the end of the treatment phase. These interviews were designed to elicit participants’ views of the process of treatment and its outcome.
Repeated measures ANOVA found no significant differences between the groups pre- and post-treatment on the primary outcome measures of pain (F(4,310) = 1.152, P = 0.332) and functioning (F(4,318)= 2.039, P = 0.132). There was a main effect of pain reduction, irrespective of group (F(2,310) = 8.185, P = 0.0005). Conversely, thematic analysis of the interview data revealed that the majority of participants reported that treatment led to reduction in pain, increased relaxation and an enhanced ability to cope.
The quantitative data suggest that reflexology was not effective for managing CLBP, while the qualitative data suggest otherwise. This incongruence between results raises an important question for the design of research studies into the efficacy of complementary and alternative medicines. In particular, ‘whose view of efficacy should be accepted?’ Whatever the verdict, it is apparent that studies which consider treatment outcome need to define that outcome in terms that have currency for providers and consumers alike.
