title: A comparison of the effects of reflexology and relaxation on pain in women with multiple sclerosis.
abstract: BACKGROUND
  Pain is a common and significant symptom in many individuals with multiple sclerosis (MS). The presence and severity of pain in individuals with MS has also been shown to be associated with higher levels of depression, functional impairment, and fatigue. It is common for MS patients and their caregivers to worry about narcotic addiction in the management of chronic pain. Therefore, this study aimed to determine and compare the effects of reflexology and relaxation on pain in women suffering from MS.
  
  
  METHODS
  This study was a single-blind randomized clinical trial performed on 75 patients with MS referred to the MS Clinic of Ayatollah Kashani Hospital (Isfahan, Iran). After simple non-random sampling, using the minimization method, participants were randomly assigned to the three groups of reflexology, relaxation, and control. In the experimental groups, foot reflexology and relaxation interventions (Jacobson and Benson) were performed within 4 weeks, twice a week for 40 min. The control group received routine care and medical treatment as directed by a doctor. Data were collected using the Numerical Rating Scale before, immediately after, and 2 months after interventions in all three groups. Data analysis was performed using SPSS version 18 and descriptive and inferential statistical tests.
  
  
  RESULTS
  Findings obtained from analysis of variance (ANOVA) showed no significant differences between mean pain intensity scores in the three groups preintervention and 2 months after interventions (p > 0.05). However, this difference was statistically significant immediately after the study (p < 0.05). Findings obtained from repeated measures ANOVA showed that the severity of pain significantly differed during different times in reflexology and relaxation (p < 0.05); however, this difference was not significant in the control group (p > 0.05). Furthermore, Fisher's least significant difference (LSD) revealed a significantly higher reduction in pain intensity scores in the reflexology group after the intervention, compared with the two other groups, but showed no significant differences between relaxation and control groups. There were no significant differences between the three groups 2 months after the interventions (p > 0.05).
  
  
  CONCLUSIONS
  The results showed that both interventions are effective on relieving pain in women with MS; however, it appears that the effect of reflexology on pain reduction is greater than that of relaxation. Hence, these two methods can be recommended as effective techniques.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Nazari
authors.forename: Mozhgan
authors.initials: M
authors.lastname: Soheili
authors.forename: SayedMohsen
authors.initials: S
authors.lastname: Hosseini
authors.forename: Vahid
authors.initials: V
authors.lastname: Shaygannejad
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D005260:Female; D006801:Humans; D008405:Massage / Q000379:methods*; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000628:therapy*; D010146:Pain / Q000517:prevention & control*; D012064:Relaxation Therapy / Q000379:methods*; D016037:Single-Blind Method; D016896:Treatment Outcome; D055815:Young Adult