Painkillers are probably one of the greatest postoperative gifts. Being cut open, rearranged and sewn back together is traumatic for the body, and the pain following surgery is often extreme. As medicine begins to embrace more complementary therapies, the effect of massage on surgical patients has become the subject of a growing body of research.
Evidence shows that massage can assist with postoperative care not only physically, but also psychologically. Stress, anxiety and tension all affect the body, so it makes sense that relaxation treatments like massage might aid in recovery. A tensed body tends to feel more pain [source: National Pain Foundation]. That's why you might have heard that you should exhale while ripping a Band-Aid off a wound -- holding your breath makes you tense. Along those lines, studies suggest that patients who receive regular massage therapy, like daily foot massage or back massage, may experience less pain than their counterparts who are not massaged [sources: ScienceDaily, UCSF].
Many studies have confirmed at least a small pain management advantage with therapies like Swedish massage and, less often, acupressure of the foot. Swedish massage is the typical type of massage many of us are familiar with -- kneading with the fingers and hands, primarily. Acupressure uses pressure points that correspond to different points on the body to increase energy flow to that body part (see How does acupressure work?). Whatever else these therapies do, there's scientific evidence that they reduce stress and tension, a definite benefit when it comes to recovering from surgery -- especially surgery for a condition like heart disease, which has proven connections to stress.
Another type of foot massage called reflexology claims to do far more than relax a patient into reduced pain. In reflexology, the way to a patient's pain is, literally, through the feet.
The Foot-Body Connection
Reflexology is based on an intricate, controversial theory that puts the control center for the whole body in our hands and feet.
In evolutionary terms, it makes sense that the body's responses might be connected to the feet. The instinctive fight-or-flight response requires quick foot action if the brain decides that flight is the path to survival.
Reflexology is somewhat similar to acupressure but probably less well-known. It has been around for just as long, perhaps as early at 2700 B.C. in China [source: RRP]. Reflexology divides the body into "zones" instead of acupressure's "meridians." The 10 zones start at the top of the head and divide the body into equal sections down to the feet. Each of those 10 zones has a corresponding area on the foot.
A good way to understand this discipline is to think of a marionette. In a marionette puppet, each piece of the body is connected to a string, and each of those strings is attached to one of two control mechanisms. The puppeteer can move every part of the puppet's body by manipulating those two mechanisms.
In reflexology, those control strings run from each part of the body -- joints, organs, muscles, everything -- to the feet. Manipulating specific points on the foot can manipulate the condition of each piece of the human body. One study published on the Reflexology Association of America (RAA) Web site says reflexive foot massage can reduce the need for pain medication after surgery by more than 50 percent [source: RAA]. That's a pretty amazing foot rub. It almost calls to mind a voodoo doll with Vicodin-tipped needles stuck in its feet. But according to reflexology's practitioners, it's entirely scientific.
They say that every nerve line in the body ends in the feet. According to the RAA, each foot has 7,200 nerve endings in it [source: RAA]. And while reflexology practitioners sometimes talk about manipulating "energy," the basic theory seems to rest with these nerve endings.
Let's say a patient just had heart surgery. This type of surgery would affect, say, the heart, the chest cavity, and lots of other body parts in the surgical vicinity. After surgery, the patient is going to be experiencing significant pain in those areas. How would a reflexive foot massage address that pain?
Nerves and Crystals in Reflexology
According to reflexology, the nerves that carry signals to and from those body parts have representatives in the feet. The heart, for instance, can be addressed by putting pressure on the ball of the left foot. The left foot corresponds with the left side of the body, and the right foot talks to the right side. To get at the pain in the chest, a practitioner would manipulate the center tops of each foot, just below the toes.
Here's where it gets a bit more complicated. Pain is a product of nerves. Very simply stated, the nerves in that heart patient's chest cavity send a signal to the brain telling it something is wrong, and the brain, in turn, sends back a signal that tells the chest it should hurt very badly. And then it does. One theory of reflexology assumes that these nerve pathways to the brain can carry a limited number of signals -- kind of like an Internet connection has only a certain amount of bandwidth. When a reflexologist applies the right amount of pressure to the ball of the left foot, that pressure is going to generate nerve signals, too.
If the pathways can only carry so many nerve signals at a time, then, in theory at least, creating nerve signals that must travel from the foot to the brain might temporarily block the travels of the pain signals. And, in theory, if the pressure is applied to the part of the foot that reaches all the way to the heart, the pain signals originating in the heart would be blocked [source: RAA].
Another part of the theory states that when muscles tense up, such as after surgery, blood circulation slows, allowing toxic crystals to form in the blood. These crystals travel to end of the line, the feet, and from there, they get in the way of normal nerve impulses, resulting in discomfort. By pressing reflex buttons, a reflexologist can break up those crystals [source: RAA].
The medical community doesn't typically back up this line of reasoning, primarily because no scientific research has proved that any part of the foot corresponds to any part of the body. So theories that build on that foundation have a hard time gaining acceptance.
Still, a study published in the 2006 edition of the journal for the Reflexology Association of America notes some dramatic results. Sixty adult postsurgery patients were divided into two groups: a control group that didn't receive reflexive foot massage, and an experimental group that did. The results showed a decrease both in pain score (how the patients rated their own pain) and in the required amount of pain medication, with medication needs down by more than 50 percent [source: RAA].
These results aren't replicated, and it's hard to prove that reflexology is the cause for the pain reduction. It could simply be that a reflexive foot massage feels a lot like a regular foot massage. In that case, the relaxation, stress relief, increased circulation and sense of calm that come from massage therapy in general could have caused those patients to experience less pain.
For more information on reflexology and other complementary therapies, go to the links on the next page.
Related HowStuffWorks Articles
More Great Links
- The impact of foot massage and guided relaxation following cardiac surgery: a randomized controlled trial. Journal of Advanced Nursing. January 2002. http://www.ncbi.nlm.nih.gov/pubmed/11851788
- Massage and acupuncture reduce pain after cancer surgery. UCSF New Office. March 29, 2007. http://pub.ucsf.edu/newsservices/releases/200703292/
- Massage May Help Ease Pain and Anxiety After Surgery. ScienceDaily. Dec.18, 2007. http://www.sciencedaily.com/releases/2007/12/071217162531.htm
- Reflexology. Aetna InteliHealth. http://www.intelihealth.com/IH/ihtIH/EM/8513/34968/360060.html?d=dmtContent
- Reflexology Reduces the Requirement and Quantity of Pain Killers After General Surgery. Reflexology Association of America. http://www.reflexology-usa.org/assets/dr_shweta_research_study.pdf
- What is Reflexology? Reflexology Research Project. http://www.reflexology-research.com/whatis.htm