Reflexology: A randomised controlled trial investigating the effects on beta-endorphin, cortisol and pregnancy related stress

Complement Ther Clin Pract. 2018 May;31:76-84. doi: 10.1016/j.ctcp.2018.01.018. Epub 2018 Feb 3.


Reflexology is used for various pregnancy related complaints. A three-armed, pilot randomised controlled trial was conducted to test changes in physiological and biochemical stress parameters. Ninety primiparous volunteers experiencing low back and/or pelvic girdle pain (LBPGP) were recruited to receive either six reflexology or footbath treatments or usual care. Primary outcome data included pain intensity and frequency measured on a visual analog scale (VAS), and salivary beta-endorphin and cortisol levels. 61 (68%) women completed the intervention. A clinically important reduction of 1.63 cm occurred for VAS pain frequency following reflexology. Beta-endorphin levels increased by 8.8% and 10.10% in the footbath and usual care groups respectively and decreased by 15.18% for the reflexology group. Cortisol increased by 31.78% for footbath participants, 31.42% in usual care and 18.82% in the reflexology group. Reflexology during pregnancy may help reduce LBPGP, and associated stress. However, antenatal reflexology is under researched and requires further investigation.

Keywords: Beta-endorphin; Cortisol; Low back pain; Pelvic girdle pain; Pregnancy; Reflexology.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Female
  • Humans
  • Hydrocortisone / metabolism*
  • Low Back Pain / therapy*
  • Massage*
  • Pain Measurement
  • Pelvic Pain / therapy*
  • Pilot Projects
  • Pregnancy
  • Pregnancy Complications / therapy*
  • Stress, Physiological
  • Stress, Psychological
  • Visual Analog Scale
  • beta-Endorphin / metabolism*


  • beta-Endorphin
  • Hydrocortisone