Foot reflexology vs. sham massage for chronic pain in Parkinson’s disease

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Created On: 21/11/2025

Parkinson’s disease (PD) not only disrupts motor function but also imposes the heavy burden of chronic pain, a symptom for which conventional pharmacological therapies provide only partial relief.

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Key take away

Foot reflexology delivers similar pain relief as sham massage in Parkinson’s disease, with brain connectivity revealing unique individual responses.

Background

Parkinson’s disease (PD) not only disrupts motor function but also imposes the heavy burden of chronic pain, a symptom for which conventional pharmacological therapies provide only partial relief. This therapeutic gap has sparked interest in non-pharmacological strategies such as foot reflexology (FR), a holistic approach believed to influence both physical and psychosocial dimensions of pain.

Researchers set out to evaluate whether FR is more effective than sham massage (SM) in reducing pain intensity among individuals with PD, aiming to provide evidence on its role as a supportive, non-pharmacological intervention.

Method

The study was conducted as a monocentric, prospective, randomized controlled trial. Randomization was performed using a random number generator in R software, with fixed-size block randomization of three implemented through Clinsight to ensure balanced allocation. Volunteers included idiopathic PD sufferers experiencing chronic pain (visual analog scale [VAS] ≥ 4).

Each patient received four sessions of 1 hour each of either FR or SM, delivered three weeks apart by the same specialized FR researcher to maintain consistency. The primary outcome was the change in pain intensity, assessed through mean VAS scores before and after the full course of interventions, with between-group comparisons performed via the Wilcoxon–Mann–Whitney test. As an exploratory outcome, alterations in brain functional connectivity were also assessed.

Result

A total of 30 PD-affected people were successfully randomized and included in the analysis. All participants completed the planned interventions without deviation. Baseline clinical characteristics showed no vital differences between the FR and SM groups.

Pain intensity, measured by VAS, dropped by −12.3 mm ± 15.2 in the FR group (n = 15) and by −17.9 mm ± 29.4 in the SM group (n = 15). However, statistical analysis revealed no prominent difference between the two groups (p = 0.88). Interestingly, distinct patterns of connectivity changes within the medial pain system emerged between responders (≥30% pain reduction) and non-responders, regardless of intervention type.

Conclusion

FR was not superior to SM in mitigating chronic pain in PD. Variations in individual responses to tactile stimulation from both interventions could be linked to unique connectivity patterns in the medial pain pathway.