Abstract :
Background:
Low back pain ranks among the most prevalent musculoskeletal disorders worldwide. It greatly affects the quality of life and contributes to higher rates of work absenteeism. Traditional treatment usually involves nonsteroidal anti-inflammatory drugs (NSAIDs), but there is a growing interest in complementary therapies like acupressure and reflexology as additional options.

Objective:
This study aimed to assess the effectiveness of merging acupressure and reflexology with conventional NSAID treatment in alleviating pain intensity in nonspecific low back pain attending the emergency department (ED).
Methods:
This prospective cohort study, conducted at a tertiary center from May 2021 to May 2023, involved 81 patients with nonspecific spasmodic low back pain, who were sequentially assigned to either a control group (NSAID therapy alone, n=41) or a combined therapy group (NSAIDs plus a 30-minute session of acupressure and reflexology, n=40). All individuals were administered 30 mg of intramuscular Ketorolac Tromethamine. The acupressure and reflexology intervention entailed the stimulation of Nei Guan (P6), He Gu (LI4), Zu San Li (ST36), and the lower medial arch of the foot. Pain intensity was assessed with the Short-Form McGill Pain Questionnaire (SF-MPQ) at baseline and 24 hours following the intervention. Statistical analysis utilized the Mann-Whitney U and Wilcoxon signed-rank tests, with a significance threshold at p < 0.05.
Results:
Baseline pain scores did not differ significantly between groups. However, the combined therapy group exhibited a significantly greater reduction in pain (mean difference: 3.85 ± 2.14) compared to the control group (mean difference: 1.27 ± 1.78, p < 0.001).
Conclusion:
The integration of acupressure and reflexology with standard NSAID therapy may provide enhanced pain relief for patients with nonspecific low back pain in the ED. Further multicenter studies with larger sample sizes and longer follow-up periods are recommended to confirm these findings and assess long-term benefits.