Hand and Foot Massage on Pain Management After Cesarean Section: A Meta-Analysis

Background: Pain following a cesarean section is a significantly stressful experience, impeding women's fast recovery. Interventions such as hand and foot massage have been employed for pain management after cesarean sections, but their effectiveness remains undetermined.

Objective: To comprehensively explore the effects of hand and foot massage on improving pain management after a cesarean section.

Methods: We searched PubMed, Cochrane Library, Web of Science, CINAHL, and China National Knowledge Internet (CNKI) for randomized controlled trials (RCTs) published from database inception to March 1, 2023 (updated to August 31, 2024), in English or Chinese. The meta-analysis was conducted in Review Manager 5.4, in which the embedded Cochrane risk-of-bias tool was employed to evaluate the quality of eligible studies. The results were pain and anxiety assessments following cesarean sections. Subgroup analysis and sensitivity analysis with a fixed-effects model and random-effects models were used to justify the pooled standard mean differences (SMDs).

Results: Seven RCTs involving 581 women after a cesarean section were included. The meta-analysis revealed that hand and foot massage could significantly reduce pain right after (SMD = -3.55, 95% CI [-3.90, -3.19], p < .001); 60 minutes (SMD = -2.44, 95% CI [-2.82, -2,06], p < .001); and 90 minutes (SMD = -1.10, 95% CI [-1.42, -0.78], p < .001) after cesarean section. Anxiety was also immediately improved when foot and hand massage was performed the first day after the cesarean section (SMD = -0.58, 95% CI [-0.95, -0.20], p = .003).

Conclusions: This meta-analysis indicated that hand and foot massage are beneficial for pain and anxiety management among women following a cesarean section. Appropriate implementation in clinical practice was suggested at an early stage.