A new study published in the Cochrane Database of Systematic Reviews examined currently available evidence on manual methods for pain management during labor, including massage and reflexology. This review included randomized controlled trials from a number of databases, which compared manual methods of pain management during labor with standard care, other non-pharmacological forms of pain management in labor, no treatment or placebo. Non-pharmacological measures included massage, warm packs, thermal manual methods, reflexology, chiropractic, osteopathy, musculoskeletal manipulation, deep tissue massage, neuro-muscular therapy, shiatsu, tui na, trigger point therapy, myotherapy, and zero balancing. But, trials related to hypnosis, aromatherapy, acupuncture, and acupressure were excluded. Overall, 14 trials were selected. From the findings, it was concluded that massage, warm pack, and thermal manual methods may have a role in reducing pain, reducing length of labor, and improving womens sense of control and emotional experience of labor. Few trials reported on safety as an outcome. It was stated that further research is warranted to ascertain the effectiveness of manual methods for pain management during labor.