Hemodialysis (HD) is the most common treatment modality for end-stage renal disease (ESRD). Hemodialysis imposes a variety of
physical and psychosocial stressors that challenge not only the adolescents but also the care givers. Muscle cramps and fatigue are
common complications of HD treatment that adversely affects adolescent's wellbeing, activities, relationships and tolerance to
treatment. There is no well-defined mean of preventing or treating these symptoms. Exercises are very important element in the
overall health of people at any age. Reflexology massage have been used with apparent success in some patients. It may be the best
measure in reducing or preventing muscle cramps and fatigue levels from occurring. The nurse can play an important role in
management of these symptoms by applying a safe and an effective assistant method beside the standard medical care as reflexology massage that can promote well-being, relaxation and improve the severity of these symptoms. This article review describes the technique of reflexology massage, the physiology behind it, and discusses the available evidence for its efficacy in reducing common complications of HD such as muscle cramps and fatigue.