By Tiffany Tiu
Tylenol and Advil are common at-home pain management strategies. However, they have a maximum dosage per day. What if there were an alternative low-cost and low-risk pain management strategy that could be used at any time? Kinesiology Tape (KT) is a stretchable therapeutic tape that has gained popularity over the last 50 years with more than 150 thousand practitioners utilizing it in their practice globally (1), despite ambiguous findings among the KT literature. Many claims have been made about the effects of KT, including enhancing exercise performance, blood circulation, joint positioning, pain reduction, and more. This review article aims to present a brief overview of the literature on the potential role of KT as a pain management strategy.
Danik Prihodko (Pexels)
Mechanism of Pain Reduction by KT: The Gate Control Theory
There are several proposed mechanisms to explain how KT may relieve pain. In summary, spinal nerves act as gatekeepers; they “open the gates” to let pain travel through to reach the brain, or they “close the gates” and prevent pain messages from going through (2). According to the Gate Control Theory, nerves responsible for conducting soft touch signals (Ab fibers) are bigger and faster at processing signals compared to those responsible for detecting pain (Ad and C fibers) (2). Stimulating the Ab touch fibers thus activates the inhibitory neurons that “close the gate” on pain signals, preventing them from travelling to the brain (2). This mechanism of pain mitigation also helps to explain the natural and unconscious reaction people have to rub the area of pain after an injury, for example, after bumping your knee. It is thought that KT applied onto the skin provides a similar stimulation to light touch, thus mitigating pain signals travelling to the brain.
Maksim Goncharenok (Pexels)
KT may Relieve Pain
Compared to no intervention, KT applied to the area of pain was shown to be effective in pain mitigation in a few studies. In one study, twenty adults with knee pain experienced a reduction in pain while climbing and going down their stairs immediately after the application of KT, compared with those not using KT (3). Paoloni et al. compared the effect of KT alone, KT and exercise, and exercise alone in 39 participants with chronic low back pain (CLBP) (4). All three interventions resulted in a significant reduction in pain to the same degree after four weeks, showing that KT alone was an effective pain management strategy in the study. Castro-Sánchez et al. compared the effects of KT to sham KT (applied not on but above the area of pain) on 60 CLBP participants and found that KT, but not sham KT, was effective in reducing pain (5). A systematic review and meta-analysis pooling data from various studies on KT and pain management concluded that KT is effective in reducing pain compared to minimal intervention (6). However, the authors of this review highlighted that the heterogeneity between the studies is high, meaning that the studies differ greatly in their methodology, which makes it difficult to compare results. Furthermore, none of the studies report effect sizes, which are measures of how meaningful statistical differences are in practice. So there is no way to know whether the pain reduction effect is substantial and meaningful, even though the statistical significance was achieved. For example, in a study that found statistically significant pain reduction in taping the knee, the median effect on a pain scale was only a 0.5 reduction, which is lower than the threshold of minimal clinically important change: improvement of 1 on the scale of 0-10 (7).
It is reasonable to say that there is some evidence to suggest KT can have some effect in relieving pain, though whether the amount of pain reduction is meaningful is uncertain. When interpreting these studies, it is important to consider the psychological effects of the interventions. It is impossible to determine whether the results are actually due to the intervention, or a general placebo effect. For example, experiencing care from the practitioner or believing and hoping that the tape will work could “trick” the mind to perceive pain relief. Yet, improving patient quality of life by decreasing pain experienced is one of the clinician’s goals, whether it is from a psychological effect or a physiological effect. Therefore, KT could be a low-risk and low-cost pain management strategy for patients seeking pain reduction.
“KT could be a low-risk and low-cost pain management strategy for patients seeking pain reduction”
KT as an Adjunctive Therapy
Rehabilitation interventions typically involve multiple combined treatments. It is therefore worth investigating whether KT used in conjunction with other forms of therapy provides an additive effect on treatment outcomes.
Exercise is an essential component of therapy
Although KT can be effective in managing pain, it cannot replace exercise and it cannot deliver the benefits of exercise. Devereaux et al. randomly allocated 100 participants with shoulder pain into three groups: KT and exercise group, anti-inflammatory medication and exercise group, and exercise alone group (8). After a two-week intervention period, all three groups experienced a significant decrease in pain when compared to pre-intervention, and there was no significant difference between the groups on all outcome measures. The results suggested that exercise alone is as effective as exercise plus KT. This means KT, in this study, did not provide any additional effect on pain relief. In the abovementioned study by Paoloni et al., even though all groups (KT plus exercise, KT alone, and exercise alone) experienced similar pain relief, only the exercise alone group demonstrate a significant reduction in disability (4). These studies suggested that KT cannot be considered a substitute for therapeutic exercise.
KT may help with early exercise intervention
Is there any value in using KT as an adjunct therapy? In the study conducted by Kaya et al., 60 participants with shoulder pain were allocated into KT plus exercise group or physiotherapy modalities (PT) (ultrasound, TENS, and hot pack) plus the exercise group (9). After the first week of intervention, the KT group reported a significantly greater reduction in pain from baseline, compared to the PT group. However, there was no significant difference between the two groups in the second week of intervention with both groups reporting significant pain reduction. If immediate pain management is desired, for example, to allow exercises to be done with less pain and apprehension, KT may provide short-term pain relief better than traditional physical therapies to allow earlier excise intervention.
KT is likely able to provide some pain-relief effects, which can be explained using the Gate Control Theory. Yet, the heterogeneity between studies makes it difficult to compare results. Clinical significance of the study results were also unclear. As an adjunctive treatment, the literature is less certain about the added benefits of KT. KT could serve as a basic pain management strategy. However, it should not substitute exercise, which is the primary means of improving function and decreasing disability in the therapeutic setting. Clinicians can explore the option to use KT to manage pain as a strategy to improve exercise adherence. Future studies should focus on refining their methodology based on existing systematic reviews on this topic, report effect sizes and whether their results achieve a minimal clinically important difference, and explore longer-term effects of KT use on pain relief and exercise adherence.
Featured illustration by Vadym Lytvynov for rehabINK.
To refer to this article, it can be cited as:
Tiu T. The Value of Kinesiology Tape in Pain Management and Therapeutic Settings. rehabINK. 2023:Issue#14. Available from: https://rehabinkmag.com
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