Sports Medicine Research: In the Lab & In the Field: Kinesio Tape and Cervical Manipulation Help Decrease Mechanical Neck Pain (Sports Med Res)
Wednesday, August 29, 2012

Kinesio Tape and Cervical Manipulation Help Decrease Mechanical Neck Pain

Short-Term Effect of Kinesio Taping Versus Cervical Thrust Manipulation in Patients with Mechanical Neck Pain: A Randomized Clinical Trial.

Saavedra-Hernández  M, Castro-Sánchez AM, Arroyo-Morales M, Cleland JA, Lara-Palomo IC, and Fernández-de-las-Penas. J Orthop Sports Phys Ther. 2012;42(8):724-730.

Mechanical neck pain is a common ailment which can affect as much as 33% of the population. While manual therapy is often performed, a gold standard for managing mechanical neck pain has yet to be determined. Also supported for managing mechanical neck pain is the use of Kinesio Tape, although there is limited evidence to support this. Therefore, Saavedra-Hernández  and colleagues completed a randomized clinical trial comparing manual therapy to Kinesio Taping. The primary outcomes measured were neck pain intensity, disability, and cervical range of motion. A total of 93 patients were screened for eligibility. Participants were excluded if the following criteria were met: a) contraindication to neck manipulation, b) history of whiplash, c) history of cervical surgery, d) diagnosis of cervical radiculopathy or myelopathy, e) diagnosis of fibromyalgia syndrome, f) previous spinal manipulation therapy or Kinesio Tape therapy, h) tape allergies, and i) younger than 18 or older than 55 years old. Thirteen participants were excluded from the study leaving 80 to undergo baseline testing. Baseline testing was comprised of completing demographic and clinical information, numeric pain rating scale, the Neck Disability Index, and a body diagram to assess the location and distribution of pain. Participants were then randomly allocated to a “tape group” or “manipulation group”. The person performing the assessments was blinded to what group participants were assigned to and the participants were not told what their treatment was being compared to.  Participants in the tape group received a “Y” strip placed over the posterior cervical extensor muscles with an overlying strip placed perpendicular to the “Y” strip over the midcervical region. Participants wore the tape for the duration of the study (7 days). Participants in the manipulation group received 2 separate cervical thrust manipulations. One directed at the midcervical spine (C3) and the other at the cervicothoracic junction (C7-T1). Participants (n = 76) returned for follow-up 7 days post-intervention where all tests from baseline were repeated. Overall, both Kinesio Tape and cervical thrust manipulation resulted in similar reduction in neck pain, which was considered clinically meaningful. Both therapies also increased cervical range of motion although the changes were small and not clinically relevant.

This study presents an interesting look at reducing pain in patients with mechanical neck pain. While cervical thrust manipulations may be the more common treatment, Kinesio Tape may also be considered as a comparable treatment option. While both methods appeared to show similar analgesic abilities, one should approach this with caution. During follow-up, 5 participants reported adverse reactions to their treatment. Three of these participants were in the manipulation group and reported increase in neck pain or fatigue after manipulation. The 2 participants in the tape group that reported adverse reactions described cutaneous irritation. Perhaps if both treatments elicit similar analgesic abilities Kinesio Tape could be the more beneficial treatment because it does not cause as many, or as severe, adverse reactions as cervical spine manipulation. Tell us what you think. Have you used either of these treatments to treat mechanical neck pain? If so, have your patients expressed any preferences or adverse reactions to the treatment?

Written by: Kyle Harris
Reviewed by: Jeffrey Driban

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Saavedra-Hernández M, Castro-Sánchez AM, Arroyo-Morales M, Cleland JA, Lara-Palomo IC, & Fernández-de-Las-Peñas C (2012). Short-Term Effects of Kinesiotaping Versus Cervical Thrust Manipulation in Patients With Mechanical Neck Pain: A Randomized Clinical Trial. The Journal of Orthopaedic and Sports Physical Therapy PMID: 22523090

7 comments:

Michael Kruse said...

Is it not a glaring error that there was no control group? Both interventions may work equally as well, but they both may have done nothing and the pain got better on its own.

Jeffrey Driban said...

Hi Michael: Thanks for the comment. There is actually a growing trend to comparative effectiveness trials. Rather than compare a novel treatment to placebo this asks if the novel treatment is better than the standard/common treatment. It's true that this ignores whether both interventions are mostly placebo but it puts the focus on is the new idea better than the old. Plus, we've gotten into the bad habit of thinking that the placebo effect is not important in our treatments. In fact, placebo is a common part of most of our treatments. In some cases, placebos perform as well if not better than the standard medications often applied. That's not to knock those medications but highlight how beneficial the placebo effect can be. Another advantage of the comparative effectiveness trial is that it is easier to blind the study participant b/c they don't know which intervention is the experimental intervention. In the coming years we'll be seeing more and more comparative effectiveness trials. Any thoughts?

Dr. Sean Delanghe BSc (Hons), DC said...

Jeff, couldn't have said it better myself. Introducing a placebo/control is pretty easy when you're looking at something like a new drug. However, the issue is a little more complicated with manual therapy is involved (how convincing is fake manipulation?).

Anyway nice to see some studies coming out looking at Kinesio tape!

Aaron Bottinick said...

Jeff, I feel the shift towards comparative effectiveness trials is welcoming. As a clinician I find this kind of research more relevant because it compares different treatment methods. I think in this particular study it could have benefited from adding a third group consisting of participants who received both treatments. Also, I agree with Dr. Delanghe that it is good to see some studies on k-tape.

One concern that I have with this study that was not touched on for a limitation was the length of time the K-tape was left on. While I have never taken a course on K-tape, from what I've seen clinically the maximum amount of time the tape stays on the body and is effective is only around 3-5 days. I'd be curious to see if repeating the tape intervention has any effect on results. I know this borders repeated interventions which could be an entirely different study. Thoughts?

Kyle said...

Aaron,

Thanks for the comment. Firstly, I too agree with you and Dr. Delanghe that its good to see a study on Kinesio tape as many athletes I encounter have questions about it. I enjoyed your idea that this study could have benefited from a third group which received both treatments. I think this would indeed add another dimension to this study. Perhaps the effects seen by the manipulation would be further extrapolated by the addition of the Kinesio tape. As reported, some patients also felt a slight increase in neck pain after recieving the manipulation. I would also wonder if the application of the Kinesio tape would mitigate this. Great thought!

On your point regarding the length of time the Kinesio tape was left of the study subject. I too have never taken a Kinesio tape course but I like the idea of repeating the tape intervention. I would also be interested in seeing a study which used a single Kinesio tape application at 5 days follow up (to see how this would differ from this study using 7 days). In the end, I think looking at how long to leave the Kinesio tape on a patient will be an important part of future research.

Kathleen White said...

These are all great comments for the use of Kinesiotape.

I agree with Aaron, the effectiveness of the tape lessens after 5 days. It is possible that the 2 cases that had reports of irritation were due to extended use of the tape. This is also a simple fix. Most individuals do not react adversely to the tape since it is latex free. However, by treating the skin before applying the tape with a liquid malox solution often decreases the irritation to the skin.

I think this is a great paper in support for kinesiotape as an effective treatment modality.

Novak Jim said...
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