Research on ‘Chronic Non-Specific Low Back Pain’ has always been one of my pet hates. Lack of
a diagnosis does not a diagnosis make. Subjects within this classification can have wildly different
contributing factors. The paper by Martin Rabey, Toby Hall et al from 2017 highlights this. Some
may have nociceptive or inflammatory mediated pain while others may have far stronger influence
from psychosocial amplifiers. Some may have tissue damage or be on the cusp of it, others may
have little evidence of ongoing structural influences and so it goes on. Applying the same
intervention to all and expecting an effect is a search for a panacea rather than a clinically
reasoned, evidence informed management approach.
It is therefore interesting when a study shows an effect in this sort of group as is the case in the
paper by Alhamari et al, published in late 2020. The immediate and short-term effects of dynamic
taping on pain, endurance, disability, mobility and kinesiophobia in individuals with chronic nonspecific
low back pain: A randomized controlled trial.
The results showed that Dynamic Tape and Kinesiotape improved pain over the no tape condition.
Again, it is hard to discern the mechanism as there is no specific deficit identified that the tape is
trying to address. Dynamic Tape did however improve spinal mobility and spinal extensor muscle
endurance over Kinesiotape and no tape groups. This demonstrates that Dynamic Tape can
provide significant force to do some of the work thereby reducing extensor muscle fatigue and
possibly aiding in the control of movement through range, exactly what it was designed to do.
Whether that has an effect on pain depends entirely on the nature of the pain and tissue damage.
If the extensor muscles are a factor in the development of pain e.g. a muscle strain or perhaps
due to fatigue then it could be anticipated that the application of Dynamic Tape may have a
beneficial effect on pain.
There may be benefits in those without ongoing tissue damage but with maladaptive movement
patterns, extension dominant splinting and guarding. This paper did not show changes in
kinesiophobia but again, a large washout effect would be anticipated as many subjects in the
cohort would not have fear of movement. Correctly identifying those who display these movement
adaptations and combining the taping application with appropriate pain education may provide
further benefit by reducing overwork of the splinting muscles that may be actings as peripheral
drivers of pain, while also help to restore movement choice and re-educate more optimal
movement patterns and control while reducing the perceived threat. Further, more robust and
specific studies are required to evaluate the contribution of each.
Once again, we see that Dynamic Tape can effectively introduce force into the system to modify
movement or load. Whether that is clinically beneficial depends on correctly identify a deficit, its
relationship to the presenting condition, the mechanisms by which introducing an external force
with the tape can address this deficit, correct application and thorough evaluation to determine
that a sufficient force was in fact created. Simply taping everyone with pain in a particular region
the same way will yield mediocre results. Thorough understanding, assessment, clinical reasoning
and application are central to the approach.