The effect of rigid taping with tension on mechanical displacement of the skin and change in pain perception

Abstract

Objectives

To investigate the effect of rigid taping that induces mechanical displacement of the skin on pain perception.

Design

Single group experiment design with repeated measures.

Methods

Twenty-three active healthy volunteers (12 men and 11 women) participated in the study. All participants received three different taping procedures: no tape, taping with tension, and taping without tension. The order of three taping conditions was randomised. Skin displacement was measured during taping with tension. A pressure algometer was used to measure the level of pain perception once before taping, and again after each taping condition, in one testing session. The participants were blind to the values of their pressure pain threshold (PPT) during the experimental period.

Results

The mean ± SD skin displacement in the condition of taping with tension was 2.58 ± 0.49 cm. There were significant differences in PPT between taping with tension and taping without tension (mean difference (mean diff) ± standard error (SE) 36.43 ± 4.22 kPa, p = 0.000) and no tape (mean diff ± SE 44.31 ± 3.13 kPa, p = 0.000). No significant difference in PPT between no tape and taping without tension was found (mean diff ± SE 7.88 ± 2.83 kPa, p = 0.067).

Conclusions

Taping with tension increases the threshold of pressure pain perception. Therefore, stretch and compression caused by rigid taping with tension could disturb the nociceptive signal transmission and alter pain perception.

Introduction

Therapeutic taping was developed to relieve pain and improve functional performance for those with musculoskeletal disorders and has been used during rehabilitation and on the sports field.1, 2, 3 It has been shown to reduce pain in different musculoskeletal problems, most commonly in patellofemoral pain syndrome (PFPS).3, 4, 5 Previous systematic reviews confirmed the effect of taping on pain relief, however, the underlying mechanism of pain relief is still unclear.6, 7, 8

Various taping techniques with different rationales have been proposed to treat musculoskeletal pain. It is postulated that pain relief in therapeutic taping could derive from mechanical factors and physiological factors by means of change in bony alignment, muscle activity, and joint function.6, 8, 9 However, recent systematic reviews showed little or no change in bony alignment, muscle activity, and joint function.8, 9 Therefore, the recent evidence does not support that pain relief with taping may relate to those mechanisms.

Because tape contacts and acts on the skin, another possible factor is the application of tape. There were no significant differences in pain in participants with PFPS in three taping conditions (medial taping with medial gliding component, placebo taping without medial gliding, and no tape).¹⁰ Pain relief was irrespective of direction of tape in another study, and the reduction of pain in lateral and neutral direction of taping was superior to medial direction.¹¹ Therefore, direction of tape may not be important to change pain.

Even though tape applications have different rationales, the method of applying tape often involves stretch, compression, or shear forces through the skin and underlying tissues. McConnell taping originally proposed to mechanically realign the patella by pulling the patella medially and stretch the lateral knee structures by applying rigid adhesive tape.3, 5 Another McConnell taping technique, called “unloading taping” uses rigid adhesive tapes to move local soft tissues towards the stable structure in a painful area. This taping technique is applied by firmly compressing and surrounding the soft tissues.3, 12 As application of McConnell taping involves different degrees of stretch and compression, the applied force should be considered.

The taping material may also affect the amount of applied force that can change pain perception, rigid tape may provide greater force than elastic tape. A review showed that elastic tape has only small or non-significant effects on pain in the immediate term compared to rigid tape,⁸ suggesting that adequate force with rigid tape could be the key factor. The aim of this study was to examine if rigid taping with tension caused a change of pressure pain perception.