Therapeutic Taping for Pain Control

If your daily mail reads like mine, hardly a week passes when I do not receive a course listing for some sort of therapeutic taping class coming to town. I am impressed by the very artistic swirly patterns that are shown on the trim/fit bodies of the models, but is that (excessive) amount and complexity of taping really necessary? I guess the answer would be, "it depends". Since I've never taken one of those classes, I can only assume that it is effective, after all, if people are paying to learn, it must work, right? I was always happy with my narrow but deep toolbox of myofascial release-related modalities, feeling that taping was not necessary to meet the needs of my pain-based practice and patients. Then nearly two years ago, I spent a weekend learning from Diane Jacobs, PT, and her DermoNeuroModulation approach to treatment. Diane spent approximately 20 minutes introducing a simple method of taping for pain, one that did not rely on complex taping patterns, odd-sounding explanations of muscle activation and deactivation, or other so-called "deep models". Instead, she taught taping for pain via a simple explanation. When we laterally stretch the skin (Hmmm, that's what I do with MFR), we activate the Ruffini mechanoreceptors.

"Ruffinis are non-nociceptive (i.e., innocuous), and are attached to large myelinated fibres, which go in and up the dorsal columns of the spinal cord instead of getting blocked and slowed in the dorsal horn. So they get their cargo all the way to the brain really fast without stopping, all the way to the dorsal column nuclei in the medulla. There is the first synapse. Another neuron (in the medial lemniscus) takes the info, crosses midline, goes to thalamus. Another neuron takes it from thalamus to rostral centers for processing. Then rostral centers can start the descending modulation process.That's the beauty of innocuous stimuli input from Type II slow adapting mechanosensory endings in skin. :) Part of the neural array that comes for free from just being a vertebrate." (with permission by Diane Jacobs, PT)

Therapeutic Taping FAQs

1. Is there a certain patient pain profile that is especially suited for pain taping?

When I first started taping, I was very selective, as I felt more than a little bit self-conscious about what I was doing. How could placing a single piece of tape on someone's skin change their pain? But after having a few successes, I broadened my reach and now am not afraid to try it with just about any patient, whether the pain seems neurological or orthopedic in origin. If I can alter the pain via a simple pinching-like action of the skin (see video below), then the patient is an appropriate candidate.

2. If the pain is lessened when the tape is applied, won't it just return once the tape is removed?

The goal of this intervention is to change the output from the brain to the effected region of the body where pain is felt and create a permanent lessening or elimination of the pain. In my experience, some patients do indeed show a permanent change (lessening) in their pain, while others show pain relief only while the tape is in place. I have yet to be able to predict how anyone will benefit, but even temporary relief is typically welcomed.

3. How long can the tape stay in place?

If the skin is clean and dry, taping will typically stay in place for 3-8 days. Much depends on a patient's skin type, activity level, and degree of motion on the body part that was taped. As long as the tape feels effective, it can stay in place. Trimming the ends may be needed as days pass, as the ends often come loose form the skin.

4. Does prepping the skin help adhesion?

If your patient has recently used lotion, body oil, etc, it is best to wash the area well with soap and water. I have started using alcohol soaked pads to clean the skin prior to application , which has help greatly with adhesion. Occasionally, a patient will have trouble removing the tape. I tell them to rub the area of the tape with lotion or oil and it will easily come off. There are aerosol skin-prep products available, but I have not tried any of these. I would typically say that massage, with lotion/oils, prior to taping will not work unless your patient washes the area very well with soap and water.

5. Do skin irritations develop from the tape and do certain brands outperform others?

I have had one patient who developed skin sensitivity not from my tape, but from a brand she bought at a chain drug store. Other that that one instance, none of my patients have experienced any issues. I buy generic/inexpensive tape on eBay or Amazon and find that it works exceedingly well for a minimal amount of money. I have spoken with therapist who feel that the name brands work better. Try a few and decide for yourself. I go through a lot of it, so I go for economy.

6. What about other uses for taping?

No comment, as I have not investigated other uses.

(Please note: Any reader of this blog post must understand that the information contained does not constitute legal permission to perform taping for pain. Please be aware of limitations of your individual professional license to determine if it is within your legal scope of practice. Also,  competence to use and practice a modality varies from state to state, etc., and the owners of the blog in no way certify competency by simple reading this blog.)

Therapeutic Taping Evaluation and Application.

There may be a few of you who read this tutorial and feel that the instructions I have provided are too vague. How can something be so simple? Do not over think this, try it a few times and evaluate your results, I think you will be surprised.

1. Isolate the pain, assure that your patient can feel the pain, whether at rest or in movement. The area of pain may be focused or diffuse, it matters very little. Pain that is sporadic/intermittant is harder to tape, as they will not always be able to report back on what they feel.

2. Now, using one or two hands, lightly contact the skin and gentle draw the skin together. If using one hand, it is as if you are pinching from a fairly wide spread, though occasionally a narrow range pinch will be perfect. Here is where the experimentation/play comes in, as you need to access all areas of the skin above, over, and below the pain to find a space that the pinch seems to lessen or eliminate the pain.

3. Do not worry about dermatomes, muscle distribution, etc., as we are working with the Ruffini mechanoreceptors, which are present throughout the skin. You are simply trying to find an area of the skin that when the skin is drawn together, the pain changes. Some areas will provide no change while others may even increase the pain. Again, do not over think this. Play with a wider area of access vs. a smaller one.

4. Once you have found a positive connection, where the pain is lessened or eliminated, cut a piece of tape to the same length as the area of pinch you just found. Round the edges slightly. Then, grab the tape and bend it so that the paper backing in the MIDDLE of the piece tears in half. Peel both ends back so you can hold the tape by the ends only. I stretch the tape to approximately 50-75% of its maximum stretchability, but you will have to experiment here. Stretch the tape and lay it on the skin, in the same orientation as you did the test skin stretch. Most of the tape, except for the area you are gripping with the paper backing, will be laid out in a stretched position. Then, allow the ends to peel away from the paper and lay onto the skin with no stretch at all. This keeps the tape from pulling away and beginning to peel right away. It takes a few practice tries to get it right, but now I only mess up 1 out of every 20 tries. Have them test their pain. If you were successful, watch their eye grow big, as it is almost too good to be true! Rarely, your patient will feel that the tape is irritating, either immediately after application or later in the day. Simple remove the tape if this occurs and try again.

5. If it is necessary to remove the tape, warn your patient not to pull too quickly. The tape can stick quite well and they do not want to tear the skin. If attempting to remove it slowly does not work, ask them to rub lotion/oil into the area of and around the tape and it will easily come off.

 Below you will find a short video I made, outlining the basic aspects of taping. Hopefully you will find a bit of humor in the video. Have fun and play with the skin and the tape, as this is the key to learning. We cover Taping for Pain in all  Foundations in Myofascial Release Seminars.

For Now,Walt Fritz, PTFoundations in Myofascial Release Seminars