Osteoarthritis (OA) is the most common disease of the joints which affects 6% of adults worldwide . The knee is the most frequently affected joint and one of the main causes of disabilities and pain, especially in people over 40.
OA can be divided into two types: primary, in which there is joint degradation without a clear underlying cause, and secondary, in which it is a trauma or other disease process. OA is typically a progressive disease, however the intensity and rate of deterioration varies for each individual.
Does arthritis cause loud knees?
Treatment of primary knee OA begins with conservative treatment and moves on to surgery and finally to knee replacement if conservative treatments become ineffective. There are numerous conservative options and evidence for some options is better than others.
Exercise has a number of high quality studies showing that it has numerous benefits for both pain management and disability reduction. Taping, on the other hand, has limited evidence and is often based on sketchy pathophysiological principles but remains a very popular treatment option for clinicians around the world.
A new systematic review published last week in Medicine aims to examine the effects of elastic taping on pain in patients with primary osteoarthritis compared to sham taping. The aim of answering the question should be the use of taping to treat pain and disability in people with primary knee OA?
Pathophysiology behind elastic taping – in simple words!
Elastic adhesive tape is a highly stretchable – not rigid – adhesive tape such as Kinesio or K-adhesive tape. It is very popular for sports injuries for numerous musculoskeletal injuries, but is becoming increasingly popular for non-athletic injuries such as knee OA.
In short, the proposed mechanism of action for K-tape is largely based on myofascial principles and the ability of the elastic band to change position along with the muscle fibers. This results in decreased nociceptor stimulation along with a compressive force that prevents fluid build-up around the tissue and further decreases nociceptor stimulation.
Methods
PubMed, Cochrane, EBSCO and gray literature databases were searched for relevant evidence using a simple and unspecified strategy, but it is unclear which data parameters were used. Studies were included if they were RCTs examining primary osteoarthritis in people over 40, published in English-language journals, and used WOMAC as the primary outcome measure. Studies with postoperative participants were excluded.
Six articles, a total of 392 participants were included in the analysis, and the risk of bias was assessed using the 2005 Oxford Standard. Follow-up losses and reasons for discontinuation were also analyzed and included in the results. The primary outcome measure was WOMAC.
Clinical significance and summary
Essentially, elastic taping does not lead to any significant change in the WOMAC values when it is used for the treatment of primary knee osteoarthritis, when it is used as a single treatment. WOMAC is a three-dimensional scale that assesses pain, stiffness and physical function.
The results of the individual studies that were included in this overview show a decrease in the WOMAC score between 3% and 16%. For the sake of clarity only the minimum percentage change in WOMAC for a person with a noticeable change in symptoms is 17%.
Brief summary of the elastic taping for knee OA
Elastic taping leads to no significant change in the WOMAC score
If the OA knee pain persists for more than 21 days alternative conservative treatments to elastic taping should be investigated .
Studies included in this overview that showed major changes in the WOMAC score have important biases that mislead the results
There are few adverse results from using Elatic taping for primary knee OA
A study (Hinman et al. 2003) showed that elastic taping had a negative impact on the WOMAC score for both pain and function compared to sham taping . In all of the studies involved, there was a high risk of bias due to poor randomization, blinding and drop-out rates. In addition, most of the studies lacked additional data, so that no meta-analysis could take place.
This systematic overview shows that, according to current knowledge, elastic taping is ineffective in the treatment of primary osteoarthritis of the knee. Other conservative treatments with a stronger evidence base should be considered.
