Am Fam Physician. 2022;105(5):467-468
Author disclosure: No relevant financial relationships.
Clinical Question
Is kinesiology taping safe and effective for the treatment of rotator cuff disease in adults?
Evidence-Based Answer
Kinesiology taping for adults with rotator cuff disease has little to no benefit compared with sham taping or conservative (i.e., nonsurgical) therapy.1 (Strength of Recommendation: B, inconsistent or limited-quality patient-oriented evidence.)
Practice Pointers
Rotator cuff disease is an umbrella term encompassing disorders such as rotator cuff tendinopathy, impingement syndrome, subacromial bursitis, and others. This group of conditions is likely the most common cause of shoulder pain.2
Kinesiology taping is the use of an adhesive cotton elastic tape on the skin, theoretically to affect the function of the joint closest to where the tape is placed. It was developed in the 1970s in Japan, where it was theorized to reduce localized pain and allow healing by lifting the skin to increase interstitial space. It also reportedly improves proprioception. The tape is latex-free and contains no active pharmacologic agents. Products are available in a variety of elastic strength, size, and shape. In addition, there are numerous taping regimens. Kinesiology taping is widely used by rehabilitation specialists and is also available for self-application. The authors sought to determine the benefits of kinesiology taping as a sole treatment or as a co-intervention with commonly used conservative (i.e., nonsurgical) therapies for rotator cuff disease. Conservative therapies included pain management with medications (oral or injectable therapies), physical modalities (e.g., therapeutic ultrasonography, transcutaneous electrical nerve stimulation), and physical therapy, both supervised and home-based.
This Cochrane review included 23 controlled trials with 1,054 participants.1 Nine trials (312 participants) assessed the effectiveness of kinesiology taping vs. sham taping. Fourteen studies (742 participants) assessed the effectiveness of kinesiology taping vs. conservative treatments. Most of the participants were between 18 and 50 years of age, and about 52% were women. Blinding was possible only when kinesiology taping was compared with sham taping. The certainty of evidence for all outcomes presented was rated as low to very low.
Mean overall pain (measured on a scale from 0 to 10, where 0 was absence of pain) was 2.96 points with sham taping and 3.03 points with kinesiology taping at four weeks; thus, there was no statistically significant difference. Compared with conservative treatment (mean overall pain score at rest = 0.9 points), kinesiology taping was not significantly different (mean overall pain score at rest = 0.46 points) at six weeks. During motion, participants who received sham taping had a mean pain score of 4.39 points, whereas participants who received kinesiology taping had a mean score of 2.91 points (absolute improvement = 14.8%; 95% CI, 7.1% to 22.5%) at four weeks. However, there was no significant difference in pain scores at four weeks between patients treated with kinesiology tape and those treated with conservative measures. It is notable that the studies did not supply information regarding baseline levels of pain in these studies.
Mean function (measured on a scale from 0 to 100, where 0 was better function) was 47.1 points with sham taping and 39.05 points with kinesiology taping at four weeks, which was not statistically significant. Mean function with conservative treatment was 46.6 points and 33.47 points with kinesiology taping (absolute improvement = 13%; 95% CI, 2% to 24%) at four weeks. The studies did not supply information on baseline function scores.
Mean active range of motion (shoulder abduction) without pain was 174.2 degrees with sham taping and 184.43 degrees with kinesiology taping at two weeks, which was not statistically significant. Mean active range of motion with conservative treatment was 156.6 degrees; with kinesiology taping it was 159.64 degrees at six weeks, which was also not statistically significant. No studies reported global assessment of treatment success. The studies did not supply information regarding baseline range of motion scores.
Mean quality of life was reported using a scale of 0 to 100, with a higher score indicating better quality of life. Participants who received conservative therapy had an average score of 37.94 points, whereas those who used kinesiology tape had an average score of 56.64 points at four weeks (absolute improvement = 18.7%; 95% CI, 14.5% to 22.9%). The studies did not supply information regarding baseline quality of life scores.
A separate systematic review and meta-analysis concluded that kinesiology taping improves pain compared with no intervention but is no better than other treatment approaches.3 One roll of generic kinesiology tape costs approximately $30 and contains about 20 strips in each roll. A six-week treatment, during which three strips are replaced every three days, would cost approximately $60. Family physicians may educate their patients that although kinesiology taping appears to offer little benefit compared with conservative therapies, there does not seem to be a risk of significant harm if a patient or physical therapist wishes to use it.
The practice recommendations in this activity are available at https://www.cochrane.org/CD012720.
The opinions or assertions contained herein are those of the authors and are not to be construed as official or reflecting the views of the Department of Defense or the Uniformed Services University of the Health Sciences.
