Abstract
The article “Medium term effects of kinesio taping in patients with chronic non-specific low back pain: a randomized controlled trial” by Arajuo et al. [1] greatly interested me. In physiotherapy, interventions for chronic low back pain (CLBP) carry great clinical significance, and the use of kinesiology tape is gradually increasing in physiotherapy and sport competitions (e.g. Olympics and football leagues). Arajuo et al.’s study subjected experimental and control groups to kinesio taping (KT) on the bilateral erector spinae with and without 10–15% tension, respectively, for four weeks, but observed no clinically significant pain relief in either group [1]. However, CLBP has various causes, and a neuromuscular system imbalance can cause problems in other body parts. Therefore, I wonder why KT was applied only to the bilateral erector spinae.
Patients with CLBP have reduced grey matter in the bilateral dorsolateral prefrontal cortex (DLPFC) and sensorimotor brain regions [2]. Functional and structural brain changes due to CLBP may contribute to the maintenance and development of chronic pain conditions [3]. Paravertebral muscle hyperactivation causes delayed anticipatory postural adjustment in the trunk muscles, which is associated with changes in the primary motor cortex [4]. New patterns are exhibited in the central nervous system, resulting from the imbalance, and related to pain experience and functional impairment [5]. Idiopathic CLBP involves modified systemic pain progression [6] accompanied by postural imbalance, affecting the overall sensorimotor system. Therefore, it is necessary to evaluate the upper and lower quarters of the body [5].
In a recent systematic review and meta-analysis, KT applied in an I-shape on the erector spinae muscle demonstrated lower-quality evidence compared to that for other interventions, and the use of KT was not supported [7]. From a physiotherapeutic perspective, a continuous application of KT to the muscles and joints relevant to the neuromuscular imbalance would yield better results than an application to only the bilateral erector spinae for CLBP. Thus, it is necessary to develop KT techniques for the body parts affected by the CLBP-induced neuromuscular system imbalance.
Normalization of left DLPFC abnormalities on functional magnetic resonance imaging (fMRI) has been used to indicate treatment completion in patients with CLBP who underwent spine surgery and zygapophysial (facet) joint block [8]. Likewise, fMRI-based trials should be attempted for the evaluation of KT and the development of physiotherapy for CLBP, identifying reversible changes in structural and functional brain abnormalities that restore normal brain function.Conflict of interest: None declared.