Tag Archives: research

Predicting the Stormy Weather Through our Pain

We probably all know at least one person who is considered to be a human barometer as they can predict upcoming weather changes due to headaches or achy joints. How and why is pain/stiffness weather sensitive? Is it actually backed by scientific findings, or is it purely psychological?

Unfortunately, the majority of studies have found no significant relationship between different weather conditions and pain. Furthermore, findings were strictly subjective pain ratings without objective medical findings. Does this mean it is purely psychological? It is highly unlikely that so many people are wrong. As you can imagine, it is hard to control for weather in a study, as so many weather variables would have to be taken into consideration, that it makes it very difficult to find relationships between any one specific variable. For example, at least 50% of headache sufferers believe that weather changes trigger their migraines/headaches. However, wind speed, temperature, humidity, barometric pressure and sunlight have all been reported as triggers. In addition, some individuals have headaches triggered by falling barometric pressure, while others report headaches with rising barometric pressure. These individual differences make it hard to see specific correlations with any one weather variable.

Overall, the studies that showed specific relationships between pain and weather generally found that cold and damp weather conditions influenced reports of pain in subjects with arthritis, headache, fibromyalgia, gout, low back pain and chronic pain.

Interestingly, one study that took place over a two-year period, examining the effects of weather on active individuals with osteoarthritis, found no relationship between weather and joint pain or stiffness. The authors concluded that exercising regularly, may have diminished the effects of weather on pain (Wilder et al., 2003).

How does weather affect symptoms?

Some studies have tried to explain the physiological effects that weather has on the body, but there haven’t been any conclusive results.

  • Some studies have shown that low vitamin D (less sunshine and less light) may play a role in increasing arthritis symptoms;
  • Some researchers suggest that mood may play a role. Damp and cold conditons are associated with a more negative mood, which in turn has been associated with higher pain levels. One study found that individuals reported the least number of symptoms on warm sunny days, due to more exercise, better sleep and a more positive mood;
  • Colder temperatures may increase joint stiffness and pain, due to an increase in viscosity of synovial fluid;
  • A decrease in barometric pressure will allow tissue to expand, therefore putting more strain on joints;
  • Increased humidity can cause increased joint swelling/stiffness.

Take home message:

There’s not much you can do to change the weather, studies have looked at different climates around the world, and they have yet to find the ideal location. As such, you need to focus on what you can control to help keep your headaches and achy joints happy.

  • Regular exercise may help prevent flare-ups of pain during poor weather conditions;
  • Add layers over your achy joints in order to keep them warm during cold and damp days;
  • Try to remain positive even if the weather is gloomy.

 

Aikman (1997). The association between arthritis and the weather. International Journal of biometeorology.

Wilder et al., (2003). Osteoarthritis pain and weather. Rheumatology. 955-95

The Sticky Truth Behind Kinesio Tape

Kinesio tape, that colourful elastic athletic tape, has been used for over a decade in the treatment of musculoskeletal injuries. It probably became most popular after the 2008 Olympics, where it was donated to team therapists, which resulted in almost every athlete using it. The majority of the people who have used this tape LOVE it! However, the research on the effectiveness of the tape isn’t so wonderful. There have been hundreds of research studies done on kinesio tape, so we’ll examine some of the more recent systematic reviews that outline what exactly the tape has been proven to achieve.

How the tape works

Kinesio tape is different from regular white athletic tape because it is flexible and 20160217_141404allows for full range of motion, (and it looks a lot cooler). Below are the main functions of kinesio tape:

  • Decrease pain;
  • Improve range of motion;
  • Increase proprioception;
  • Correct joint alignment;
  • Improve swelling and lymphatic drainage;
  • Facilitate or inhibit muscles

In order to achieve any of the desired effects above, the tape MUST be properly applied, including the direction of pull of the tape and the amount of tension applied.

What does the research say?

  • Overall, most studies show that kinesio taping for pain reduction, function and proprioception is better than no treatment, yet it is no better or worse than other traditional treatment options (Choon Wyn Lim et al., 2015)
  • Good support for reduction of pain in individuals with musculoskeletal injuries, (Montalvo et al., 2014)
  • Some support that it may improve painfree range of motion (Taylor et al., 2014).
  • Some support that it may help correct alignment i.e., patellar tracking (Barton et al., 2013).
  • Inconclusive support for improved swelling and lymphatic drainage (Kalron et al., 2013).
  • No support for the facilitation of muscle strength. A review of 19 studies that examined if kinesio tape increases muscle strength or facilitates muscle contraction showed no difference compared to a control group (Csapo et al., 2015).
  • A lot of the research discusses a potential placebo effect to help explain the benefits of kinesio tape

Take home message:

Kinesio tape is inexpensive, noninvasive, and has little to no side effects (there is a potential for skin irritation). Therefore, it is a safe and effective treatment option for pain relief, improvement in range of motion and correction of joint alignment. Future research may show beneficial effects on swelling, lymphatic drainage and facilitation of muscles.

References:

Choon Wyn Lim et al. (2015). Kinesio taping in musculoskeletal pain and disability that lasts for more than 4 weeks: Is it time to peel off the tape and throw it out with the sweat? A systematic review with meta-analysis focused on pain and also methods of tape application. British Journal of Sports Medicine. 

Montalvo, E. Cara and G. Myer. Effect of kinesiology taping on pain in individuals with musculoskeletal injuries: Systematic Review and Meta-analysis. Physician and Sports Medicine.  2014. Vol 42. Issue 2. P. 48-52.

Taylor et al. (2014). A Scoping Review of the use of Elastic Therapeutic Tape for Neck and Upper Extremity Conditions. Journal of Hand Therapy.

Barton, et al. (2014). Patellar taping for patellofemoral pain: a systematic review and meta-analysis to evaluate clinical outcomes and biomechanical mechanisms. British Journal of Sports Medicine, 48(6), 417-424.

Kalron and S. Bar-Sela. A Systematic Review of the Effectiveness of Kinesio Taping-Fact or Fasion? European Journal of Physical and Rehabilitation Medicine. 2013. Vol. 49. Issue 5. P. 699-709.

Csapo et al. (2015). Effects of Kinesio taping on skeletal muscle strength – a meta-analysis of current evidence. Journal of Science and Medicine in Sport, 18(4), 450-456.

ice therapy Sheddon Physioyherapy Sports Clinic Oakville Mississauga

To ice, or not to ice?

We’ve all twisted an ankle and instinctively grabbed some ice to make it feel better. We never questioned whether it was working; it was just common sense that icing it was the best thing to do. Is it possible that all these years we’ve had it wrong? Lately, there has been a lot of coverage in the media surrounding the use of ice post-injury and whether or not it actually works. Some researchers, trainers, professional athletes and therapists are supporting the idea that you should toss out your ice packs and eat those frozen peas because they won’t help your injury and may actually be making it worse. What has lead to this new way of thinking and is it supported by research?

The Healing Process

Let’s start with the basics. Once a tissue is injured the body will respond by increasing blood flow to the area and sending specific cells to start the repair process. Unfortunately, this leads to inflammation, redness, pain and increased temperature at the injury site. For years, ice has been used during this stage of healing to limit swelling and reduce pain. The two fundamental effects of icing an acute injury are 1. vasoconstriction of blood vessels, which will decrease the blood flow to the area; hence limiting the amount of swelling, and 2. Ice will block and reduce pain by decreasing nerve impulses. We know physiologically what ice does, but practically, does the research evidence support these findings?

What does the research say?

Unfortunately, there is not a lot of high quality research surrounding this topic, which makes it hard to come to any conclusions. Maclean’s magazine recently published an article on why icing doesn’t help injuries. However, they only cited two research articles to support their claim along with anecdotal evidence. A study by Tseng et al., (2013) continually gets cited to support the “ice is bad” claim. The study was conducted on only 11 healthy subjects, which found icing delayed recovery from eccentric exercise-induced muscle damage. This isn’t a huge sample size to hang your hat on such a claim. They also cited Bleakley et al., (2004), who conducted a review of the literature and found insufficient evidence on the benefits of icing post-injury. More recently, Collins (2008) review of the literature showed that there was sufficient research to support that modest icing helped reduce swelling, but excessive and prolonged icing was damaging to the injured tissue. Furthermore, Hubbard et al., (2004) conducted a review of the literature and showed that icing soon after injury was effective in speeding up return to play. They hypothesized that the quicker return to play was due to better pain control.

Take home message

Ice is beneficial during the early phases of healing in order to control excessive inflammation and help with pain control. However, long term, it has been shown that prolonged use of ice can interfere with blood flow and the delivery of cells and oxygen needed to stimulate tissue formation and healing. Should you toss out your ice packs? Probably not. Ice is still beneficial for acute swelling and pain control, and at the very least, for keeping your beverage cold long-term!!

Bleakley et al., (2004). The use of ice in the treatment of acute soft tissue injury. A systematic review. The American Journal of Sports medicine. 251-261.

Collins, N.C. (2008).Is ice right? Does cryotherapy improve outcome for acute soft tissue injury? Emergency medicine Journal. 65-68.

Hubbard et al., (2004). Does cryotherapy hasten return to participation? A systematic review. Journal of Athletic Training. 39(1): 88-94.

Tseng et al., (2013). Topical cooling (icing) delays recovery from eccentric exercise-induced muscle damage. Journal of strength and conditioning research. 1354-1361.