Thursday Thoughts: Tapping as Distraction | Modern Manual Therapy Blog

Thursday Thoughts: Tapping as Distraction

This edition of Thursday Thoughts comes from an amazing online consult I did a few months back with a chronic pain patient who was coping very well.

She found me by googling "central sensitization syndrome," we set up a google hangout for some pain science education and other strategies, and I think I got more out of her than she learned from me!

There were two nuggets I got from our 1.5 hour long conversation.

Tapping as a Distraction

  • she was centrally sensitized and she had allodynia in many parts of her body
  • when she had to have some dental or other procedures, or blood draws that required needles this the pain was excruciating
  • however, she found on her own, that tapping in other places that were not peripherally sensitized completely eliminated the perceived painful sensation from the needle
  • the bottom line: if a technique (TDN, other otherwise) is very uncomfortable, try having the patient tap in a place that is not threatened to modulate your treatment (or don't use that treatment)

Severe Tinnitus Neuroscience Nugget - borrowing from NOI Jam's great posts
  • this same amazing woman previously had severe tinnitus at night
  • it was causing extremely high anxiety, thus further lowering her pain thresholds
  • her self breakthrough was thinking of the ringing as her guardian angel communicating with her and protecting her
  • eliminating the threat abolished her anxiety and perceived threat about the tinnitus

Needless to say, much of the pain science education I normally deliver, she had already figured out, including graded exposure to movement, etc... She was already well on her way to improved function and meeting her goals of a long spiritual trek next year. I felt blessed to have met and spoken to her, and will possibly interview her for my Stop Thought Viruses/Physio Answers Sites.

Keeping it Eclectic...


  1. Ben Ness, PT, Cert MDT, CertDNJuly 25, 2014 at 2:45 PM

    I have used some of these distraction techniques as well with patients who are fearful or very hypersensitive to dry needling. If I know they are centrally sensitized and hyper-sensitized to any palpation then obviously they are going to get an exaggerated response to the needle insertion. I have used both techniques, using a smaller, thinner needle and not going in very far (actually studies that have compared deep needling with just sham pricking have received very similar positive responses - central mediation) as well as putting a hot pack on a different area. e.g. patients that I have electric DN going to C/S and L/S will usually do much better with a hot pack placed in-between to distract them as well as relax their para-spinals from a different location.

  2. Great ideas, but as with any technique I use, if a patient is fearful, I would rather talk someone out of a technique rather than convince them to do it.