Traction in Physiotherapy


Traction today, otherwise known as "spinal decompression therapy",  addresses the functional and mechanical aspects of discogenic pain and has been used by physiotherapists for years. Before the computer technology was available, and even now, we will occasionally do this manually.  
tractionWe also have access to computerized systems that will cycle through  preprogrammed patterns, ramping up and down the amount of axial decompression allowing for higher levels of spinal traction and disc rehydration. During spinal decompression therapy, a negative pressure is created within the disc. Because of that negative pressure, disc material that has protruded or herniated can be assisted back within the normal confines of the disc, and permit healing to occur. Pressure is released off of inflamed nerve roots allowing the inflammation to subside.

A specific force predetermined by your physiotherapist gently separates the bones of the lower back or neck. This relieves the pressure on the outer fibers on the disc. With repeated treatments over a period of time this allows for the outer fibers to heal and hold the gel-like material back in the center of the disc. Additionally, this negative pressure forces nutrients and fluid into the disc to assist with rehydration and healing of the disc.  By altering the position of the traction pull and the height of the table we may also localize the traction force to a particular segment of the spine and in a specific direction.

tractionTreatments are painless. In fact some individuals get immediate relief from their pain once decompression takes place.  There is little evidence that shows traction alone is effective in managing low back pain. It is important that you comply with the specific home exercises prescribed by your physiotherapist to minimize the stresses on the disc, and partake in an appropriate strengthening and stabilization program when appropriate.  Your McKenzie trained practitioner can assist you with this.

Traction is effective for:
  • Bulging, prolapsed, or herniated discs
  • Spinal stenosis
  • Sciatica
  • Facet syndrome
  • Degenerative disc disease
  • Neck pain
  • Pain radiating down the arm
  • "Pinched nerves"
  • Spondylitis
Back Pain/Sciatica lumbar traction

A pelvic harness is worn by the patient. The specially equipped table on which the patient lies is slowly extended, and a distraction force is applied via the pelvic harness until the desired tension is reached. This is followed by a gradual decrease of the tension, and the cycle is repeated. The cyclic nature of the treatment allows the patient to withstand stronger distraction forces compared to static lumbar traction techniques. The level of tension is individually calibrated and recorded.  

Neck Pain/ Radicular arm pain

cervical traction

The patient's head is comfortably positioned into a supportive device that pulls behind their neck gently distracting the joints in the upper part of their neck.  As more tension is used, distraction forces affect joints further down the spine.  It is through careful calibration and positioning that we are able to apply just enough tension to relieve symptoms.

References

Ramos, G., & Martin, W. (1994). Effects of vertebral axial decompression on intradiscal pressure. Journal of Neurosurgery, 81 (3), 350-353. Retrieved April 19, 2002 from PubMed database.

Andersson GB, Schults AS, Nachemson AL.(1983)  Intervertebral disc pressures during traction. Scand J Rehabil Med; 9:88-91

 Earl E. Gose, William K. Naguszewski, and Robert K. Naguszewski. (1998)  , . "Vertebral Axial Decompression Therapy for Pain Associated with Herniated or Degenerated Discs or Facet Syndrome: An Outcome Study." The Journal of Neurological Research, Volume 20

 Frank Tilaro, MD, Dennis Miskovich, MD., (January 1999). "The Effects of Vertebral Axial Decompression on Sensory Nerve Dysfunction in Patients with Low Back Pain and Radiculopathy." Canadian Journal of Clinical Medicine

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