Lumbar traction is commonly used to treat patients with back pain. Typically, clinicians rely on expert opinion in making decisions about when and how to implement lumbar traction. The purpose of this paper was to review current knowledge of lumbar traction and to identify what, if any, empirical evidence supports the expert opinions. This review found that whereas the mechanical effects of lumbar traction are well substantiated, the results of studies examining clinical effectiveness are conflicting. The failure to conclusively demonstrate the clinical benefit of lumbar traction may be related to the varied diagnostic categories and treatment techniques employed in the studies. Of the 10 types of lumbar traction described in the literature, static and intermittent mechanical traction are the two most commonly used. Indications, contraindications, and treatment techniques for these two types of traction are discussed. Based on the findings of this review, further study is needed to determine optimal treat...

https://www.jospt.org/doi/pdf/10.2519/jospt.1994.20.5.262

Lumbar traction: a review of the literature.

Study Design Single group test-retest repeated measures. Objectives To determine the effects of lumbar traction with 3 different amounts of force (10%, 30% and 60% body weight) on pain-free mobility of the lower extremity as measured by the straight leg raise (SLR) test. Background There are several recommendations on how lumbar traction should be performed, but the duration, frequency, force, and type of technique to be applied differ among the sources. Methods and Measures Ten subjects with subjective complaints of low back pain or radicular symptoms with a positive unilateral SLR test below 45° participated in this study. The pain-free mobility of the lower extremity in the SLR test position was measured prior to and immediately following 5 minutes of static traction in the supine position. Random assignment in the order of the amount of applied traction was implemented. Results The straight leg raise measurements were found to be significantly greater immediately following 30% and 60% of body weight t...

Effect of 10%, 30%, and 60% body weight traction on the straight leg raise test of symptomatic patients with low back pain.

The purposes of this study of low back pain patients were to determine: 1) if presence of sacrospinalis myoelectric activity is a consistent phenomenon in supine and prone positions; 2) if there is a difference between magnitudes of myoelectric activity for two types of lumbar traction (static and intermittent); and 3) if there is a difference in patient perceived pain level after traction between the two types of traction. Results show that surface electrode myoelectric activity is absent in resting supine and prone positions, there is no significant difference in magnitude of myoelectric activity between the two different types of traction, and more than 50% of patients in both traction groups experienced decreased pain after traction.

Comparison of sacrospinalis myoelectric activity and pain levels in patients undergoing static and intermittent lumbar traction.

Study design An in vivo rat-tail model was adopted to study the structural changes of degenerated intervertebral disc after different traction protocols. Objective To investigate the effects of traction with different modes and magnitudes on disc with simulated degeneration. Summary of background data Traction has been commonly used in clinical practice for treating low back pain. Its effects on disc with degeneration have not been fully investigated. Methods Forty-seven mature rats were used. Continuous static compression of 11 N was applied to the rat caudal 8-9 disc for 2 weeks to simulate disc degeneration. Tractions with different modes (static or intermittent) and magnitudes (1.4 N or 4.2 N) were applied to the degenerated disc for 3 weeks. The disc height was quantified in vivo on days 4, 18, and 39. The treated discs were then harvested for morphologic analysis. Results Significant decrease in disc height with degenerative morphologic changes was observed after the application of the static compression. The changes in disc height after the application of traction were found to be magnitude dependent. Continuous decrease in disc height was observed after 4.2-N traction, whereas the disc height maintained after traction of 1.4 N. However, no obvious morphologic change was found in comparison with the degenerated discs without traction. Conclusion Although traction was not demonstrated to have restored disc with degeneration, traction with relatively low magnitude was found to have significant beneficial effect in maintaining disc height of degenerated disc, and it might be a potential intervention to slow down the process of degeneration. Future studies of the effects of low-magnitude traction on degenerated disc are recommended.

Effects of traction on structural properties of degenerated disc using an in vivo rat-tail model.

The modern thrust of manipulation and traction therapy.

/pdf/intermittent-pelvic-traction-in-the-treatment-of-the-236t4zedod.pdf

Lucille B. Hood

Papers

Intermittent pelvic traction in the treatment of the ruptured intervertebral disk.