Lumbar Traction

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Search Strategy[edit | edit source]

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Definition/Description[edit | edit source]

Various forms of lumbar traction has been used for the relief of pain since the time of Hippocrates. During the 1950’s and 1960’s it became a popular, and until today it is used by physiotherapists for threatening patients with low back and leg pain.[1] Although its effectiveness is still being questioned by a few clinical trials (see further), there are three benefits described of lumbar traction: distraction to increase the intervertebral space, tensing of the posterior longitudinal vertebral ligament and suction to draw the disc protrusion towards the center of the joint.[2]

Different types of lumbar traction can be used.[3] First of all there is mechanical traction, using a mechanical device and a specially designed table that is divided into two sections.[2] The device delivers a certain tension to perform the traction. The patient wears a harness, which consists of two rings, to support the patient.[4]

Autotraction also utilized a table divided into two sections, the patient provides the traction force by pulling with the arms and/or pushing with the feet.[2] Finally there is manual traction performed by the therapist, pulling at the patient his ankles. Another way of manual traction is with the patient his legs over the therapist his shoulders, the therapist will place his arms on the patient’s thighs and pull.[4]

Continuous traction is applied for several hours with the use of a small amount of weight. Sustained traction has a shorter duration but a larger tension force.[3] Intermittent traction is similar sustained traction but alternately applies and releases the traction force at certain intervals.[2]

Clinically Relevant Anatomy[edit | edit source]

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Epidemiology /Etiology[edit | edit source]

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Characteristics/Clinical Presentation[edit | edit source]

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Differential Diagnosis[edit | edit source]

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Diagnostic Procedures[edit | edit source]

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Examination[edit | edit source]

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Medical Management
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Physical Therapy Management
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Lumbar traction is used in many disorders of the low back.

Lumbar disc herniation:
Several studies have investigated the effect of lumbar traction on lumbar disc herniation. Tesio et al (1993)[5] demonstrated that autotraction showed continued improvement after three months, pain ratings remained stable but disability scores decreased to 0 to 23% of the pretreatment value. Autotraction does not change the location and size of an herniation but there is an marked clinical improvement in the patients.[6]

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Resources
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Clinical Bottom Line[edit | edit source]

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Recent Related Research (from Pubmed)[edit | edit source]

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References[edit | edit source]

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  1. ↑ Lee RY et al. Loads in the lumbar spine during traction therapy. Australian Journal of Physiotherapy. 2001; 47(2): 102-108. (LEVEL E)
  2. ↑ 2.0 2.1 2.2 2.3 Pellecchia GL et al. Lumbar traction: A review of the literature. J Orthop Sports Phys Ther. 1994 Nov;20(5):262-267. (LEVEL 1A)
  3. ↑ 3.0 3.1 Saunders HD. Lumbar traction*. J Orthop Sports Phys Ther. 1979; 1(1): 36-45. (LEVEL 1A)
  4. ↑ 4.0 4.1 http://www.surgery-lumbar.com/lumbar_traction
  5. ↑ Cite error: Invalid <ref> tag; no text was provided for refs named Tesio et al
  6. ↑ Cite error: Invalid <ref> tag; no text was provided for refs named Gillström et al
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