Lumbar Traction - Types, Benefits, and Contraindications.

Introduction:

Lumbar traction is a type of decompression therapy that helps to relieve pressure in the spine. Traction is derived from "tractico," a Latin word that means to pull or draw. The lumbar vertebral column is applied with a stretching force on the individual segments of the spine to achieve pain relief in conditions like disc protrusion, back pain, and leg pain. Weights are used for applying traction force, and they can weigh about 26 percent of the total body weight of the individual.

What Are the Types of Lumbar Traction?

1. Continuous Traction: It is also known as bed traction. It is done using low weights for several hours at one time. This type of traction is slightly ineffective in separating the spinal structures that are to be treated. Patients cannot withstand huge weights, which can cause separation of the vertebrae for an extended time.

2. Manual Traction: Manual traction is done by the therapist. The hands of the therapist pull the belt, that in turn pulls the legs of the patient. Traction force is applied only for a few seconds. It can also be done in sudden, quick thrusting motions.

3. Intermittent Mechanical Traction: This technique is somewhat resembling sustained traction in the duration and intensity of application. This technique has a mechanical unit that can apply force and release the traction force alternatively that are at preset intervals.

4. Sustained Traction: It is also called static traction. This type is done in shorter periods that range from a few minutes up to one hour. Since it is used for little time, heavier weights can be used that are applied steadily on the spinal columns.

5. Autotraction: It consists of a table that is specifically designed and divided into two sections. These two sections can be rotated and tilted individually. The traction force is given by the patient by asking them to pull with the arms and push with the feet.

6. Positional Traction: This type of traction is applied longitudinally to pull the spinal structures. The patient is placed in various positions using blocks, pillows, and sandbags to apply the traction. Lateral bending is incorporated in this and affects the spinal segment on one side only.

7. Gravity Lumbar Traction: This type uses a chest harness to provide a traction force. The chest harness is used to hold the patient securely, and the treatment table is tilted to a vertical position. This will enable the patient to use the lower body weight to induce traction.

What Are the Effects of Lumbar Traction?

Traction, when performed correctly, can cause the following effects:

1. Separation or destruction of the vertebral bodies.

2. Spinal curves straightening.

3. Intervertebral foramen widening.

4. Combination of gliding and distraction of the facet joints.

5. Spinal musculature stretching.

6. Tensing of the ligaments of the spinal segment.

What Is the Effectiveness of Lumbar Traction?

• Sciatica: Sciatica refers to pain along the course of the sciatic nerve that runs from the buttock, lower back, and leg. Lumbar auto traction is the preferred method to obtain immediate pain relief.

• Joint Hypomobility: Traction is considered a form of mobilization because it involves the passive movement of joints by manual or mechanical means. Joint stiffness and hypomobility can be effectively treated through traction.

• Degenerative Joint Disease: It is related to joint hypomobility. Patients affected with degenerative disc disease have a reduced range of motion. Traction can help restore the movement of the affected segments and also help interrupt the degenerative process.

• Lumbar Disc Herniation: Lumbar disc herniation refers to the bulging, protruding, or rupturing of the disc in the lumbar spine. They can cause sciatica, low back pain, and leg pain. Lumbar disc herniation can be treated conservatively through lumbar traction in six weeks. Autotraction and manual traction can be used for pain relief and improvement in function. Mechanical lumbar traction is incorporated along with extension exercises for functional improvement. The size of the hernia can be decreased by combining physical therapy and lumbar traction.

• Low Back Pain: Traction, along with other modalities, can provide a little amount of pain relief.

• Muscle Guarding and Spasm: Intermittent traction is done to treat muscle guarding and muscle spasms.

• Joint Pain: Mobilization and traction done within the normal range of movements can be effective in treating joint pain.

• Discogenic Pain: Traction can help relieve spinal pain that is discogenic in nature. If traction produces slight modification or restoration in the anatomy, it can produce favorable effects.

• Compression Fractures: After the healing of the fracture, some amount of pain is persistent in the affected individuals. Traction is not considered a routine treatment choice. However, it can be used for effective pain relief in certain cases.

Who Can Benefit From Lumbar Traction?

Patients can benefit from lumbar traction if they have the following conditions:

• Degenerative disc disease (a degenerative condition causing neck and back pain due to wear and tear of spinal discs).

• Disc herniation (bulging of the spinal disc that can cause neck, leg, and back pain).

• Slipped discs.

• Facet disease (a condition in which facet joints that are present in between the vertebrae are affected).

• Bone spurs (bony prominences present on the ends of bones).

• Pinched nerves may occur due to excess pressure on a nerve by the adjacent tissues.

• Foraminal stenosis (caused due to narrowing of the cervical disc space occurring due to joint enlargement).

• Sciatica.

What Are the Clinical Benefits of Lumbar Traction?

• It has been effective in treating radicular low back pain.

• Adhesions are also corrected through traction.

• The nerve root or disc pressure has been significantly reduced after lumbar traction.

• It can help correct joint hypomobility.

• Traction has helped to relieve contractures in connective tissues.

• Muscle spasms can be corrected through traction.

What Are the Contraindications?

Patients suffering from the following conditions should be refrained from undergoing lumbar traction:

• Spinal malignancy.

• Spinal infection.

• Osteoporosis.

• Cord compression.

• Uncontrolled hypertension.

• Hiatal hernia.

• Acute lumbago.

• Pregnancy.

• Cardiovascular disease.

• Abdominal hernia.

• Severe respiratory disease.

• Rheumatoid arthritis.

• Severe hemorrhoids.

Conclusion:

Lumbar traction can be effectively used for treating several musculoskeletal disorders. Traction has been clinically effective in treating various pain disorders. Static traction has been essential to fatigue the muscles and allow the traction force to act on the joints and help relieve pain. Static traction has helped treat disc protrusions, and intermittent traction to treat degenerative joint disease and joint hypomobility.