OrthoNeuroSpine & Pain Institute
In spinal health care, traction refers to the practice of relieving pressure on the spine and neuro-musculoskeletal system by applying a distracting force to the ends of a particular spinal segment(s).
Traction is commonly used in the cervical spine to relieve pressure on the cervical nerve roots in patients with disc herniations, degenerative disc disease and spinal stenosis. Cervical traction can be applied manually by a trained health care professional, and there are many different types of hope traction units that can be purchased to provide temporary relief of symptoms for patients who show benefit in the clinic.
The use of traction in the lumbar spine has much less supporting evidence. Because of the large amount of force needed to overcome the compressive forces in the lumbar spine, manual traction is usually not a viable option. Some patients may find some benefit to lumbar traction. However, multiple treatments are usually necessary and most patients find that treatment is not very beneficial in the long run. Also, home inversion tables have been associated with patient injuries and may exacerbate other health problems (e.g. High blood pressure) in improperly selected patients.
Traction should be performed in a safe environment prior to the purchase of any home unit. Significant harm can occur to patients who aren’t evaluated medically and cleared to use traction. Discussion with your physician and/or therapist is strongly advised to determine if you are an appropriate candidate for traction.
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.
We 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.
Treatments 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
- Facet syndrome
- Degenerative disc disease
- Neck pain
- Pain radiating down the arm
- "Pinched nerves"
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
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.