Decompression/Traction Research Studies
Controlled distraction as a therapeutic option in moderate degeneration of the IVD-an animal study in vivo. German Ortho J 2006. The study results suggest disc regeneration can be induced by axial dynamic distraction. The decompressed rabbit IVD showed signs of tissue recovery after temporary disc distraction.
Is there a sub-group of patients with LBP likely to benefit from traction? Spine 2007. There may be a sub-group of patients who can benefit from traction: root compression leg pain, crossed-leg raise test or peripheralization with extension. Benefit at 2 weeks, equivocal at 6.
Manipulation and traction for lumbago and sciatica. Physio Prac 1988. A controlled trial of traction with manipulative techniques led to substantial relief in 85% of participants.
Comparison of sacrospinalis myoelectric activity and pain levels in patients undergoing static and intermittent lumbar traction. Spine 1993. Study indicated there in NO EMG activity in prone or supine traction positions. Improved comfort is noted in intermittent group.
Comparison of electrical activity in sacrospinalis musculature during traction in two different positions. J Ortho Sports Phys Ther 1995. EMG indicates no electrical activity prone vs. supine traction positions.
Biomechanics of traction for lumbar disc prolapse. Chin Ortho 1994. IVD was recorded before & during traction. 62% of prolapsed discs showed negative pressure prior to traction. 64% reduced IDP with traction. 19% showed pressure increase with applied distraction.
Non-linear finite element analysis of formation & treatment of disc herniation. Proc Inst Mech Eng 1992. Analysis shows loads not greater than those occurring in daily life can cause loss of stability and allow lateral displacement. The model indicates traction therapy may retract herniation by 40%.
Effects of axial decompression on IDP.J Neurosurg 1994. Significant negative pressure was achieved in 3 patients during prone traction (VAX-D)…-100mmHg. A minimal threshold of 50 pounds is assumed. Patients prone with extended arm restraint.
Reducibility of cervical herniation: evaluation at MRI during cervical traction. Radiology 2002. 29 patients and 7 healthy volunteers had intermittent traction while in MR. Substantial vertebral elongation was seen. Full herniation reduction was seen in 3 and partial reduction in18.
Effects of intermittent traction on vertebral separation. Arch of Phys Med & Rehab 1969. A rope to harness angle of 18º afforded the greatest separation through L4/L5 with reduction of frictional resistance. Separation is greatest posterior vs. anterior with separation noted through T12.
Intermittent cervical traction for cervical radiculopathy due to large volume herniations. JMPT 2002.Three weeks of traction as described resulted in complete resolution of symptoms in 4 patients. Over-the-door supervised traction utilized.
New concepts in back pain management. AJPM 1998. The application of supine lumbar traction with adherence to several specific characteristics including progression to peak force, hip flexion, split-table and altering pull angle helped to enhance outcomes
Vertebral axial decompression for pain associated with herniated and degenerated discs or facet syndrome: an outcome study. Neuro Res 1997. A retrospective of 770 cases assumed, though uncontrolled as to previous treatments showed a 71% good-to-excellent response through 20 prone traction treatments.
Lumbar spine traction: evaluation of effects and recommended application. Manual Ther 2000. Traction most likely benefits acute <6 weeks of pain with radicular symptoms and neurological deficit. Apparent lack of ‘dose’ response suggests low dose is probably sufficient to achieve benefit.
Traction for LBP with or without sciatica; a Cochrane systematic review. Spine 2006. Intermittent or static traction as a single treatment cannot be recommended. However the literature allows no firm negative conclusion that traction, in a generalized sense is not an effective treatment for LBP.
Comparison of 3 PT modalities for acute pain in lumbar disc herniation measured by clinical evaluation and MRI. JMPT 2008.Traction, ultrasound and Laser were all effective in this group with LDH.
Effects of different cervical traction weights on neck pain and mobility. Niger Postgrad 2006.
This study suggests 10% body weight as the ideal weight with minimal side effects and highest therapeutic effect
Computed tomographic investigation of the effects of traction on LDH. Spine 1989. CT scans before, during and after traction in 30 patients shows retraction in 78% medial, 66% posterlateral and 57% lateral herniations. Report of 93% success in pain relief at 6 month follow-up.
The natural history of HNP with radiculopathy. Spine 1996. Reduction of extraforaminal disc herniation using a multi-modal approach including traction therapy
The non-operative treatment of HNP with radiculopathy: an outcome study.Spine 1989. Through an aggressive multi-modal approach patients with recalcitrant pain and disc prolapse showed an 85% success rate. Traction was used when it reduced leg symptoms.
Current use of lumbar traction in the management of LBP (UK). Arch of Phys Med Rehab 2005. 41% use traction for sub-acute, nerve root signs. 87% use it in a multi-modal approach.
Effects of hydrostatic pressure on matrix synthesis & matrix metalloproteinase production in human lumbar IVD. Spine 1997. The results suggest that hydrostatic pressures influence IVD cell metabolism. Abnormal hydrostatic pressure may accelerate disc degeneration.
The influence of different unloading positions upon stature recovery and paraspinal muscle activity. Clin Biomech 2005.
Elevated EMG activity in paraspinals is found in the chronic LBP population. Gravity inversion position results in the lowest EMG activity and recovery of stature.
Effect of 10%-30% & 60% body weight traction on SLR test of symptomatic patients with LBP. J Ortho Sports Phys Ther 2000. Positive SLR below 45º improved post traction treatment in both 30% & 60% body weight. Low force many have equal benefits
Effect of continuous lumbar traction on the size of herniated disc material in lumbar herniation. Rheumatol Int 2005.
Size of herniated disc material from CT images decreased significantly as did symptoms. Lumbar traction is both effective in improving symptoms and clinical findings as well as the size of herniation.
CT evaluation of lumbar spinal structures during traction. PhysioTher 2005. During traction there was a reduction of LDH, increased spinal canal space, widening of the neural foramen & decreased thickness of psoas.
Efficacy of home cervical traction therapy. Am J Phy Med Rehab 1999. 3-5 minutes of daily cervical traction provided symptom relief in 81%.
Blood pressure & pulse rate changes associated with cervical traction. Niger J Med. 2006. It is advised that cardiovascular risk factor patients (elderly & unstable systems) should be comprehensively assessed prior to the therapy. Cervical traction can create cardiovascular alterations