Lumbar traction: Indications and risks (physiotherapist advice)

lumbar tractions to relieve symptoms of sciatica

Lumbar traction is a form of decompression therapy that reduces pressure on the spine. It can be performed manually or mechanically to treat various spinal pathologies. This article explains several benefits and risks associated with this technique, and shares the opinion of a physiotherapist on its relevance for relieving pain in the lower back.

Definition and benefits

The term "traction" is derived from the Latin word "tractico", which refers to a pulling process. Thus, lumbar traction consists of applying a stretch along the axis of the spine through the weight of the body, an external force (such as the hands of a therapist), or even adapted devices.

The objective is to create a pulling force at the level of the Lumbar spine, more precisely by enlarging the space between the vertebrae and the spinal joints. The targeted therapeutic effects are as follows:

  • pain relief
  • better spinal alignment
  • stimulate blood circulation
  • reduce compressive forces on the spine
  • release pressure on nerves
  • reduction of paresthesias (numbness, tingling, etc.) in the lower limb
  • disc decompression
  • muscle stretching
  • improvement in function
  • avoid the use of medications, infiltrations or surgeries

Note: Certain therapeutic virtues conveyed by therapists or sellers of traction devices are devoid of scientific evidence, and remain to be demonstrated by studies. Moreover, there are even itself that traction would not be effective, although many therapists continue to use the technique for its empirically observed beneficial effects.

Indications

People suffering from low back pain or other problems of the lumbar spine can benefit from this form of therapy. Spinal traction is used regularly by healthcare professionals for the following conditions:

Risks and contraindications

Although often effective in relieving pain, lumbar traction can sometimes make symptoms worse. Likewise, the body sometimes reacts to pull-ups by causing muscle spasms, especially if the techniques are aggressive and unpredictable.

Thus, certain conditions constitute precautions (even contraindications) to spinal traction. We think, for example, of osteopenia, some forms of arthritis, infection, cervical vascular disease, osteoporosis, some cancers with bone metastases, or any impairment of spinal cord. Traction should also be avoided immediately after surgery involving the lumbar region, or in the presence oflumbar instability.

Finally, lumbar traction must be adapted in the acute phase (for example after a lumbago). Indeed, the traction will have the effect of stretching the lumbar structures such as muscles or ligaments. If they are inflamed or irritated by the trauma, the patient might feel more pain instead of relief.

If lumbar traction causes an increase in symptoms, it will be important to communicate the information to your healthcare professional. This one to adjust the parameters of the traction, or stop administering it altogether to focus on another treatment approach.

Procedure

Spinal tractions can be administered manually or mechanically, depending on the patient's condition and the therapist's preference.

Manual lumbar traction

In the case of manual traction, the healthcare professional (often a physiotherapist, physiotherapist, osteopath or chiropractor) uses his hands to perform the technique. It exerts a manual force aimed at enlarging the space between the vertebrae and the spinal joints.

One can even adopt certain positions oneself which aim to eliminate the effect of gravity on the spine, and exert a lumbar traction which would relieve the symptoms. For example, the use of a Swiss ball makes it possible to create a slight pulling force when balancing on the belly, or the use of 2 chairs making it possible to use the weight of one's body to widen the intervertebral space:

It should be noted that pull-ups can be applied according to various parameters. One can adjust the intensity of the traction (referred to as grades in manual therapy) to have to have the desired therapeutic effect.

Similarly, vibratory movements can be performed to modulate the pain and provide a relaxation effect. Finally, lumbar traction can be performed just before a joint manipulation to prepare the back for a crack.

Mechanical lumbar traction

Lumbar traction can also be done using adapted tools or devices (such as a inversion table). We then speak of mechanical traction. Here are examples of instruments used to decompress the lumbar vertebrae:

Traction can be held for an extended period, or held for short periods (between 10-20 seconds) repeatedly. One can also apply spinal traction several times a day to relieve its symptoms.

Opinion of the physiotherapist

If performed by an expert, lumbar tractions can greatly relieve symptoms and improve quality of life. As a physiotherapist (physiotherapist), I use them regularly in the practice to treat the neck pain of many patients.

The problem is that some medical professionals convey the message that tractions will correct disc problems "by returning the disc to its original position". This theory has not been scientifically proven, and it is not correct to assume that spinal tractions will correct his herniated disc, disc protrustion or other disc pathology.

Similarly, pull-ups most often provide a short-term effect only. Certainly, this creates an optimal environment for healing, but other approaches must be integrated to obtain lasting relief. Currently, studies show that progressive and adapted therapeutic exercises not only reduce long-term pain, but also prevent recurrences and improve function.

In summary, lumbar tractions are beneficial for treating many conditions, but they must be integrated within a global approach that takes into consideration all the facets of the person who contribute to the pain (physical, psychological, emotional, etc.) .

References

  • https://www.physio-pedia.com/Lumbar_Traction
  • https://www.sciencedirect.com/topics/medicine-and-dentistry/lumbar-traction
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