Understanding Lumbar Traction & What To Expect at Your First Session

Lumbar traction, a practice with roots in ancient civilizations, has evolved into a sophisticated technique for managing lower back pain.

By applying controlled forces to the spine, lumbar traction alleviates pressure on spinal discs and nerves, relieving various spinal conditions.

Understanding the types of traction, its effects, and the indications and contraindications is essential for anyone considering this treatment. From historical perspectives to modern techniques, this guide provides a comprehensive overview of lumbar traction and its role in spinal health.

The History of Spinal Traction

Spinal traction has a long history, dating back to ancient civilizations.

Early practitioners in Egypt, Greece, and China used ropes, weights, and manual manipulation to stretch the spine and relieve pressure on spinal discs and nerves.

In the 19th and early 20th centuries, modern physical therapy and chiropractic care refined these techniques.

Mechanical traction devices were developed, allowing for more precise control of applied force and improving safety and effectiveness.

Today, lumbar traction is a well-established practice incorporating advanced technology and a better understanding of spinal biomechanics. Devices like motorized traction and inversion tables provide controlled and adjustable traction forces, enhancing patient comfort and treatment outcomes.

The evolution of lumbar traction reflects continuous advancements in medical knowledge and technology. Building on centuries of practice, it offers practical solutions for spinal health.

The Basics of Lumbar Traction

Lumbar traction involves pulling the lumbar spine to separate the vertebrae and reduce pressure on spinal discs and nerves.

Physical therapists use this method to alleviate lower back pain and treat various spinal conditions. The goal is to create space between the vertebrae, relieve pressure on intervertebral discs and spinal nerves, reduce pain and inflammation, improve spinal alignment, and enhance mobility.

Types of Lumbar Traction

Sustained Traction

This method applies a consistent force for 15 to 30 minutes, promoting muscle and ligament relaxation.

Often used in clinical settings, it benefits patients with chronic conditions by providing an intensive stretch to the lumbar spine, helping to decrease pain and improve mobility.

Intermittent Mechanical Traction

Alternates between periods of pulling and relaxation. Commonly used in modern therapy, it helps alleviate pressure on spinal discs while providing intermittent relief, making it more comfortable for patients, improving circulation, and reducing muscle spasms.

Manual Traction

Performed by a therapist using their hands to apply controlled force to the lumbar spine. This technique allows for precise adjustments based on the patient’s response, targeting specific spine areas and providing individualized care.

Positional Traction

Involves placing the patient in specific positions to achieve the desired stretch on the lumbar spine. It can be performed at home with proper instruction and helps manage symptoms outside a clinical setting. Using an inversion table is a great example.

Effects of Lumbar Traction

Lumbar traction therapy offers various benefits, though research on its effectiveness is mixed.

Many people experience relief from both manual and mechanical traction methods. While traction may not be suitable for everyone, it can potentially relieve various spinal conditions that might be preventing you from doing things that you enjoy.

Let’s explore the physical effects of lumbar traction to help you understand how it may relieve specific symptoms for various conditions.

Distraction or Separation of Vertebral Bodies

Lumbar traction helps separate vertebrae, reducing pressure on intervertebral discs and spinal nerves.

This separation helps retract herniated or bulging discs and alleviates pain from conditions like herniated discs, degenerative disc disease, and sciatica.

Additionally, it enhances nutrient and oxygen flow to the discs, promoting healing and improving spinal health.

Improved Gliding of Facet Joints

The facet joints at the back of the spine are crucial for stability and flexibility. However, due to conditions like facet joint syndrome, they can become stiff or misaligned, leading to pain and restricted movement.

Lumbar traction facilitates the gliding motion of facet joints, restoring their normal function, reducing stiffness and pain, and enhancing range of motion.

Proper facet joint movement prevents further joint degeneration and improves overall spinal function.

Widening of Intervertebral Foramen

Lumbar traction widens the foramen—the spaces where spinal nerves exit—relieving nerve root compression.

This decompression alleviates symptoms like pain, numbness, and weakness, improving nerve function and range of motion.

It provides significant relief for patients with nerve root compression, such as sciatica or radiculopathy.

Pain Relief From Spinal Curves

Perhaps you’re one of the many people who struggle with conditions like upper cross syndrome or scoliosis.

Abnormal spinal curves, such as those seen in conditions like scoliosis or kyphosis, can cause pain and postural issues.

Lumbar traction can help straighten these curves by applying a gentle, corrective force to the spine. This effect improves spinal alignment and reduces discomfort associated with poor posture and abnormal curves.

While traction isn’t a cure for curvature abnormalities, it can help relieve postural-related pain.

Stretching of Spinal Muscles

The muscles surrounding the spine play a crucial role in supporting and stabilizing it. Tight or spasmodic spinal muscles can contribute to back pain and restrict movement.

Lumbar traction stretches these muscles, promoting relaxation and reducing muscle spasms. This stretching effect improves muscle flexibility and function, enhancing overall spinal health.

Relieving muscle tension and spasms can reduce pain and improve the range of motion, facilitating better movement and activity levels.

Conditions Best Suited for Lumbar Traction—And Others That Are Not

As with most medical treatments, traction might be a great idea for some patients, while it’s simply not advised for others.

Here are some of the most common conditions that lumbar traction might help with:

Conditions Commonly Treated by Lumbar Traction

• Herniated Discs: Traction helps retract protruding disc material, reducing compression on spinal nerves and alleviating pain.
• Nerve Root Impingement: Increases space between vertebrae, relieving pressure on impinged nerves, reducing pain, and restoring normal nerve function.
• Joint Hypomobility: Enhances joint mobility, making movement easier and less painful.
• Degenerative Joint Disease: Traction reduces pressure on affected joints, alleviating pain and stiffness and improving daily activity performance.
• Muscle Spasms and Guarding: Promotes muscle relaxation and reduces spasms, improving flexibility and function.
• Discogenic Pain: Decreases pressure within spinal discs, alleviating pain and promoting healing.
• Joint Pain: Reduces pressure on spinal joints, providing significant pain relief and improving joint function.

While lumbar traction has been shown to help with many of these conditions, every spinal problem is different. It’s always a good idea to talk to your doctor before assuming that traction is suitable for you.

Conditions That Are Not Appropriate for Traction

Lumbar traction is not suitable for everyone.

Conditions such as spinal malignancy, cord compression, spinal infection, osteoporosis, hiatal hernia, acute lumbago, pregnancy, uncontrolled hypertension, cardiovascular disease, severe respiratory disease, aortic aneurysm, abdominal hernia, rheumatoid arthritis, and severe hemorrhoids must be considered.

Applying traction in these cases can exacerbate the condition or cause further injury. Here’s a closer look at some specific conditions that are not appropriate for spinal traction:

• Acute Strains and Inflammations: Traction can worsen acute injuries or inflamed tissues, increasing pain and prolonging healing. It’s typically avoided in those with acute strains or active inflammation in the lumbar region.
• Hypermobility of the Spine: Patients with excessive spinal mobility are at risk of further joint instability with traction. The pulling force can exacerbate instability, potentially leading to increased pain or injury. Careful assessment and alternative treatments are recommended.
• Spinal Tumors: Traction can aggravate spinal tumors, leading to increased pain or other complications. Tumors can weaken vertebrae, and traction may worsen this weakness, causing further damage or compression of the spinal cord and nerves.
• Osteoporosis: This condition, characterized by weakened and brittle bones, makes patients more susceptible to fractures. Traction can increase the risk of vertebral fractures, as the weakened bone structure may not withstand the forces applied.

While spinal traction is not advised for these issues, other options may be helpful. Talk to your physician or spinal specialist to get the proper guidance for your specific condition.

Assessment for Traction & What to Expect At The Clinic

If traction seems like a good option for you, you’re likely wondering how it works. As with any medical intervention, the process begins with a thorough assessment, followed by treatment adjustments specific to your needs.

Here is what you can expect before and during your first treatment.

Patient Suitability Assessment

Before starting lumbar traction therapy, a thorough assessment ensures its safety and effectiveness. This involves several key components:

Medical History and Physical Examination

Your therapist will carefully review your medical history, current medications, and pain symptoms to identify any factors that could impact your treatment. During the physical examination, they will assess your spinal alignment, mobility, and signs of nerve or muscle issues.

Manual Traction Tests

These tests involve your therapist manually applying traction to your lumbar spine to observe how your body responds. This helps determine if mechanical traction is suitable for you. Any discomfort or adverse reactions during manual traction will guide your therapist’s recommendations for your treatment plan.

Functional Assessments

Your therapist will assess your range of motion, strength, and gait to tailor your traction therapy to your specific needs. These assessments provide a baseline for monitoring progress and adjusting your treatment plan as necessary.

How Your Therapist Will Apply Traction In Your Treatment

Once your therapist determines lumbar traction may benefit you, several factors are considered:

Importance of Correct Poundage

Traction force is carefully calibrated, typically ranging from 25% to 50% of your body weight. Starting gently and avoiding excessive force ensures your comfort and minimizes any risk of discomfort or injury.

Correct Positioning and Patient Comfort

Proper positioning is crucial for effective traction. Your therapist will ensure you are relaxed and comfortable throughout the session, using pillows for support whether you lie on your back or stomach.

Use of Mechanical and Manual Techniques

Both mechanical devices and manual techniques are used based on your individual needs. Mechanical devices provide consistent traction force, while manual techniques offer flexibility for personalized adjustments.

These assessments and considerations ensure that your lumbar traction therapy is both safe and effective, tailored to your specific needs and comfort during treatment.

Common Results & Patient Experiences

In real-world applications, many patients report significant pain relief and improved mobility following a series of traction sessions.

However, traction alone is not a complete solution for lower back pain. For better results, it is often combined with exercises, spinal stabilization movements, and postural re-education.

A survey of physical therapists in the U.S. found that nearly 75% use some form of manual or mechanical traction for patients with low back pain.⁴

If your physical therapist has determined that traction seems like an appropriate option, they will carefully assess, apply treatment, and modify as needed for best results. While it works for many people traction is not for everyone.

As always, the benefits of treatment, alongside your comfort while receiving it should be the main determining factor with traction or any other treatment.

Key Takeaways

• Lumbar traction has evolved from ancient techniques to advanced mechanical devices for spinal health.
• It involves pulling the lumbar spine to reduce pressure on spinal discs and nerves, alleviating lower back pain.
• Types of lumbar traction include sustained, intermittent mechanical, manual, and positional traction.
• Benefits include vertebral separation, facet joint gliding, widening of intervertebral foramen, pain relief, and muscle stretching.
• Conditions treated by lumbar traction include herniated discs, nerve root impingement, joint hypomobility, degenerative joint disease, muscle spasms, discogenic pain, and joint pain.
• Contraindications include acute strains, hypermobility, spinal tumors, osteoporosis, and various medical conditions.
• Patient assessments are crucial for safe and effective traction therapy.
• Correct poundage, positioning, and a combination of mechanical and manual techniques enhance treatment outcomes.
• Traction is often combined with exercises, spinal stabilization, and postural re-education for comprehensive care.

References

1. Thackeray, A., Fritz, J. M., Childs, J. D., & Brennan, G. P. (2016). The effectiveness of mechanical traction among subgroups of patients with low back pain and leg pain: a randomized trial. Journal of Orthopaedic & Sports Physical Therapy, 46(3), 144-154.
2. Masood, Z., Khan, A. A., Ayyub, A., & Shakeel, R. (2022). Effect of lumbar traction on discogenic low back pain using variable forces. JPMA. The Journal of the Pakistan Medical Association, 72(3), 483-486.
3. Saunders, H. D. (1979). Lumbar traction. Journal of Orthopaedic & Sports Physical Therapy, 1(1), 36-45.
4. Madson, T. J., & Hollman, J. H. (2015). Lumbar traction for managing low back pain: a survey of physical therapists in the United States. Journal of Orthopaedic & Sports Physical Therapy, 45(8), 586-595.