1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms.

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Traction

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Effects of Spinal Distraction

Joint Distraction– Separation of two

articular surfaces– Can treat facet joint &

spinal nerve root symptoms

– Distraction force - 50% of BW for L-spine & 7% for C-spine

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Reduction of Disc Protrusion– Suction due to

decreased intradiscal pressure

– Force of 60-120 #’s have been shown to reduce lumbar disc protrusion

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Soft Tissue Stretching– Muscles, tendons,

ligaments, discs– Increase soft tissue

length & increase joint mobility

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Muscle Relaxation– Can facilitate muscle

relaxationMay be due to

reduction of painMay be due to

prolonged stretch (may fire the GTO)

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Joint Mobilization– Stretching of soft

tissues with traction can increase joint mobility

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Patient Immobilization– Very low-load traction

(10-20 #’s) has been used to immobilization pts with spinal disorders (Bucks Traction)

– Presently, not as popular

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Clinical Indications for the Use of Spinal Traction

Disc Bulge or Herniation– Traction may be more beneficial for disc bulge than

herniation– The greater the damage to the disc, the less

effective traction may be.

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Nerve Root Impingement

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Joint Hypomobility– Traction cannot isolate a local area of

hypomobility– Traction can improve mobility throughout the

treated area (c-spine, l-spine)

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Subacute Joint Inflammation– Traction may reduce strain on injured

tissues &/or joints

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Paraspinal Muscle Spasm– Can reduce muscle spasm by reducing by &/or firing

the GTO

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Contraindications for the Use of Traction

Where motion is contraindicated– Example – unstable fracture, spinal cord

compression, or shortly after spinal surgery

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With an acute injury or inflammation– Example – shortly after trauma, surgery, RA, OA

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Joint hypermobility or instability– Example – fractures, dislocation, surgery,

pregnancy, lactation, RA, Down’s syndrome

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Peripheralization of symptoms with traction

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Uncontrolled hypertension (for inversion traction)

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Precautions for the Use of Traction

Structural diseases or conditions affecting the spine(tumor, infection, rheumatoid arthritis, osteoporosis, or prolonged systemic steroid use)

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When pressure of the belts may be hazardous (pregnancy, hernia, vascular compromise, osteoporosis)

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Displacement of annular fragment– Traction is not likely to change the position

of the fragment

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Severe pain relieved by traction– May indicate the spinal nerve root becoming

more compressed as a result of the traction intervention

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Claustrophobia

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Patients who cannot tolerate the prone or supine position– Pain in prone or supine position or acid

reflux

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Disorientation

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Temporomandibular joint (TMJ) problems and dentures

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Adverse Effects of Spinal Traction

Worsening of symptoms New symptoms (radiculopathy due to

excessive strain on the spinal cord dura)

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Application Technique: Mechanical Traction

Mechanical Lumbar Traction Procedure

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Application Technique: Mechanical Traction

Mechanical Cervical Traction Procedure

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Application Techniques: Self-Traction

Examples of Self-Traction– Sitting Self-Traction– Self-Traction Between

Corner Counters– Self-Traction With

Overhead Bar

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Application Techniques: Positional Lumbar Traction

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Application Techniques: Manual Traction

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Traction

MRI results before and after cervical traction

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VAX-D

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VAX-D

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Sari et al. Computed tomographic evaluation of lumbar spinal structures during traction. Physiother Theory Pract. 2005 Jan-

Mar;21(1):3-11.

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1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms.

Documents

use of spinal traction

inversion traction slide

herniation traction

effective traction

spinal surgery slide

osteoporosis slide

gto slide

use of traction severe