Transcript Traction - Faculty

Traction
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Effects of Spinal Distraction

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Joint Distraction
– Separation of two
articular surfaces
– Can treat facet joint &
spinal nerve root
symptoms
– Distraction force 50% of BW for Lspine & 7% for Cspine
Effects of Spinal Distraction
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Reduction of Disc
Protrusion
–
–
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Suction due to
decreased intradiscal
pressure
Force of 60-120 #’s
have been shown to
reduce lumbar disc
protrusion
Effects of Spinal Distraction
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Soft Tissue
Stretching
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–
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Muscles, tendons,
ligaments, discs
Increase soft tissue
length & increase
joint mobility
Effects of Spinal Distraction
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Muscle Relaxation
– Can facilitate muscle
relaxation
 May be due to
reduction of pain
 May be due to
prolonged stretch
(may fire the GTO)
Effects of Spinal Distraction

Joint Mobilization
–
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Stretching of soft
tissues with traction
can increase joint
mobility
Effects of Spinal Distraction
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Patient
Immobilization
–
–
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Very low-load traction
(10-20 #’s) has been
used to
immobilization pts
with spinal disorders
(Bucks Traction)
Presently, not as
popular
Clinical Indications for the Use of
Spinal Traction

Disc Bulge or Herniation
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Traction may be more beneficial for disc bulge than
herniation
The greater the damage to the disc, the less
effective traction may be.
Clinical Indications for the Use of
Spinal Traction
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Nerve Root
Impingement
Clinical Indications for the Use of
Spinal Traction
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Joint Hypomobility
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–
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Traction cannot isolate a local area of
hypomobility
Traction can improve mobility throughout the
treated area (c-spine, l-spine)
Clinical Indications for the Use of
Spinal Traction
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Subacute Joint Inflammation
–
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Traction may reduce strain on injured
tissues &/or joints
Clinical Indications for the Use of
Spinal Traction

Paraspinal Muscle Spasm
–
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Can reduce muscle spasm by reducing by &/or firing
the GTO
Clinical Indications for the Use of
Spinal Traction
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Contraindications for the Use of
Traction
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Where motion is contraindicated
–
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Example – unstable fracture, spinal cord
compression, or shortly after spinal surgery
Contraindications for the Use of
Traction
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With an acute injury or inflammation
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Example – shortly after trauma, surgery, RA, OA
Contraindications for the Use of
Traction
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Joint hypermobility or instability
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Example – fractures, dislocation, surgery,
pregnancy, lactation, RA, Down’s syndrome
Contraindications for the Use of
Traction
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Peripheralization of symptoms with traction
Contraindications for the Use of
Traction
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Uncontrolled
hypertension (for
inversion traction)
Precautions for the Use of Traction

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Structural diseases or conditions affecting the
spine(tumor, infection, rheumatoid arthritis,
osteoporosis, or prolonged systemic steroid
use)
Precautions for the Use of Traction

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When pressure of the belts may be hazardous
(pregnancy, hernia, vascular compromise,
osteoporosis)
Precautions for the Use of Traction

Displacement of annular fragment
–
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Traction is not likely to change the position
of the fragment
Precautions for the Use of Traction
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Severe pain relieved by traction
–
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May indicate the spinal nerve root becoming
more compressed as a result of the traction
intervention
Precautions for the Use of Traction
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Claustrophobia
Precautions for the Use of Traction
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Patients who cannot tolerate the prone or
supine position
– Pain in prone or supine position or acid
reflux
Precautions for the Use of Traction
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Disorientation
Precautions for the Use of Traction
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Temporomandibular joint (TMJ) problems and
dentures
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Adverse Effects of Spinal Traction
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Worsening of symptoms
New symptoms (radiculopathy due to
excessive strain on the spinal cord dura)
Application Technique: Mechanical
Traction
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Mechanical Lumbar
Traction Procedure
Application Technique: Mechanical
Traction
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Mechanical Cervical
Traction Procedure
Application Techniques: SelfTraction
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Examples of SelfTraction
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–
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Sitting Self-Traction
Self-Traction Between
Corner Counters
Self-Traction With
Overhead Bar
Application Techniques: Positional
Lumbar Traction
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Application Techniques: Manual
Traction
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Traction
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MRI results before and after cervical traction
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 JanMar;21(1):3-11.
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