Post on 12-Apr-2017
Cervical and Lumbar Traction
BY BRINA KITTS, SPTA
The Purpose of Traction
In medical terminology, traction refers to the practice of exerting a slow, gentle pull on a body part.
The purpose of spinal traction is to pull the vertebrae apart from each other to relieve pressure.
Cervical Traction
Cervical spinal traction is used to relieve pain associated with neck nerve root compression or neck muscle spasms. The head is lifted to a 25-30 angle to stretch the muscles and soft tissues of the neck. This opens up the spaces between the upper vertebrae which releases tension and pressure on neck structures.
When to Use Cervical Traction
Indications for Treatment: Cervical Spine Instability Herniated Cervical Intervertebral
Disc Reduced Cervical Curve Speed healing of injured neck
structures Muscle spasms Loss of cervical mobility
Contraindications for
Treatment: Acute or unhealed
injuries Osteomyelitis Severe osteoporosis Spinal hypermobility Tumors Rheumatoid arthritis
Different Types of Cervical Traction
There are many different types of cervical traction devices which can provide treatment:
Overhead pulley system
o 20lb = 2 ½ gallons
o No more than 30 min
Different Types of Cervical Traction
Manual Traction
o May be done using hands or some type of strap or towel.
o Therapist must take care with force and positioning.
Different Types of Cervical Traction
Pneumatic Harness System
o Utilizes a hand pumpo Patient-controlled
Different Types of Cervical Traction
Posture Pump
o Utilizes air pump as well
o Allows patient to lie supine
o Applies pressure on dorsal aspect of cervical spine
Different Types of Cervical Traction
Mechanical Traction
o Must be monitored by therapist
o Can be used with “static” or “intermittent” setting
Lumbar Traction
Lumbar traction uses a designated amount of tension to the lower spine to reduce the pain associated with muscle spasms and nerve root impingement in the lumbar area.
When to Use Lumbar Traction
Indications for Treatment: Narrowing of the
intervertebral foramen Osteophyte encroachment Disc bulge or herniation Nerve root impingement Subacute injury Paraspinal muscle spasm
Contraindications for Treatment: In presence of unhealed
fractures Spinal cord compression Immediately following spinal
surgery Acute injury or inflammation Hypermobility Peripheralization of symptoms Hypertension
Different Types of Lumbar Traction
Traction Table with Pulley Systemo Use half of patient’s body weight for distraction.o Should be monitored by healthcare professional.
o Can be done continuously or intermittently.
Different Types of Lumbar Traction
Inversion Tableo Table allows for tilting at desired angles
o Uses patient’s body weight and position for distractiono Several contraindications for this method
Different Types of Lumbar Traction
Posture Pumpo Patient-controlled
o Can be used easily at homeo Portable
Different Types of Lumbar Traction
Manual Lumbar Tractiono Healthcare professional uses own body as weight
o In hook-lying position, patient’s knees are pushed toward their head as the pelvis is pulled in the
opposite direction.
Different Types of Lumbar Traction
Unilateral Tractiono Some healthcare providers utilize a manual “leg pull” method of
traction.o The patient must be fitted with a counter-action harness.
o The clinician holds the ankle of the affected extremity and elevates the hip to 30 flexion, 30 abduction and full ER for focus of hip joint pain and to 30 flexion and 15 abduction for SI joint pain.
o Straight and steady pull is performed until noticeable distraction is felt.
Different Types of Lumbar Traction
Unilateral Position Tractiono Traction can also be performed using a roll or half-
roll of some type.o The roll should be placed under the unaffected side of
the body between the rib cage and iliac crest with the patient in side-lying position across the roll with the upper leg flexed at the hip and knee until lumbar spine
curved.o If feasible, the patient can perform trunk rotations to
maximally open the foramen.
Effectiveness of Cervical/Lumbar Traction
This is a topic that appears to be greatly debated among healthcare professionals, medical journalists, and patients alike.
The treatment should be discontinued if not providing benefits to patient after a few trials.
Overall, this treatment is used when preferred by healthcare professional or patient. There are many differing opinions as to its effectiveness. Individual results and patient inclination are the driving forces of this treatment.