By Peter Georgilopoulos, APA Sports Physiotherapist, Spine + Body Gold Coast.
Is spinal traction the solution for your back pain?
Spinal traction is one of the many “tools” available to treat disc, joint and spinal arthritic pain.
For the right condition, spinal traction can achieve remarkable results without invasive or risky procedures at minimal cost. It should not however be considered the panacea for all spinal conditions as in some cases it may cause muscular spasms especially in conditions where there may be an acute, highly unstable disc lesion causing the pain.
For many chronic arthritic, joint and some disc related problems however, spinal traction can offer rapid resolution of pain and improve pain-free movement.
What is spinal traction?
Spinal traction is a mechanical means of decompressing inflamed spinal joints and reducing intra- discal pressure. Traction can be applied manually by the therapist [usually undertaken for severe neck problems] or, more typically, it can be applied through the use of a computerised traction unit operating on a sliding bed or neck traction halter.
Traction progression and force is programmed by the therapist and applied gently and gradually with a safety trip switch controlled by the patient. Treatment usually lasts between ten to twenty minutes depending on the severity and irritability of the problem.
Traction is usually used in conjunction with other manual therapy techniques to achieve maximal outcomes in the quickest possible time frame.
What conditions respond best to spinal traction?
- Osteoarthritic back pain [by decompressing affected joints pain is gently relieved and movement restored]
- Spinal canal stenosis in which the opening for the spinal cord narrows most commonly due to osteoarthritic bone spurs or a bulging [prolapsed] disc.
- Spondylolisthesis – this refers to an actual slip forward of a vertebra in relation to vertebrae above and below often encroaching spinal nerves or even the spinal cord.
- Disc bulge [also referred to as a prolapsed or “slipped” disc]. Pressure from a disc bulge can impinge nerves supplying muscles and skin to the legs and can therefore cause radiating nerve pain anywhere along the nerve pathway.
Can I achieve the same results on an inversion table?
Technically, inversion tables can apply a distraction force to a healthy back as a means of relieving compressive tightness following prolonged standing or running but in the case of an unstable disc problem or other pathology, the rapid application of distraction force and the uncontrolled force being applied can actually exacerbate back pain.
Another serious consideration is the unknown vascular status in middle aged or older people in whom a sudden increase in intracranial pressure may lead to a vascular haemorrhage. For these reasons, it is best to avoid inversion tables but some benefits may be gained by those that can hang off a chin up bar or use parallel bars to unload tight spinal structures. Computerised spinal traction by comparison is entirely controlled throughout the entire application in regards to the number of increments used to achieve the desired force as well as the type of force profile that will benefit the specific structural issue being treated.
In some cases the force is applied in a static or constant load whereas in other cases it may be more useful to utilise intermittent or cyclic traction which offers more of a mobilisation function for very compressed and rigid backs.
So traction helps – what now?
Before undergoing spinal traction, a patient must first have a consultation with one of our therapists to determine if it would be beneficial as part of a successful maintenance programme. Traction can be used by our therapists to compliment and enhance other therapies within a consultation. Current patients at Spine+Body who have already been assessed have the option to use spinal traction [neck or back] for a nominal fee without a consultation or a scheduled appointment. Patients can avail themselves of this service without the inconvenience or expense of a formal consultation at a convenient time.
Clearly, many conditions that respond to traction may represent irreversible damage to joints, disc and other spinal structures which are likely to require some degree of maintenance at regular intervals. The plan is always to obtain the best outcome in terms of pain and mobility as quickly as possible. Once a level of stability is achieved, your therapist will guide you in the correct maintenance exercises, things to avoid, correct lifting and sitting posture and impact absorbing footwear.
In addition to our traction machine, there are other commercially available and cost effective systems available for purchase that can be used at home only for neck traction. Speak to your therapist about their effectiveness and application.
Peter is Director and Founder of Spine + Body Centre of Allied Health on the Gold Coast ph: 07 5531 6422 or contact us by email here.