Cervical and Lumbar Traction

1. Cervical and Lumbar Traction By Brina Kitts, SPTA

2. 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.

3. 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.

4. 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

5. Different Types of Cervical Traction There are many different types of cervical traction devices which can provide treatment: Overhead pulley system 20lb = 2 ½ gallons No more than 30 min

6. Different Types of Cervical Traction Manual Traction May be done using hands or some type of strap or towel. Therapist must take care with force and positioning.

7. Different Types of Cervical Traction Pneumatic Harness System Utilizes a hand pump Patient-controlled

8. Different Types of Cervical Traction Posture Pump Utilizes air pump as well Allows patient to lie supine Applies pressure on dorsal aspect of cervical spine

9. Different Types of Cervical Traction Mechanical Traction Must be monitored by therapist Can be used with “static” or “intermittent” setting

10. 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.

11. 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

12. Different Types of Lumbar Traction Traction Table with Pulley System Use half of patient’s body weight for distraction. Should be monitored by healthcare professional. Can be done continuously or intermittently.

13. Different Types of Lumbar Traction Inversion Table Table allows for tilting at desired angles Uses patient’s body weight and position for distraction Several contraindications for this method

14. Different Types of Lumbar Traction Posture Pump Patient-controlled Can be used easily at home Portable

15. Different Types of Lumbar Traction Manual Lumbar Traction Healthcare professional uses own body as weight In hook-lying position, patient’s knees are pushed toward their head as the pelvis is pulled in the opposite direction.

16. Different Types of Lumbar Traction Unilateral Traction Some healthcare providers utilize a manual “leg pull” method of traction. The patient must be fitted with a counter-action harness. T he 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. Straight and steady pull is performed until noticeable distraction is felt.

17. Different Types of Lumbar Traction Unilateral Position Traction Traction can also be performed using a roll or half-roll of some type. 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. If feasible, the patient can perform trunk rotations to maximally open the foramen.

18. 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.