Lumbar Traction?Not Effective??!

Reference:Reference: Komori H, Shinomiya K, Nakai O 1996 The natural history of herniated nucleus pulposis with radiculopathy. Spine 21: 225-229

There are several studies concluding with the same thing?lumbar traction does not help non-specific low back pain. (Komori et al 1996).

Personal Comment: I will however continue to use traction as a treatment for SOME of my patients!

All these traction studies are so frustrating to read, as they are ludicrous! They practically take every single patient diagnosed with ?low back pain? and throw him or her into the study. Half of them receive traction and half don?t, when they find no difference between the two groups they conclude, traction is a waste of time!

I agree traction is a waste of time, if applied to every single patient with low back pain (LBP). Clinically this would seem ridiculous, no one ever treats every LBP patient with traction?but these studies assume clinically this is what we do!

The challenge comes down to the fact all ?low back pain? patients are put in one big bowl. The fact that there are several potential causes and sources of low back pain is ignored. Only a small percentage of my patients with low back pain receive lumbar traction from me (10-20%). I experience great results with these selected few patients!

How effective lumbar traction is, ultimately depends on what the patient selection criteria is.

A simple selection criterion is… if manual lumbar traction ?feels good? consider mechanical traction? if manual lumbar traction has no effect or ?it hurts?, consider another treatment option!

Personal Comment:Traction the right patients, get good results, traction every patient, get poor results!

Posted on: July 21, 2002

Categories: Lumbar Spine

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