Relieve Lumbar Neural Irritations Symptoms?by positional distraction!
Reference:Mitchell U, Wooden M, McKeough D 2001 The short term effect of lumbar positional distraction. The Journal of Manual & Manipulative Therapy 9(4); 213-221
30 patients presenting with signs & symptoms of lumbar nerve root irritations participated in this study (All with pain and specific dermatomal and/or myotomal signs)
They were randomly allocated into 2 groups:
Control Group: Patients were asked to ?comfortably lie on their pain-free side? for 5 minutes
Positional Distraction Group: These patients were also positioned in side lying with the effected side on top for 5 minute, however?
A towel roll was placed just above the iliac crest to produce side flexion away, in order to ?open up? the intervertebral foramen.
Both hips were passively flexed until the flexion was palpated at the suspected level of pathology.
The PT then moved the lowermost shoulder forward in order to rotate the lumbar spine to the level to be treated. i.e. rotation towards the painful side.
Result:: The treatment group had significantly less pain, more centralization of pain and significant increase in SLR test ROM (P<0.005).
The control group showed no significant changes after 5 minutes of regular side lying.
Clinical Relevance: Positional distraction may be given to patients as a home program to help self-manage symptoms of nerve root irritation.
Clinical Relevance #2: When applying modalities (e.g. IFC/TENS) it may be wise to position patients with neural irritations in the positional distraction position instead of the usual prone or normal side lying position.
Other effective management options for lumbar nerve root irritations are reviewed in the APTEI Video/Book program, ?Lumbar Neural Tissue Pathodynamics?.
Posted on: January 24, 2003
Categories: Lumbar Spine