Great question. We frequently encounter this question from patients dealing with new or long standing history of low back pain (note: leg pain not included).
The response is two fold: 1. What does the scientific evidence say about this, and 2. How do I respond to a neighbor that swears against traction or is all for the procedure?
The evidence: There is conflicting evidence to suggest that traction is beneficial for low back pain. In simple terms, traction specifically is not proven to help low back symptoms. In a review performed by Clark and his colleagues, there were no difference between people who used traction, people who were tricked into thinking that were receiving traction, and people who received no traction at all. That means people who did nothing at all did just as well as people who used traction. Interesting.
Additionally, Beurkensens and all also performed a study comparing traction vs. “fake” traction, finding that after 5 weeks of treatment, there was no difference in pain, perceived recovery, or disability. The findings remained unchanged when Beurkensens followed up with patients 6 months and 12 months afterwards.
The take home: Traction alone will most likely not improve your back pain. If you have found that traction did improve your low back pain in the past, it’s possible that it was not due to the physical separation of the spinal segments. Most likely, the improvement was related to other factors associated with the experience (stretching/mobility in muscles and joints of the low back, developing psychological control over one’s symptoms, etc). This, of course, can be accomplished without a traction machine.
With this information, we will always encounter the neighbor or relative that swears by traction, and is convinced that it helped him or her recover when nothing else could. If they found something that works for them, that’s great! With that said, if these same people were to foam roll their lower back, perform strengthening exercises, stretch their low back, etc, there’s a good chance that would improve their symptoms too. It’s also more cost effective than buying an inversion table or paying for a health care visit for traction alone. Use what you have available to you to improve your symptoms.
If you’re dealing with low back pain and need more suggestions, please give us a call at (908) 328-3074 or send us an email here.
References:
Clarke J, van Tuider M, Blomberg S, de Vet H, van der Heijden G, Bronfort G. Traction for low back pain with or without sciatica: an updated systematic review within the framework of the Cochrane collaboration. Spine (phila Pa 1976). 2006; 31:1591-1599
Beurskens AJ, de Vet HC, Koke AJ et al. Efficacy of traction for non-specific low back pain: a randomised clinical trial. Lancet. 1995; 346:1596-1600
Physical therapy to include traction for low back pain in Columbia and Baltimore, Maryland
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