Is There a Subgroup of Patients With Low Back Pain Likely to Benefit From Mechanical Traction?

Abstract

A subgroup of patients likely to benefit from mechanical traction may exist. The results of this study suggest this subgroup is characterized by the presence of leg symptoms, signs of nerve root compression, and either peripheralization with extension movements or a crossed straight leg raise. Further research is needed to validate this finding.

Outcomes differ between subgroups of patients with low back and leg pain following neural manual therapy: a prospective cohort study

“…Also in chronic cases with long-term damage to the nervous system such as scar formation, endoneurial fibrosis and Wallerian degeneration [24], it is unlikely that any form of nerve mobilisation will be of benefit. Instead, if a nerve root is acutely compressed and oedematous, interventions (such as traction), aimed at unloading nerve structures to promote resolution of the effects of compression could be helpful [25].…”

The clinical effectiveness and cost-effectiveness of management strategies for sciatica: systematic review and economic model

“…The duration of follow-up ranged from 1 week 242 to 4 weeks. 245 Three further studies [254][255][256] combined the use of mixed treatments that incorporated traction with an alternative treatment.…”

“…176,[242][243][244][245][246][247][248][249][250] One further study compared mixed treatment that included traction, with mixed treatments or with other comparators without traction (Table 57a). [253][254][255][256] Three studies compared different types of traction (Table 57b). 248,251,252 Summary of study participants for traction Summary data for included participants are presented in Table 58.…”

“…Six RCTs, 68,242,255,256,264,265 one of which was a crossover trial, 265 compared the use of active physical therapy with other interventions (Table 99).…”

No effect of traction in patients with low back pain: a single centre, single blind, randomized controlled trial of Intervertebral Differential Dynamics Therapy®

“…However, reports of high-quality RCTs to evaluate traction therapy are scarce [5,7]. For example, reported studies lacked a randomized comparison group [2,19], had a retrospective design [10,11,15,16], sample sizes were too small [6,10,11], heterogeneous patient groups were studied [3,6,19] or the authors were commercially related to the evaluated therapy [11,16]. Moreover, within this particular field there is still controversy since various different traction techniques and corresponding protocols exist.…”