Basis, indications and risk

Treatments Basis, indications and risk Patient information Postural hygiene Exercise Maintaining level of Activity Bed rest Pharmacological therapy Neuroreflexotherapy (NRTI) Spinal column surgery Surgery for Pain and Pain Clinics Vertebral manipulation Behavioral treatment Epidural injections Facet joint infections Trigger point and ligament infections Rhizotomy Corsets and lumbar belts Traction Physical therapy/physiotherapy Electromyografic Feedback TENS: Transcutaneous electrical Nerve Stimulation Shoe insoles and shoe lifts Acupunture Recommended treatments

Traction

It consists of the mechanical stretching of the spinal column.

Objective

To improve pain and muscle contracture.

Theoretical base

When contracting, the muscle shortens its length. The idea is that contracture may resolve through mechanical muscular stretching.

However, the functioning of a muscular contraction is quite more complex. Under normal conditions, nerves control muscle action, so that when nerves are activated, muscles contract. When this occurs, the nerves conducting muscle sensitivity perceive their contracture -by increased tension of the muscle fibers- and the movement performed -by the nearing of bones caused by the muscle contracture-.

Traction detractors argue that if muscle contracture persists it is through the activation of the nerve that controls that muscle. If the muscle is stretched in this situation, the Nervous System perceives the distancing of the bones where the muscle is inserted and sends out orders for a greater contracture. Traction advocators claim that in those cases where perpetuated contracture has provoked muscle shortening, the situation is no longer due to nerve activation, and traction may be useful.

Efficacy evidence

Available studies show that traction is not useful, even to treat cervical or lumbar disorders. In fact the existing recommendations based on scientific evidence all agree traction to be ineffective for cervical and lumbar pain.

Risks and contraindications

Traction may trigger the onset of radiated pain in patients without this type of pain prior to this therapy, or may worsen existing radiated pain.

Indications

There are no indications due to unproven efficacy. The existing recommendations based on scientific evidence do not include it as appropriate treatment for back pain.

Those recommendations contraindicate the use of traction in the treatment of back pain with the patient in bed. Besides being inefficient, it adds to the risks of bed rest and the inconvenience of inmobility and increases the risk of joint flexibility loss, bone and muscle mass loss, blood pressure alterations and thromboembolism.