1 traction. 2 effects of spinal distraction joint distraction – separation of two articular...

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1 Traction

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Page 1: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Traction

Page 2: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Effects of Spinal Distraction

Joint Distraction– Separation of two

articular surfaces– Can treat facet joint &

spinal nerve root symptoms

– Distraction force - 50% of BW for L-spine & 7% for C-spine

Page 3: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Effects of Spinal Distraction

Reduction of Disc Protrusion– Suction due to

decreased intradiscal pressure

– Force of 60-120 #’s have been shown to reduce lumbar disc protrusion

Page 4: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Effects of Spinal Distraction

Soft Tissue Stretching– Muscles, tendons,

ligaments, discs– Increase soft tissue

length & increase joint mobility

Page 5: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Effects of Spinal Distraction

Muscle Relaxation– Can facilitate muscle

relaxationMay be due to

reduction of painMay be due to

prolonged stretch (may fire the GTO)

Page 6: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Effects of Spinal Distraction

Joint Mobilization– Stretching of soft

tissues with traction can increase joint mobility

Page 7: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Effects of Spinal Distraction

Patient Immobilization– Very low-load traction

(10-20 #’s) has been used to immobilization pts with spinal disorders (Bucks Traction)

– Presently, not as popular

Page 8: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Clinical Indications for the Use of Spinal Traction

Disc Bulge or Herniation– Traction may be more beneficial for disc bulge than

herniation– The greater the damage to the disc, the less

effective traction may be.

Page 9: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Clinical Indications for the Use of Spinal Traction

Nerve Root Impingement

Page 10: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Clinical Indications for the Use of Spinal Traction

Joint Hypomobility– Traction cannot isolate a local area of

hypomobility– Traction can improve mobility throughout the

treated area (c-spine, l-spine)

Page 11: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Clinical Indications for the Use of Spinal Traction

Subacute Joint Inflammation– Traction may reduce strain on injured

tissues &/or joints

Page 12: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Clinical Indications for the Use of Spinal Traction

Paraspinal Muscle Spasm– Can reduce muscle spasm by reducing by &/or firing

the GTO

Page 13: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Clinical Indications for the Use of Spinal Traction

Page 14: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Contraindications for the Use of Traction

Where motion is contraindicated– Example – unstable fracture, spinal cord

compression, or shortly after spinal surgery

Page 15: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Contraindications for the Use of Traction

With an acute injury or inflammation– Example – shortly after trauma, surgery, RA, OA

Page 16: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Contraindications for the Use of Traction

Joint hypermobility or instability– Example – fractures, dislocation, surgery,

pregnancy, lactation, RA, Down’s syndrome

Page 17: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Contraindications for the Use of Traction

Peripheralization of symptoms with traction

Page 18: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Contraindications for the Use of Traction

Uncontrolled hypertension (for inversion traction)

Page 19: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Precautions for the Use of Traction

Structural diseases or conditions affecting the spine(tumor, infection, rheumatoid arthritis, osteoporosis, or prolonged systemic steroid use)

Page 20: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Precautions for the Use of Traction

When pressure of the belts may be hazardous (pregnancy, hernia, vascular compromise, osteoporosis)

Page 21: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Precautions for the Use of Traction

Displacement of annular fragment– Traction is not likely to change the position

of the fragment

Page 22: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Precautions for the Use of Traction

Severe pain relieved by traction– May indicate the spinal nerve root becoming

more compressed as a result of the traction intervention

Page 23: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Precautions for the Use of Traction

Claustrophobia

Page 24: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Precautions for the Use of Traction

Patients who cannot tolerate the prone or supine position– Pain in prone or supine position or acid

reflux

Page 25: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Precautions for the Use of Traction

Disorientation

Page 26: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Precautions for the Use of Traction

Temporomandibular joint (TMJ) problems and dentures

Page 27: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Page 28: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Adverse Effects of Spinal Traction

Worsening of symptoms New symptoms (radiculopathy due to

excessive strain on the spinal cord dura)

Page 29: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Application Technique: Mechanical Traction

Mechanical Lumbar Traction Procedure

Page 30: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Application Technique: Mechanical Traction

Mechanical Cervical Traction Procedure

Page 31: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Application Techniques: Self-Traction

Examples of Self-Traction– Sitting Self-Traction– Self-Traction Between

Corner Counters– Self-Traction With

Overhead Bar

Page 32: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Application Techniques: Positional Lumbar Traction

Page 33: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Application Techniques: Manual Traction

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Traction

MRI results before and after cervical traction

Page 35: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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VAX-D

Page 36: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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VAX-D

Page 37: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Page 38: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Page 39: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Page 40: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Sari et al. Computed tomographic evaluation of lumbar spinal structures during traction. Physiother Theory Pract. 2005 Jan-

Mar;21(1):3-11.

Page 41: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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Page 42: 1 Traction. 2 Effects of Spinal Distraction Joint Distraction – Separation of two articular surfaces – Can treat facet joint & spinal nerve root symptoms

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