Ah – intermittent spinal traction – what a technique. Traction is not the done thing these days due to a number of guideline reccomendations. This may be a pity.
I have fond memories of traction though – It was great – You could put a patient on traction and go and have a smoke or see another patient at the same time. Many therapists have gone out for lunch and come back and realised they still had a patient on traction (“We won’t be charging you for long consult!). My traction techniques have pulled a man’s pants down and in another case a bad reaction followed – my patient had been held by his ankles over the side of a building site. If only I was more biopsychosocial in the old days, traction may not have been the treatment selection.
James Cyriax of course was a great tractioner. I can still see an X-Ray image in his book of a lumbar spine before and during traction – wow – traction seemed to let a lot of air in and give everything space. If anyone has the image I would love you to post it. Traction machines come in all shapes, sizes and complexity and still do. The simple one drawn in Geoff Maitland’s books was two pieces of wood rolling on wooden dowels. Geoff tried to sell it to me once for 50 bucks but I declined and a famous piece of physiotherapy equipment went to the dump.
But I am pleased that there is research suggesting that there may be subgroups of patients who may benefit from lumbar traction (Fritz, J. et al 2007 Spine 32:E793). One group had suggestions of nerve root compression, and presented with leg symptoms and crossed straight leg raise. Have you ever thought what a powerful word it is too – “I am going to give you some traction” has a ring about it.
We would love your traction stories and discussion.