Week 5: Cervical & Lumbar Traction

What is traction

applying tensile forces to the long axis of the spine to increase space between vertebrae.

What are the primary purposes of traction therapy?

Traction is used for joint distraction, reduction of disc protrusion, soft tissue stretching, muscle relaxation, and joint mobilization.

What sensations should a patient expect during traction therapy?

Patients should feel a slight stretch in the neck, which should be relaxing and not painful.

What are the biomechanical effects of cervical traction?

Cervical traction increases the space between vertebrae and the dimensions of the intervertebral foramen

Reduces the area of disc herniation

What are the biomechanical effects of lumbar traction?

May enhance fluid exchange and nutrient transport within the disc

Passive traction can reduce pressure

Reduction of disc herniation

Minimum amount of time to monitor patient

A minimum of 2-3 minutes of observation after start is recommended to monitor patient response

If the patient reports any worsening of upper extremity symptoms during a treatment session, whether pain or paresthesia, traction should

stop

What is the recommended force range for intermittent cervical traction?

The tension amounts typically range between 10 and 25 pounds.

What is the typical duration for a cervical traction session?

The duration is usually 10 to 20 minutes.

Cycles for cervical mechanical traction

~30s high / 10s low.

60s high/ 20s low

What are some objective indicators of favorable responses to cervical traction?

Indicators include increased cervical range of motion, improved ability to perform daily activities, enhanced upper extremity reflexes, increased strength, and reduced pain.

What are some adverse events associated with traction therapy?

Adverse events can include symptom exacerbation, headaches, nausea, and fainting.

Purpose of traction

Joint distraction

Reduction of disc protrusion

Soft tissue stretching

Muscle relaxation

Joint mobilization

What are the indications for using traction therapy?

Spinal disc bulge or herniation

Spinal nerve root impingement

Joint hypomobility

Subacute joint inflammation

Muscle spasm

Radiating or radicular symptoms

What are some contraindications for traction therapy?

Acute cervical trauma, including whiplash-associated disorders

Osteoporosis or osteopenia

Peripheralization symptoms

Use of steroids or other medications that tend to compromise bone integrity

Rheumatologic disorders affecting connective tissue, including rheumatoid arthritis and ankylosing spondylitis

Joint hypermobility/instability

Pregnancy

Prior surgical stabilization or decompression

Spinal implants/prosthetic discs

Nonmechanical pain

Patients who have undergone cervical spine discectomies

Lumbar traction during pregnancy

Cancer

Fracture

Hernia, hemorrhoids, aneurysm

What precautions should be taken when administering traction therapy?

COPD and other respiratory disorders

Claustrophobia

Disorientation

Acute injury

When severe pain fully resolves with traction

Inability to tolerate prone or supine

Medial disc protrusion

Annular ligament displacement

What is the recommended force range for lumbar traction?

The force should be between 30% to 50% of body weight.

What is the typical duration for a lumbar traction session?

The duration is usually 11 to 20 minutes.

What are the typical cycles for lumbar traction?

A typical cycle is approximately 30 seconds at maximum tension followed by 10 seconds at lower tension.

Position for lumbar mechanical traction

supine (90/90) or prone.

What are the signs of a positive response to lumbar traction?

Signs include reduced pain, increased ambulatory tolerance, and improved reflexes or sensation.

What is the dosage for cervical manual traction?

Reps: 5-10

Hold Times: 10-30 seconds

Sets: 3-5

Total Duration: 5-20 minutes

common mechanical traction combos

30 seconds hold time 10s rest time

60s hold time hold 20 seconds rest

lower cervical problem for traction

more flexion required

upper cervical problem

less flexion required

What is the recommended cervical flexion angle during traction therapy?

The general cervical flexion angle should be between 20-30 degrees.

What is the initial traction force for acute cervical conditions?

The initial traction force is typically 3-4 kg or 6.6-8.8 lbs.

What is the force range for joint distraction during cervical traction?

The force for joint distraction is 9-13 kg or 20-29 lbs, approximately 7% of body weight.

What is the initial traction force for acute lumbar conditions?

The initial traction force is typically 13-20 kg or 29-44 lbs.

Hold/rest times for joint distraction

15/15 for 20-30 mins

Hold/rest times for decreasing muscle spasm

5/5 for 20-30mins

hold times for disc problems or soft tissue stretching

60/20 for 20-30 mins

What is the force for joint distraction during lumbar traction?

22.5 kg or 50 lbs; 50% body weight

What is the force for reducing muscle spasm during lumbar traction?

The force for reducing muscle spasm is 25% of body weight.

What is the force for disc problems or soft tissue stretching during lumbar traction?

What is the force for reducing muscle spasm during lumbar traction?

What should be done if a patient reports worsening symptoms during traction?

If a patient reports worsening symptoms, traction should immediately cease.

What is the typical treatment cycle for mechanical traction?

Common cycles include 30 seconds hold time with 10 seconds rest or 60 seconds hold time with 20 seconds rest.