Effect of new traction technique of prone position on distraction of lumbar vertebrae and its relation with different application of heating therapy in low back pain
Affiliations: [a] Department of Physical Medicine and Rehabilitation, University of Dicle, Faculty of Medicine, Diyarbakir, Turkey | [b] Department Radiology, University of Dicle, Faculty of Medicine, Diyarbakir, Turkey | [c] Department of Neurosurgery, University of Dicle, Faculty of Medicine, Diyarbakir, Turkey
Correspondence:
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Address for correspondence: Remzi Cevik, MD, Physical Medicine and Rehabilitation, Dicle University School of Medicine, 21280 Diyarbakir, Turkey. Tel.: +90 5322282856; Fax: +90 412 2488579; E-mail: ftremzi@dicle.edu.tr
Abstract: Objective:In medicine, traction is used for act of pulling force for producing distraction or separation between two or more parts of body. However, it is limited to the cervical or lumbar spine in physiotherapic application. We aimed to investigate effect of new traction technique on anatomic structures of lumbar vertebrae, and its’ relation to different application of heating therapy. Method:Ninety five consecutive patients with persistent low back pain participated in this study. Traction applied on new table in prone position. Heating therapy applied concomitantly with traction (group I, n: 32) and sham traction (group III, n: 31), and before traction (group II, n:32). Lateral lumbosacral radiographs were obtained before and during traction. Results:Significant distraction in each disc space; decreasing in both lumbosacral angles and increasing in L1–S1 total distance were found with lying on new table without traction in three groups. Significant widening of all disc spaces and L1–S1 total distances were also obtained during traction in group I, while there were significant widening in L1–L2 anterior, L3–L4 anterior and posterior, L5–S1 posterior disc spaces, and L1–S1 anterior and posterior total distances during traction in group II and in posterior disc space of L5–S1 during sham traction in group III as compared to lying on table without traction. Conclusion:This is a preliminary study to investigate efficacy of new traction technique in prone position. Significant increasing in lumbar intervertebral disc spaces and changes in other anatomic structures were obtained on new table. Efficacy of traction application seemed to be increased by synchronized heating therapy. Creation of negative intradiscal pressure is important to suck back herniated disc material with distraction of lumbar vertebrae in prone position. Future clinical studies should be carried out to investigate efficacy of this traction technique in treatment of low back pain.
Keywords: Traction, prone position, low back pain, distraction, heating
