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Lumbar Traction: Guidelines versus Practice

Very few studies support the use of traction for low back pain (LBP). But according to healthcare researchers this may have more to do with poor study methods than to poor results with traction. As a result there are no clinical guidelines to help physical therapists know how and when to use traction.

In this study therapists in the United Kingdom (UK) were surveyed about their use of traction. Almost half use lumbar traction for LBP patients with sciatica. Traction was not used right after a back injury (acute phase) or for chronic LBP patients. Patients receiving traction were labeled subacute.

Most patients were treated two to three times a week for four weeks. Length of time (minutes) for the treatment was based on how severe the condition was. For example, traction was used longer for stiffness (up to 20 minutes) than for nerve root irritation (less than 10 minutes). Traction was never used alone as the only treatment. It was usually combined with other treatments such as mobilization, advice, and exercise.

The authors conclude that physical therapists in the UK use traction even though the research doesn't support its use. Future studies on traction should divide LBP patients into groups by diagnosis. Those with nerve root irritation should be separate from patients with nonspecific LBP. Traction should be studied alone as the only treatment and compared with combined treatments.

References: Annette Agnes Harte, BSc, et al. Current Use of Lumbar Traction in the Management of Low Back Pain: Results of a Survey of Physiotherapists in the United Kingdom. In Archive of Physical Medicine and Rehabilitation. June 2005. Vol. 86. No. 6. Pp. 1164-1169.

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