Transcript Spinal Traction - Therapeutic Modalities

Spinal Traction
Overview
Chapter 17
Purpose
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Force that separates the vertebrae, opening the
intervertebral space
Effects:
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Decreased pressure on intervertebral disks
Decreased pressure spinal nerve rots
Opens facet joints
Elongates tissue
Body areas:
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Cervical
Lumbar/pelvis
Types of Traction
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Sustained
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Intermittent
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Alternately applied and
withdrawn traction
Manual
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Continuous, small force for
an extended period (appx.
45 min)
Administered by the
clinician
Positional
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Body positioning to
elongate the involved tissue
General Principles
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Angle of pull
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Neutral: Transverse plane
Flexion/Extension: Frontal plane
Unilateral: Sagittal plane
Multiaxial: Two or more planes
Anatomical differences
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Cervical inferior facet joints angle anteriorly
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Flexion opens facet joints
Lumbar facets angled posteriorly
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Extension opens facet joints
General Principles
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Tension
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No clear formula
The traction must
overcome the resistance
exerted by the soft tissue
Use the least amount of
tension needed to relieve
symptoms
Duration is inversely
related to tension
Physiological Effects
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Encourages movement of spine between each vertebra
Improves circulation
Increases metabolism
Enhances nutrition
ROM increases dependent on:
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Patient position
Amount of force applied
Type of traction
Treatment time
Indications
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Disk protrusions
Degenerative disk disease
Nerve root compression
Facet joint pathology
Muscle spasm
Contraindications
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Acute injury
Unstable spinal segments
Cancer, meningitis, or other spinal cord/
vertebrae disease
Vertebral fracture
Extruded disk fragments
Intervertebral Disks and Disk Lesions
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Anatomy
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Annulus fibrosus
Nucleus pulposus
Dehydration
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Decrease range of motion narrowing intervertebral
foramen
Weakens annulus fibrosis
Day vs. night
Age
Disk protrusion
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Body weight and muscle tone compress the disk
and force the nucleus pulposus posteriorly
Traction
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Decreases the pressure
Increases disk hydration
Imbibe
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Traction applied for too long can absorb too much fluid
Intervertebral Foramen Stenosis
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Anatomy:
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Disk degeneration
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Intervertebral foramen:
Opening for 31 pairs of spinal nerve roots
Narrowing of intervertebral space
Osteophytes
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Decrease opening
Inflammation of nerve sheath’s
Facet Joint Pathology
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Healthy facets transmit approximately 20%
of the body weight
Inflamed facets transmit approximately 47%
of body weight (lumbar spine)
Traction can open the facet joints
Muscle Spasm
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Long, slow stretching can reduce tonic
muscle contraction by elongating the involved
fibers
Intermittent traction promotes relaxation
during the OFF phase
Increased diameter of the intervertebral
foramen decreases muscle spasm
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Reduced pressure on spinal nerve roots
Maintenance
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Cleaning
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Follow manufacturer’s instructions for unit and
harness
Avoid liquids from entering unit
Check cords and traction cable
Recalibrate unit
Unit must be inspected and serveced by a
technician annually