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Back Pain Therapy

Watch your back - not everyone is your friend. But the therapist who tries traction on your back and relieves your back pain will be your best friend.

Although they call it the rack, traction is actually reasonably comfortable. Especially if you do it to somebody else. (Only joking!)

There are no scientific guarantees that traction is effective for low back pain or for relieving pressure on the nerve roots of your spine. We don't know exactly how much traction force therapists should apply or for how long to treat the various back problems for which it's used. But traction is commonly used by therapists to relieve symptoms of neck and back pain, so someone thinks it must work.

ON THE RACK

Traction is set up on your lumbar spine by passing a strap across your chest and placing a second strap around your pelvis. The strap around your chest is fixed. A weight is then applied to the strap around your pelvis to pull your spine to its full length. This relieves the pressure on the intervertebral discs of your lumbar spine.

HOW AND WHERE?

People in orthopaedic wards in hospital are sometimes treated with traction, when weights are attached to the pelvis or legs for long periods. But traction can be applied for short periods, say 15-20 minutes, to people who are not bedridden. This might be done during visits to a treatment clinic such as a physiotherapy department. Then the period of treatment will be stretched out, probably being repeated up to three times per week for several weeks.

Nowadays, most traction is done in the physiotherapy outpatient clinic. In the past, when people were stuck in hospital having long periods of traction, their muscles wasted. Then, when they did finally get off the traction and out of bed, their muscles were so weak they couldn't keep their spine stable, and they lost the benefits from the treatment.

Outpatient traction is usually applied electronically. You lie on the treatment couch. The traction machine (note: machine, not engine!) is attached to the strap around your pelvis by a rope. The machine is then adjusted to the correct weight for you, depending on your problem and body size. Some therapists apply a constant weight for the whole 20 minutes or so of the treatment session, others use intermittent traction. In this case, the traction will pull at its maximum for about 30 seconds, followed by a comparative rest period of half-pull power for around 10 seconds. This on-almost-off pattern is continued for the length of the session.

A good traction couch splits in the middle. As the weight is applied, the lower section of the bed moves on rollers to accommodate the tension that is applied to your back. This means that not so much weight is needed to actually pull on your spine, as the friction of the manoeuvre is reduced.

It's difficult to get the straps round very fat people (obviously nobody's ever heard of longer straps), so if this describes you, tough!

THE GRAVITY OF THE SITUATION

You can apply gentle traction to yourself at home, taking care not to harm your back. Hanging by both of your arms from a door or other strong, tall structure could give temporary relief from your back pain. Place a cloth over the door, near to the hinges. (Pulling the door off and wrestling with it on your knees ain't gonna do you much good.) Grip the top of the door over the cloth with your hands and slowly lift your body off the ground. Alternatively, place two upright chairs near enough together that you can sit on the floor between them with an elbow and forearm on each seat. Gently lift your bottom off the ground and let your body hang.

CAN TRACTION DO HARM?

Traction can give you increased pain if the outer layer of the nerve is stuck to the tissue around it through inflammation. Then, when the weights pull on the spine, you will yelp. Sometimes the benefits you gain during the traction are lost by the time you have struggled off the bed. But then, you're not in any condition to complain, are you?

WHEN DOES TRACTION HELP?

If you have an arthritic spine, traction might help. The stretching movements of the traction may well help if you've been immobile.

With an intervertebral disc problem, where the centre of the disc is bulging but has not actually slipped out between the two vertebrae, relieving the pressure on it by using traction can help it settle back into place.


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