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Abstrait

Lumbar Traction in the Management of Low Back Pain: A Survey of Latest Results

Luca Cavagnaro, Marco Basso, Mattia Alessio Mazzola and Matteo Formica

Introduction : Low back pain (LBP) is one of the most common complaints in the general population, affecting about 70-80% of the population at some point in life. LBP management comprises a wide range of different intervention strategies. One of the treatment options is traction therapy. The aim of our short review is to summarize and analyze the latest result reporting the use of lumbar traction in LBP treatment in order to evaluate the real effectiveness and indications of this specific physical therapy.

Materials and methods: A comprehensive search of PubMed, Medline, Cochrane, Embase, and Google Scholar databases was performed, covering the period between 2006 and 2013. 54 citations were obtained. Relevant data from each included study were extracted and recorded.

Results: A total of 14 studies were included in the review. Among these 14 studies, 11 were randomized clinical trials, 1 was a retrospective cohort study and 2 were case series. The majority of included studies used traction on patients that suffered nerve root compression symptoms. The mean number of traction sessions was 19. At most, the duration of each session was 30 min (range 3-30 min). The mean period of traction treatment was 6 weeks(range 3-12 weeks). 11 studies coupled with traction other therapies. Only 3 studies used traction as a single treatment. The mean follow up period was 16,5 weeks from the end of treatment.

Conclusion: Several biases can be introduced by limited quality evidence from the included studies. Lumbar traction seems to produce positive results in nerve root compression symptoms. Data in degenerative and discogenic pain are debatable. To date, the use of lumbar traction therapy alone in LBP management is not recommended by the best available evidence.