The Effectiveness of Mechanical Traction Among Subgroups of Patients With Low Back and Leg Pain: A Randomized Trial.

The recommended initial management strategy for these patients with low back pain and signs of nerve root compression is conservative treatment but there is little evidence to guide the most appropriate management strategy. Preliminary research suggests a treatment protocol of mechanical traction and extension-oriented exercises may be effective management, particularly in a specific sub-group of patients. The objective of this study was to  examine the effectiveness of mechanical traction in patients with lumbar nerve root compression and within a pre-defined sub-group. Methods 120 patients with low back pain with nerve root compression were recruited from physical therapy clinics. Using pre-defined sub-grouping criteria, patients were stratified at baseline and randomized to receive an extension-oriented treatment approach (EOTA) with or without the addition of mechanical traction. During a 6-week period, patients received up to 12 treatment visits. Primary outcomes of pain and disability were collected at 6 weeks, 6 months and 1 year by assessors blinded to group allocation. Outcomes were examined using linear mixed model analyses examining change over time by treatment and the interaction between treatment and sub-grouping status. The mean age of participants was 41.1 (SD 11.3) years, median duration of symptoms was 62 days, and 57% were male. No significant differences in disability or pain outcomes were noted between treatment groups at any time point, nor was any interaction found between subgroup status and treatment.

Patients with lumbar nerve root compression presenting for physical can expect significant changes in disability and pain over a 6-week treatment period. There is no evidence mechanical lumbar traction in combination with an extension-oriented treatment is superior to extension-oriented exercises in management of these patients, nor within a predefined subgroups of patients.

Neck Pain

Out of all 291 conditions studied in the Global Burden of Disease 2010 Study, neck pain ranked 4th highest in terms of disability and 21st in terms of overall burden.

Comments

Josh
Josh
February 22, 2016 at 6:53 pm

Are you sure about the reference? Can that be reviewed. I would be interested in this article.

Bernhard Reichert

This is the correct reference: Thackeray A, Fritz JM, Childs JD, Brennan GP. The Effectiveness of Mechanical
Traction Among Subgroups of Patients With Low Back Pain and Leg Pain: A
Randomized Trial. J Orthop Sports Phys Ther. 2016 Mar;46(3):144-54. doi:
10.2519/jospt.2016.6238. Epub 2016 Jan 26. PubMed PMID: 26813755.

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