Lumbar and Cervical Traction Flashcards
Pain Generators
Muscle; facet joint; ligaments; IV disc; Nerve Root
Effects of Traction
distraction/separation of ertebral bodies
combination of distraction and gliding of the facet joints
tensing of the ligamentous structure of the spinal segment
widening of the IV foramen
stretching of the spinal musculature
Tending of ligamentous structure
stimulates collagen repair
Wolffs law: stress tissues to get growth of new tissues
Widening of IV foramen
opens neural foramen (shut down spasm cycle)
takes pressure off the N (dec irritation and relieves N root impingement)
Effect on Centralization of Pain
radiating pain disappears, but local BP may inc slightly
considered a good thing
Effect on Peripherlization of Pain
radiating pain increases, inc irritation to N
stop traction - BAD
Indications
N root impingement Jt hypomobility - facets "stuck" DJD Muscle spasm/guarding Discogenic pain (local or reffered - STATIC )
N root impingement
herniated nucleus pulposus ligament encrouchment stenosis of IV foramen Osteophyte encrouchment spinal nerve root swelling
Herniated nucleus pulposus
60-120 lbs = vaccuum back into disc space
correction is unstable (wear corset to maintain)
disc injury = STATIC traction
Spondy
CONTROVERSY - let’s not use traction…
Contraindications
Acute injury or inflammation infectious disease osteoporosis spinal malignancy pregnancy motion contraindications (fx, surgery - fusion) vascular compromise hypermobile/unstable claustrophobia hernia/ S4 signs/ TMJ IF increases symp - STOP
Static Lumbar Traction
up to 1/2 hour
wt equal or greater than 1/2 body wt
start at 1/4 and increase as tolerable
Intermittent Lumbar Traction
gentle jt mob
alternating on/off
7-10 sec on ~5sec off/ 30 on 10 off/ 50 on 100 off
wt = or > BWt
Positional Traction
side bend over bolster to take pressure off N root
good for at home
Prone Traction
spinal disc
moves anterior and away from N root
Gravity
Medical screen before inversion bc hard to control force
inc occular pressure (HR, BP)
watch out for CV and HTN issues
Manual
if they like it - home unit
Types of cervical traction
home unity
manual
Sanders “cadillac” table
Check Vertobrobasilar Insufficiency
supine: R neck rotation 10 sec; neutral 10 sec; L 10 sec; neutral 10; extension 10
dizzy, nauseous, faint = avoid
PART 2 - r rotation with extension check for dizzy nauseous, faint, nystagmus, pupil size, count backwards from 10 - if any NO CERV traction!
Basics
Relaxation - to get benefit of traction
angle of pull (0 for upper cerv; 25 for lower)
head halters - pull at occiput
force - 10 lbs upper; no more than 40lbs for lower
