Modalities Ch. 19 Traction

Question 1

traction definition

Answer 1

use of machine/mechanical or manual force to apply a traction force to the body

Question 2

distraction forces effects

Answer 2

decrease pressure on spinal nerves
relieve entrapment of synovial tissue at the facet
reduce internal disc pressure –> central disk migration
reduce muscle spasm and guarding by stretching muscles

Question 3

effects of traction on the body

Answer 3

bone
-increased spinal movement
-positive effect on bone density
ligaments
-ligament deformation
--increased movement
--decreased impingement
articular facet joints
-increased space between point surfaces
--increased space for synovial fluid
muscles
-decreased muscle spasm
--lengthen, better blood flow
-activate proprioceptors - decrease pain
nerves
-decreased compression on nerve

Question 4

traction indications

Answer 4

herniated disc (tear/rupture)
nerve root syndromes
bulging disc (deformed)
facet joint pathology
joint hypomobility
pain relief and muscle spasms
degenerative joint disease (DJD)

Question 5

contraindications

Answer 5

both cervical and lumbar
-cancer
-uncontrolled hypertension
-osteoporosis
-acute injury
-hypermobile vertebrae
-infectious spinal disease
-rheumatoid arthritis
-aortic aneurysm
-increased pain/symptoms
cervical
-positive vertebral artery test
-positive alar ligament test
lumbar
-pregnancy
-claustrophobia
-active peptic ulcer
-hiatal or abdominal hernia

Question 6

cervical traction preapplication

Answer 6

test stability of dens and integrity of vertebral arteries first
if history includes trauma use both
-alar ligament test
-vertebral artery test
if history does not include trauma use the vertebral artery test

Question 7

alar ligament test

• used for
• procedure

Answer 7

used for
-dens fracture
-occurs with whiplash
procedure
-palpate spinous process of C2
-passively sidebend or rotate head - if doesn't move then refer to MD for possible fracture

Question 8

vertebral artery test

• used for
• procedure

Answer 8

used for vertebral artery sclerosis
procedure
-supine
-extend and rotate head
-watch for dizziness, nystagmus, blurred vision, etc.
-hold at least 15 seconds (recommended 30 seconds)

Question 9

manual cervical traction

Answer 9

always try manual before mechanical
patient should be supine
cradle your patients head in your hands or with a towel in a comfortable position
apply a gentle traction force, gradually increasing in intensity
traction should be applied in a neutral position for upper cervical pain
patient’s neck should be flexed to 30 degrees for lower cervical pain
incorporate mild lateral flexion for patients with radiculopathy (pressure on spinal nerves)