Traction Flashcards
What is traction?
a mechanical force applied to the body in a way that separates the joint surfaces and elongates surrounding soft tissue
Who is the “father” of traction?
James Cyriax
6 Types of Lumbar Traction
- Mechanical
- Positional
- Auto-traction
- Manual
- Inversion
- Gravity
3 Types of Cervical Traction
- Mechanical
- Manual
- Take home units (over the door/wall mounted)
Mechanical traction can be describe as either _____ or _____.
static or intermittent
5 things spinal traction can do
- Distract joint surfaces
- Reduce protrusions of nuclear disc material
- Stretch soft tissue
- Relax muscles
- Mobilize joints
Spinal traction pulls longitudinally on the spine which will result in what 3 things?
- Reducing pressure on the discs and facet joints
- Enlarging the intervertebral foramina
- Stretching the ligaments, tendons, and muscles
Define joint distraction
The separation of two articular surfaces perpendicular to the plane of the articulation
__% body weight can increase the length of the lumbar spine
25%
__% body weight is necessary to distract the lumbar facet joints
50%
_% body weight is necessary to distract the cervical facet joints
7
Cyriax beleived that traction is the treatment of choice for what?
small nuclear protrusions
Disc protrusion symptoms are not improved under what 3 circumstances?
- There is a large HNP
- Calcification of the disc protrusion is present
- If the forces are too low
2 ways spinal traction can cause an improvement is symptoms
It can reduce pressure on pain-sensitive structures, or it can gate pain transmission by mechanoreceptor stimulation
Describe how intermittent traction gates pain
It interrupts the pain-spasm-pain cycle and stimulates the GTOs to inhibit alpha motor neuron firing
Describe how static traction gates pain
It depresses the monosynaptic response caused by static stretch
When is spinal traction indicated?
- when a patient experiences back or neck pain due to a disc bulge or herniation
- nerve root impingement
- joint hypomobility
- subacute joint inflammation
- paraspinal muscle spasm
When is traction most effective?
When applied soon after disc injury
Increased flexion localizes the force to what part of the spine?
upper lumbar and lower thoracic spine
Neutral or extension localizes the force to what part of the spine?
lower lumbar spine
When should intermittent traction be used?
typically with chronic inflammation
When should intermittent traction be avoided?
During the acute inflammatory phase
If a patient is experiencing paraspinal muscle spasms and you apply high-load spinal traction what will the effect be?
It may alleviate protective paraspinal muscle spasms by reducing the cause of the underlying pain (HNP)
Why should a patient be instructed to avoid sneezing and coughing while on full traction?
It increases intraabdominal pressure and intradiscal pressure
5 contraindications for spinal traction
- Unstable fracture, cord compression, post-spinal surgery
- Acute injury or inflammation
- Joint hypermobility or instability
- Peripheralization of symptoms with traction
- Uncontrolled Hypertension
3 precautions for spinal traction
- When pressure from belts may be hazardous (pregnancy, hiatal hernia, etc.)
- Structural diseases affecting the spine (tumor, RA, osteoporosis, prolonged steroid use, infection)
- Displacement of annular fragment
- Severe pain fully relieved by traction
- Claustrophobia
- Intolerance of position
- Disorientation
- TMJ or Dentures with cervical traction
Why is severe pain fully relieved by traction a precaution?
It may indicate a complete compression on a nerve root
When should you use static traction?
If…
- the area is easily inflamed
- symptoms are easily aggravated
- symptoms are related to disc protrusion
When symptoms are related to a disc protrusion how long should hold times be with intermittent traction?
long hold times
When symptoms are related to joint dysfunction how long should hold times be with intermittent traction?
short hold times
How long should treatment time be for a patient with a disc protrusion?
5-10 minutes
How long should treatment time be for a patient with other indications?
20-30 minutes
For a patient with in the acute phase what should the force, hold/relax sequence, and treatment time be for lumbar traction?
Force: 29-44 lbs
Hold/Relax: Static
Time: 5-10 minutes
For a patient who requires joint distraction what should the force, hold/relax sequence, and treatment time be for lumbar traction?
Force: 50% of their body weight
Hold/Relax: 15/15
Time: 20-30 minutes
For a patient who wants to decrease muscle spasm what should the force, hold/relax sequence, and treatment time be for lumbar traction?
Force: 25% of their body weight
Hold/Relax: 5/5
Time: 20-30 minutes
For a patient with a disc problem what should the force, hold/relax sequence, and treatment time be for lumbar traction?
Force: 25% of their body weight
Hold/Relax: 60/20
Time: 20-30 minutes
For a patient who wants a soft tissue stretch what should the force, hold/relax sequence, and treatment time be for lumbar traction?
Force: 25% of their body weight
Hold/Relax: 60/20
Time: 20-30 minutes
For a patient with in the acute phase what should the force, hold/relax sequence, and treatment time be for cervical traction?
Force: 7-9 lbs
Hold/Relax: Static
Time: 5-10 minutes
For a patient who requires joint distraction what should the force, hold/relax sequence, and treatment time be for cervical traction?
Force: 7% of their body weight
Hold/Relax: 15/15
Time: 20-30 minutes
For a patient who wants to decrease muscle spasm what should the force, hold/relax sequence, and treatment time be for cervical traction?
Force: 25% of their body weight
Hold/Relax: 5/5
Time: 20-30 minutes
For a patient with a disc problem what should the force, hold/relax sequence, and treatment time be for cervical traction?
Force: 11-15 lbs
Hold/Relax: 60/20
Time: 20-30 minutes
For a patient who wants a soft tissue stretch what should the force, hold/relax sequence, and treatment time be for lumbar traction?
Force: 11-15 lbs
Hold/Relax: 60/20
Time: 20-30 minutes
