When it comes to a condition like low back pain, the care a patient receives can depend on case history and examination findings, as well as the doctor’s training and treatment preferences. For the patient with a lumbar disk pathology, Dr. Tim Harcourt may employ lumbar traction in combination with manipulation and joint mobilization techniques.
Lumbar traction (LT) is often performed on patients with radicular pain, or pain that radiates into the leg due to intervertebral disk conditions such as a herniated disk, degenerative conditions such as osteoarthritis, and/or spinal stenosis (a combination of aging factors that result in narrowing of the foramen, or holes that nerves travel through). The specific benefits of LT include increasing the disk space, which produces a negative pressure within the disk to draw in a disk protrusion, stretching ligaments, widening the foramen, and encouraging movement of the facet joints. Unfortunately, there is no hard and fast rule that exists for when and/or how to apply traction, leaving this decision up to each clinician to judge what, when, and how—that is until recently!
A group of researchers tackled the job of developing a clinical guideline to identify patients with lumbar disk herniation (LDH) that would most likely benefit from mechanical lumbar traction (MLT). Doctors applied MLT on over 100 LDH patients over the course of two weeks and measured the benefits using history and physical examination as well as various questionnaires that measure pain intensity, function, and psychological parameters. The research team defined “responders” as those who improved at least 50% over the initial, baseline evaluation.
Of the 103 participants, 24 were responders (23.3%), and from this group, the researchers used the following five features to establish clinical prediction rules: 1) limited lumbar extension (backward bending) movement; 2) low-level fear-avoidance beliefs regarding work; 3) no segmental hypomobility in the lumbar spine; 4) short duration of symptoms; and 5) sudden onset of symptoms. For those who had at least three of five of these predictors, the probability of pain and function improvement rose from 23.3% to 48.7% compared to those with fewer predictors. The authors concluded that healthcare providers can use these five predictors to help select patients with LDH who might benefit from applying lumbar traction.
A 2020 study reported that combining spinal manipulation and mobilization with traction produced better outcomes than traction alone. Dr. Tim Harcourt offers a multi-modal treatment approach to patient with LDH, of which traction may be included in the management plan. These non-surgical options frequently work very well, and guidelines recommend utilizing non-surgical care options before considering surgery.
So, if you are experiencing back pain, lower back pain, or pain in the coccyx and type in pain management near me, you may find Coast Chiropractic Centers with Dr. Timothy Harcourt, me, comes up.
You may wonder, “Do I need an MRI scan of my back.”
Also, if you feel leg pain it may indicate things are getting worse and may indicate a bulge on the disc or worse yet a herniated disc in your back. Some people will try stretching the lower back first to see if they get relief from their back pain. Pain very low in the lower back may be originating from the coccyx or tailbone. A pulled muscle in the back generally will get better with rest. Persistent or worsening pain intensity and/or frequency necessitates a visit to see a professional.
Call me, Dr. Tim Harcourt, at (239) 278-3344 and mention this article for an awesome discounted first visit to include history, exam, and adjustment or Class IV high-intensity laser treatment.
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