Effect of continuous lumbar traction on the size of herniated disc material in lumbar disc herniation


We investigated the effects of continuous lumbar traction in patients with lumbar disc herniation on clinical findings, and size of the herniated disc measured by computed tomography (CT). In this prospective, randomized, controlled study, 46 patients with lumbar disc herniation were included, and randomized into two groups as the traction group (24 patients), and the control group (22 patients). The traction group was given a physical therapy program and continuous lumbar traction. The control group was given the same physical therapy program without traction, for the same duration of time. Data for the clinical symptoms and signs were collected before and after the treatment together with calculation of a herniation index, from the CT images that showed the size of the herniated disc material. In the traction group, most of the clinical findings significantly improved with treatment. Size of the herniated disc material in CT decreased significantly only in the traction group. In the traction group the herniation index decreased from 276.6±129.6 to 212.5±84.3 with treatment (p<0.01). In the control group, pretreatment value was 293.4±112.1, and it decreased to 285.4±115.4 after the treatment (p>0.05). Patients with greater herniations tended to respond better to traction. In conclusion, lumbar traction is both effective in improving symptoms and clinical findings in patients with lumbar disc herniation and also in decreasing the size of the herniated disc material as measured by CT.

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  1. 1.

    Mathews JA, Mills SB, Jenkins VM, Grimes SM, Morkel MJ, Mathews W, Scott CM, Sittampalam Y (1987) Back pain and sciatica: controlled trials of manipulation, traction, sclerosant and epidural injections. Br J Rheumatol 26:416–423

    PubMed  Article  CAS  Google Scholar 

  2. 2.

    Deyo R, Loeser JD, Bigos SJ (1990) Herniated lumbar intervertebral disc. Ann Intern Med 112:598–603

    PubMed  CAS  Google Scholar 

  3. 3.

    Burton CV (1981) Conservative management of low back pain. Postgrad Med 70:168–183

    PubMed  CAS  Google Scholar 

  4. 4.

    Fast A (1988) Low back disorders: conservative management. Arch Phys Med Rehabil 69:880–891

    PubMed  CAS  Google Scholar 

  5. 5.

    Postacchini F (1996) Spine update. Result of surgery compared with conservative management for lumbar disc herniations. Spine 21:1383–1387

    Article  PubMed  CAS  Google Scholar 

  6. 6.

    Fagerlund MKJ, Thelander U, Friberg S (1990) Size of lumbar disc hernias measured using computed tomography and related to sciatic symptoms. Acta Radiol 31:555–558

    PubMed  CAS  Article  Google Scholar 

  7. 7.

    Maigne J, Deligne L (1994) Computed tomographic follow-up study of 21 cases of nonoperatively treated cervical intervertebral soft disc herniation. Spine 19:189–191

    PubMed  CAS  Article  Google Scholar 

  8. 8.

    Beurskens AJ, Van der Heijden GJ, De Vet HC, Koke AJ, Lindeman E, Regtop W, Knipschild PG (1995) The efficacy of traction for lumbar back pain: design of a randomized clinical trial. J Manipul Physiol Ther 18:141–147

    CAS  Google Scholar 

  9. 9.

    Onel D, Tuzlacı M, Sarı H, Demir K (1989) Computed tomographic investigation of the effect of traction on lumbar disc herniations. Spine 14:82–90

    PubMed  Article  CAS  Google Scholar 

  10. 10.

    Tesio L, Merlo A (1993) Autotraction versus passive traction: an open controlled study in lumbar disc herniation. Arch Phys Med Rehabil 74:871–876

    Article  PubMed  CAS  Google Scholar 

  11. 11.

    Scheer SJ, Radack KL, O’Brien DR (1996) Randomized controlled trials in industrial low back pain relating to return to work. Part 2. Discogenic low back pain. Arch Phys Med Rehabil 77:1189–1197

    Article  PubMed  CAS  Google Scholar 

  12. 12.

    Bush K, Cowan N, Katz DE, Gishen P (1992) The natural history of sciatica associated with disc pathology. A prospective study with clinical and independent radiologic follow-up. Spine 17:1205–1212

    PubMed  Article  CAS  Google Scholar 

  13. 13.

    Dullerud R, Nakstad PH (1994) CT changes after conservative treatment for lumbar disc herniation. Acta Radiol 35:415–419

    PubMed  CAS  Google Scholar 

  14. 14.

    Reust P, Chantraine A, Vischer TL (1988) Traitement par tractions mécaniques des lombosciatalgies avec ou sans déficit neurologique. Schweiz Med Wschr 118:271–274

    PubMed  CAS  Google Scholar 

  15. 15.

    Cailliet R (1982) Disc disease. In: Cailliet R (ed) Low back pain syndrome. Davis Company, Philadelphia, pp144–171

    Google Scholar 

  16. 16.

    Ellenberg MR, Ross ML, Honet JC, Schwartz M, Chodoroff G, Enochs S (1993) Prospective evaluation of the course of disc herniations in patients with proven radiculopathy. Arch Phys Med Rehabil 74:3–8

    PubMed  CAS  Google Scholar 

  17. 17.

    Saal JA, Saal JS, Herzog RJ (1990) The natural history of lumbar intervertebral disc extrusions treated nonoperatively. Spine 15:683–686

    PubMed  Article  CAS  Google Scholar 

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Correspondence to Osman Hakan Gunduz.

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Ozturk, B., Gunduz, O.H., Ozoran, K. et al. Effect of continuous lumbar traction on the size of herniated disc material in lumbar disc herniation. Rheumatol Int 26, 622–626 (2006). https://doi.org/10.1007/s00296-005-0035-x

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  • Lumbar disc herniation
  • Conservative treatment
  • Physical therapy
  • Traction
  • Computed tomography