Abstract
BackgroundTraction is commonly used for the treatment of low back pain (LBP), predominately with nerve root involvement; however its benefits remain to be established. The aim of this study was to test the feasibility of a pragmatic randomized controlled trial to compare the difference between two treatment protocols (manual therapy, exercise and advice, with or without traction) in the management of acute/sub acute LBP with 'nerve root' involvement.Methods30 LBP patients with nerve root pain were recruited and randomly assigned to one of two treatment groups. Primary outcome measures were the: McGill pain questionnaire, Roland Morris disability questionnaire, and the SF36 Questionnaire; recorded at baseline, discharge, 3 and 6 months post-discharge.Results27 patients completed treatment with a loss of another four patients at follow up. Intention to treat analysis demonstrated an improvement in all outcomes at follow up points but there appeared to be little difference between the groups.ConclusionThis study has shown that a trial recruiting patients with 'nerve root' problems is feasible. Further research based upon a fully powered trial is required to ascertain if the addition of traction has any benefit in the management of these patients.Trial RegistrationRegistration number: ISRCTN78417198
Highlights
Traction is commonly used for the treatment of low back pain (LBP), predominately with nerve root involvement; its benefits remain to be established
Traction continues to be commonly used by physiotherapists in the management of LBP; a recent UK-wide survey indicated that 41% of therapists used traction with 5% of LBP patients, who almost exclusively presented with 'nerve root' problems
Subjects in each group received a similar number of treatments (LT, mean 11.4, SD 5; Manual Therapy Group (MT) mean 10, SD 3.3) lasting no longer than 30 min at each session and were seen for treatment on an average of twice weekly (Mean LT 2.3, SD .79; MT 2; SD .73), ensuring equal contact time for each group
Summary
Traction is commonly used for the treatment of low back pain (LBP), predominately with nerve root involvement; its benefits remain to be established. Any future research should distinguish between symptom pattern and duration and should be carried out according to the highest methodological standard to avoid bias [2].' Despite such recommendations, traction continues to be commonly used by physiotherapists in the management of LBP; a recent UK-wide survey indicated that 41% of therapists used traction with 5% of LBP patients, who almost exclusively presented with 'nerve root' problems (page number not for citation purposes). Between 3 โ 10% of LBP sufferers will experience 'sciatica' or 'nerve root' pain, with or without neurological signs [4,5,6] with 90% recovering, but a further 10% requiring surgery [6] Guidelines highlight this small group of patients in their triage system with the implication that this group of patients may be more severe, slower to recover, and may require specialist referral when compared to 'simple' LBP [5,7,8,9,10]. Effective management of this group of patients is essential to limit costly onward referral and surgery that may result
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
