Are you experiencing back pain? Can traction relieve back pain?

Author: Xiao Jing, Chief Physician, Xiyuan Hospital, China Academy of Chinese Medical Sciences

Reviewer: Zhang Zhihai, Chief Physician, Guang'anmen Hospital, China Academy of Chinese Medical Sciences

There are three types of people in the world: those who have experienced back pain, those who are currently experiencing it, and those who may experience it in the future. In other words, most people will experience back pain. From the epidemiology of back pain, the incidence rate is about 12%-15%, of which 10% of the population suffers from chronic back pain.

Figure 1 Original copyright image, no permission to reprint

Low back pain that lasts for 12 weeks, or occurs intermittently or repeatedly within 12 weeks, is called chronic low back pain. Most low back pain has no particularly clear cause, which is called chronic nonspecific low back pain, accounting for more than 70%-85% of chronic low back pain. Chronic nonspecific low back pain is mainly manifested as persistent pain, or intermittent and recurrent pain, accompanied by functional limitations, some manifestations include lower limb weakness, limb numbness, abnormal gait, inability to sit or stand continuously, and some sleep is affected, accompanied by tension and anxiety.

Is traction therapy useful for low back pain? Traction is one of the methods for treating low back pain, and there are many ways of traction. When traction therapy is performed in a hospital, a medical device called a traction bed is used. The device uses a fixed belt under the armpit and a pelvic pocket in the pelvic area to fix the body, and uses the power generated by the motor to achieve opposite traction at both ends, thereby forming traction. This is a traction therapy method implemented in the hospital using professional equipment.

Figure 2 Original copyright image, no permission to reprint

Another simple home traction method is to use a similar traction device, which has no motor, but can also produce a traction effect by manually shaking it. In addition, hanging on a horizontal bar is also a traction method, using the body's own weight to stretch the muscles, thereby achieving traction.

Traction can stretch tense and spasmodic muscles, thereby releasing compressed joints and relieving the pain caused by them; stretching can release tense muscles, joint membranes, fascia, and compressed nerves in the intervertebral space, and relieve pain; it can also reduce the bulging intervertebral disc to a certain extent, relieving pain. In the short term, traction can relieve acute or persistent low back pain symptoms. However, many studies have shown that traction cannot control low back pain in the long term or continuously. There is no significant difference in the long-term efficacy between people who have received long-term traction treatment and those who have not received traction treatment, indicating that long-term traction is actually not effective in relieving low back pain and may even cause some problems. For example, long-term, repeated or excessive traction may cause abnormal compliance of muscles and bones.

Traction can relieve muscle tension, significantly limited joint movement, or even compression of the intervertebral foraminal nerves due to protruding intervertebral discs or incarcerated synovium, which can lead to radiating pain and severe pain in the lower limbs. For example, if the body is weak and the muscles themselves are not strong enough, traction may increase the risk of muscle injury; traction may affect the bones of patients with osteoporosis; traction is not suitable for patients with bone tuberculosis, bone tumors, and vascular problems. Therefore, for the treatment of low back pain, it is necessary to first identify the cause and determine whether traction treatment is suitable based on the specific physical condition.

How long does traction treatment for low back pain take? This depends on the specific situation. If the traction force is relatively large, the traction time should be short. For example, when the traction force reaches half of the body weight, or 70%-80% of the body weight, the traction time is about 20 minutes. If the traction force is relatively small, the traction time should be appropriately increased to continue to work. In addition, it depends on the patient's reaction to traction. Generally speaking, traction is relatively safe. However, if there is obvious muscle discomfort after one or two tractions, or even the original lower limb radiation pain is aggravated after traction, it means that traction is not suitable and it should be stopped in time.

Traction can relieve low back pain for a certain period of time. The initial effect is usually more obvious, but as the treatment time increases, its effect may gradually weaken. For example, the effect is significant in the first few days, but the effect may not be as ideal as in the initial period. In this case, continuing to increase the frequency of traction is actually of no benefit. Usually, traction treatment is only for 7-10 days.