Tugging Hard-to-Find Results of Traction for Low Back Pain
The University of Ulster in Northern Ireland may seem far away. But the Internet makes it possible to conduct worldwide research from any spot on the map. Researchers from the School of Rehabilitation Sciences asked the question: Does traction really work for low back pain?
To answer this question, they looked at studies from around the world. A computer-aided search was done for the years 1966 to 2001. Five of the largest medical databases were searched. All studies were in English. A hand search of other journals was also included. In all the studies, patients either received traction, a sham treatment, or some other treatment without surgery. Sham traction is a "pretend" treatment. Sham treatment uses no-weight or low-weight traction that is known to be useless.
The authors review the many reasons why it's difficult to study traction alone in the treatment of LBP. Traction is usually used by physical therapists. Most physical therapy programs are tailored to fit each patient's needs. No two patients get the same treatment. Many programs combine traction with advice, exercise, heat, and electrotherapy. It's hard to tell if just one of those treatments is what works. And traction is applied with different weights for differing lengths of time.
Success was measured using reports of pain relief, improved function, and quality of life. A positive result means traction worked better than other treatments. A negative result is defined as no difference between traction and other treatment. A negative result is also given if traction was the same as other treatments. Results are inconclusive if the results were positive sometimes and negative other times.
The authors conclude that it isn't possible to tell if traction is a good treatment for low back pain. Studies are poorly done and need to improve before results can be trusted. Better research in this area is needed. And using only studies in English leaves out research on traction in the Netherlands and Germany. This is where many of the studies on traction are done.
Annette A. Harte, BSc, et al. The Efficacy of Traction for Back Pain: A Systematic Review of Randomized Controlled Trials. In Archives of Physical Medicine and Rehabilitation. October 2003. Vol. 84. No. 10. pp. 1542-1553.