The Role of Intermitten Traction in the Conservative Treatment of Acute Low Back Pain Caused by Disc Herniation - Permanent Solution or Postponement of Surgery

Abstract

The aim of this study was to present possibilities and effectiveness of individual conservative treatment of acute low back pain caused by disc herniation. Is it possible to avoid or postpone surgical treatment with conservative methods? Seventeen subjects aged between 21 and 61 years were included in the study. All of them had the acute low back pain caused by disc herniation at the L4–L5 and/or L5–S1 level and all of them were candidates for surgical treatment. The subjects underwent intermittent traction treatment, also known as conservative spinal decompression, for the lumbar spine during two weeks with the addition of heating the paravertebral musculature and electro analgesic procedures. Over the next two weeks all of the subjects underwent individual exercises with a therapist based on the DNS (dynamic neuromuscular stabilization) principle twice a week and on the other six days they performed medical or hydro gymnastics for lumbar spine combined with individually adapted electro procedures. The degree of pain according to NRS (Numerical Rating Scale), Finger-to-floor distance test, Lasègue test and dorsiflexion of the foot on the painful side according to the manual muscle test were measured for each participant before and after two series of physical therapy. The results showed that there is a significant difference in all measured values before and after physical therapy. A significantly higher level of pain (p<0.001), positive Lasègue test on the lower angle (p<0.001), weaker dorsiflexion of foot (p=0.008) and higher distance in Finger-to-floor test (p<0.001) were reported before physical therapy was conducted. According to the results of our study it could be concluded that intermittent traction in combination with an individual approach to the patient, in terms of education and persistence in targeted medical gymnastics, is the key to successful conservative treatment of acute low back pain caused by disc herniation, not only to postpone but also to prevent surgical treatment.  

DOI: 10.5671/ca.48.2.6