Efficacy of prone lumbar traction on chronic discogenic low back pain and disability

Objective: To compare the outcomes of prone and supine lumbar traction in patients with chronic discogenic low back pain. Design: Prospective, randomized control trial. Setting: Urban Physical Medicine and Rehabilitation clinic. Participants: A total of 124 subjects with chronic low back pain (LBP) and evidence of a degenerative and/or herniated inter-vertebral disk at 1 or more levels of the lumbar spine, who have not our exclusion criteria. Intervention: A 4-week course of lumbar traction, prone or supine in case and control groups consecutively, consisting of six 30-minute sessions every other days, followed by four 30-minute sessions every 3 days. Main Outcome Measures: The numeric Visual pain rating scale and the Oswestry Disability Index (ODI) were completed at pre-intervention and discharge (within 2 weeks of the last visit). Results: A total of 124 subjects completed the treatment protocol. We noted significant improvements for all post-intervention outcome scores when compared with pre-intervention scores (P<0.01). Also found significant difference between 2 groups in favor of prone traction (P<0.01) Conclusions: Traction applied in the prone position for 4 weeks was associated with improvements in pain intensity and ODI scores at discharge, in a sample of patients with activity limiting LBP. However, because we lacked a reasonable long time follow-up, we cannot imply a long lasting relationship between the traction and outcome, and a long time follow-up is suggested.