Tags

Type your tag names separated by a space and hit enter

Traction for low-back pain with or without sciatica.

Abstract

BACKGROUND

Various types of traction are used in the treatment of low-back pain (LBP), often in conjunction with other treatments.

OBJECTIVES

To determine the effectiveness of traction in the management of LBP.

SEARCH STRATEGY

We searched The Cochrane Library 2004, Issue 4, MEDLINE, EMBASE, and CINAHL to November 2004, references in relevant reviews, and our personal files.

SELECTION CRITERIA

Randomized controlled trials (RCTs) examining any type of traction for the treatment of acute (less than four weeks duration), sub-acute (four to 12 weeks) or chronic (more than 12 weeks) non-specific LBP with or without sciatica.

DATA COLLECTION AND ANALYSIS

Study selection, methodological quality assessment and data extraction were done independently by sets of two reviewers. As available studies did not provide sufficient data for statistical pooling, a qualitative analysis was performed.

MAIN RESULTS

Twenty-four RCTs, involving 2177 patients (1016 receiving traction) were included in the review. Five trials were considered high quality. There is strong evidence that there is no significant difference in short or long-term outcomes between either continuous or intermittent traction and placebo, sham, or other treatments for patients with a mixed duration of LBP, with or without sciatica. There is moderate evidence that: autotraction is more effective other forms of traction are no more effective than placebo, sham or no treatment for patients with a mixed duration of LBP with sciatica. There is limited evidence that: there is no significant difference in outcomes between a standard physical therapy program with continuous traction and the same program without traction, for patients with a mixed duration of LBP, with or without sciatica autotraction on its own is more effective than a physical therapy program that includes Tru-Trac traction for patients with a mixed duration of LBP with sciatica. There is conflicting evidence regarding the short-term effectiveness of either continuous or intermittent traction compared to placebo, sham or other treatments, in the management of patients who have either chronic LBP or a mixed duration of LBP with sciatica.

AUTHORS' CONCLUSIONS

The evidence suggests that traction is probably not effective. Neither continuous nor intermittent traction by itself was more effective in improving pain, disability or work absence than placebo, sham or other treatments for patients with a mixed duration of LBP, with or without sciatica. Although trials studying patients with sciatica had methodological limitations and inconsistent results, there was moderate evidence that autotraction was more effective than mechanical traction for global improvement in this population.

Authors+Show Affiliations

Institute for Work & Health, 481 University Avenue, Suite 800, Toronto, Ontario, Canada. jclarke@iwh.on.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

16235311

Citation

Clarke, J A., et al. "Traction for Low-back Pain With or Without Sciatica." The Cochrane Database of Systematic Reviews, 2005, p. CD003010.
Clarke JA, van Tulder MW, Blomberg SE, et al. Traction for low-back pain with or without sciatica. Cochrane Database Syst Rev. 2005.
Clarke, J. A., van Tulder, M. W., Blomberg, S. E., de Vet, H. C., van der Heijden, G. J., & Bronfort, G. (2005). Traction for low-back pain with or without sciatica. The Cochrane Database of Systematic Reviews, (4), CD003010.
Clarke JA, et al. Traction for Low-back Pain With or Without Sciatica. Cochrane Database Syst Rev. 2005 Oct 19;(4)CD003010. PubMed PMID: 16235311.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Traction for low-back pain with or without sciatica. AU - Clarke,J A, AU - van Tulder,M W, AU - Blomberg,S E I, AU - de Vet,H C W, AU - van der Heijden,G J M G, AU - Bronfort,G, Y1 - 2005/10/19/ PY - 2005/10/20/pubmed PY - 2006/2/25/medline PY - 2005/10/20/entrez SP - CD003010 EP - CD003010 JF - The Cochrane database of systematic reviews JO - Cochrane Database Syst Rev IS - 4 N2 - BACKGROUND: Various types of traction are used in the treatment of low-back pain (LBP), often in conjunction with other treatments. OBJECTIVES: To determine the effectiveness of traction in the management of LBP. SEARCH STRATEGY: We searched The Cochrane Library 2004, Issue 4, MEDLINE, EMBASE, and CINAHL to November 2004, references in relevant reviews, and our personal files. SELECTION CRITERIA: Randomized controlled trials (RCTs) examining any type of traction for the treatment of acute (less than four weeks duration), sub-acute (four to 12 weeks) or chronic (more than 12 weeks) non-specific LBP with or without sciatica. DATA COLLECTION AND ANALYSIS: Study selection, methodological quality assessment and data extraction were done independently by sets of two reviewers. As available studies did not provide sufficient data for statistical pooling, a qualitative analysis was performed. MAIN RESULTS: Twenty-four RCTs, involving 2177 patients (1016 receiving traction) were included in the review. Five trials were considered high quality. There is strong evidence that there is no significant difference in short or long-term outcomes between either continuous or intermittent traction and placebo, sham, or other treatments for patients with a mixed duration of LBP, with or without sciatica. There is moderate evidence that: autotraction is more effective other forms of traction are no more effective than placebo, sham or no treatment for patients with a mixed duration of LBP with sciatica. There is limited evidence that: there is no significant difference in outcomes between a standard physical therapy program with continuous traction and the same program without traction, for patients with a mixed duration of LBP, with or without sciatica autotraction on its own is more effective than a physical therapy program that includes Tru-Trac traction for patients with a mixed duration of LBP with sciatica. There is conflicting evidence regarding the short-term effectiveness of either continuous or intermittent traction compared to placebo, sham or other treatments, in the management of patients who have either chronic LBP or a mixed duration of LBP with sciatica. AUTHORS' CONCLUSIONS: The evidence suggests that traction is probably not effective. Neither continuous nor intermittent traction by itself was more effective in improving pain, disability or work absence than placebo, sham or other treatments for patients with a mixed duration of LBP, with or without sciatica. Although trials studying patients with sciatica had methodological limitations and inconsistent results, there was moderate evidence that autotraction was more effective than mechanical traction for global improvement in this population. SN - 1469-493X UR - https://www.unboundmedicine.com/medline/citation/16235311/Traction_for_low_back_pain_with_or_without_sciatica_ L2 - https://doi.org/10.1002/14651858.CD003010.pub3 DB - PRIME DP - Unbound Medicine ER -