Manipulation and traction for lumbago and sciatica: Physiotherapeutic techniques used in two controlled trials

Abstract

Controlled clinical trials were undertaken for four specifically defined syndromes of low back pain alone (lumbago) and low back pain with pain in the leg (sciatica), The detailed design and statistics of these studies are not included in this paper but are published elsewhere. In two of the trials patients were treated using techniques of manipulation and traction which are described in detail in this paper. The manipulation method utilised over-pressure at the extreme of range. The traction technique used a continuous force sufficient to eliminate pain and was given daily for 30 minutes.Patients were randomly allocated into groups for treatment or control, the latter receiving thrice-weekly infra-red therapy. In all treated groups there was hastening of pain relief over the control groups within the first 2 weeks. This was most marked in group B2, in which patients with lumbago with limitation of back movements and straight leg raise (SLR) were treated by manipulation. The difference in pain relief was statistically highly significant. In group B1 (patients had lumbago, limited back movements but full SLR; treatment was manipulation) and in group C (patients had lumbago, limited back movements, limited SLR and sciatica; treatment was traction) the difference in pain relief reached borderline statistical significance. The early pain relieving effects of these treatments have not been previously demonstrated and published, although the techniques have been in widespread use for at least the past half-century. No longer term benefits are claimed.