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TO EVALUATE THE EFFECTIVENESS OF TRACTION IN THE MANAGEMENT OF LUMBOSACRAL RADICULOPATHY



Abstract

Background and purpose: Lumbar traction is a common treatment for LBP with radiculopathy. Despite this, its benefits remain to be established. This paradox has significant economic and therapeutic consequences as 3–10% of patients with LBP in the UK have radiculopathy and over 40% of UK physiotherapists use this approach (Harte et al 2005). The purpose of this pragmatic randomised clinical trial was to assess the benefit of lumbar traction in addition to a manipulation package with these patients in a manner that reflects clinical practice.

Methods: 30 patients meeting the inclusion criteria for lumbosacral radiculopathy were recruited from the NHS and randomly assigned to one of two treatment groups: Group 1 received manipulation, advice and exercises; Group 2 received traction, manipulation, advice and exercises. Outcome measures were recorded at baseline, completion of treatment and at 3 and 6 months post completion of treatment (MPQ, RMDQ, SF36, and the ALBPSQ). In addition VAS scores for back and leg pain and the percentage of overall improvement (patients perception) were recorded after each treatment.

Results: 30 patients were recruited over an 11-month period: 40% male, mean age 44 years, mean duration of current episode 7 weeks. Post treatment results (n = 27) showed a significant improvement in all outcomes for both groups (paired t-test, p > .01) but there was no significant difference demonstrated between groups (ANCOVA).

Conclusion: This pilot study demonstrates the feasibility of a trial with this sub-group of LBP patients and a large multi-centred trial would need to be conducted to fully address this research question.

Correspondence should be addressed to Ms Alison McGregor, c/o BOA, SBPR at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.