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sush kiru manual therapy.pptx
- 1. LUMBAR TRACTION MANUAL THERAPY DONEBY : KIRUTHIKA KARTHIKEYAN SUSHMITHA RAMAIAH PUSHPAMALA 504 GROUP GENERAL MEDICINE
- 2. • Lumbar tractionis the process of applying a stretching force to the lumbar vertebrae through body weight /or pulleys to distract individual joints of the lumbar spine. • Lumbar (low back) traction helps to separate the spaces between your vertebrae, the bones that make up your spine. In theory, slightly separating these bones can help take the pressure off pinched nerves (such as the sciatic nerve) to decrease your pain and improve your mobility. • The word traction is a derivative of the Latin word "tractico", which means "a process of drawing or pulling, and various forms of spinal traction have been described, since the time of Hippocrates, for the relief of pain.
- 3. • The lumbarspine is made up of five individual vertebrae L1 to L5 and together they create the concave lumbar curvature in the lower back. • the lumbar vertebrae make up the region of the spine inferior to the thoracic vertebrae in the thorax and superior to the sacrum and coccyx in the pelvis.These vertebrae carry all of the upper body’s weight while providing flexibility and movement to the trunk region. They also protect the delicate spinal cord and nerves within their vertebral canal.
- 4. • Connecting eachvertebra to its neighbouring vertebra is an intervertebral disk made of tough fibrocartilage with a jelly-like centre. The outer layer of the intervertebral disk, the annulus fibrosis, holds the vertebrae together and provides strength and flexibility to the back during movement. The jelly-like nucleus pulposus acts as a shock absorber to resist the strain and pressure exerted on the lower back.
- 5. INDICATIONS FOR TREATMENT •Narrowing of intervertebral foramen • Osteotype encroachment • Disc bulge or herniation • Nerve root impingement • Subacute injury • Paraspinal muscle spam
- 6. CONTRAINDICATIONS FOR TREATMENT •In presence of unhealed fractures • Spinal cord compressions • Immediately following spinal surgery • Acute injury or inflammation • Hypermobility • Peripheralization of symptoms • Hypertension
- 7. TRACTION TABLE WITHPULLEY SYSTEM • Use half of patients body weight for distraction • Should be monitored by healthcare professionals • Can be done continuosly or intermittently
- 8. INVERSION TABLE • Tableallows for tilting at desired angles • Uses patients body weight and position for distractions • Several contraindications for this method
- 9. POSTURE PUMP • Patient- controlled • Can be used easily at home • Portable
- 10. MANUAL LUMBAR TRACTION •Health care professional uses own body as weight • In hook - lying position, patients knees are pushed towards their head as the pelvis is pulled in the opposite direction
- 11. UNILATERAL TRACTION • Somehealth care providers utilizes a manual “ leg pull” as method of traction • The patient must be fitted with a counter-action harness • The physician holds the ankle of the affected extremity and elevates the hip to 30 degree flexion ,30 degree abduction and full ER for focus of hip joint pain and to 30 degree flexion and 15 degree abduction for SI joint pain • Straight and steadt pull performed until noticebale destruction is felt
- 12. UNILATERAL POSITION TRACTION •Traction can also be performed using a roll or half - roll of some type • The roll should be placed under the unaffected side of the body between the rib cage and iliac crest with the patient in side -lying position across the roll with the upper leg flexed at the hip and knee until lumbar spine curved • If feasible ,the patient can perform trunk rotations to maximally open the foramen
- 13. EFFECTIVENESS OF LUMBARTRACTION • The treatment should be discontinued if not providing benefits to patient after a few trials • The treatment is used when preferred by health care professionals or patient . There are many differing opinions as to its effectiveness. Individual results and patients inclination are the driving force of the treatment.