INDICATIONS: Patients who have any of the following symptoms may qualify for the procedure. Specific measurements and findings will be evaluated to see if your condition will respond favorably. Only patients with conditions that are very likely to respond are admitted into the centers for treatment.
Decompressive traction is to be contrasted from mobilization traction methods by 1) the characteristics of the 'pull', 2) adhering to protocols [shown to more consistently create the effect], 3) the intention of doing more than mere mobilization of tissue. Obviously the force, time, position and numerical reproducibility necessary to create significant decompression are not amenable to 'hands-on' treatment methods.
Any low back/leg or neck/arm pain syndrome generated from the discs and facets (usually of gradual onset > 1 week duration) not related to a disease process, canal stenosis or acute strain/sprain injury is theoretically treatable by this therapy. Manual axial traction should be utilized as a preliminary screening test for tolerance. The initial acute inflammation stage (very guarded movements) should be reduced by other means, in most cases, prior to beginning DTS. Contraindications are similar to manipulation, however since mechanical 'stretch' creates no impact, osteoporosis (<45% loss) may not be directly contraindicated. (This holds true overall for frail and elderly patients who could potentially be injured by manipulative thrusts). Disc fragmentation, calcification, severe arthritis, spondylolisthesis (+2 grade); pregnancy (>3 months) and any surgical intra-spinal appliances are all relative contraindications. Inter-spinal appliances are direct contraindications as is any bone compromising disease. 7,35,40,41,43
Our clinical findings suggest the DTS will create a relatively quick initial response. Patients who will do well tend to feel a sense of relief (which can be direct pain cessation or a centralization of pain) within two-six sessions. Full relief, if attainable will usually not exceed 18 sessions. (Rarely a stubborn pain syndrome may continue to improve slowly over 18+ sessions). Often patients will be treated 4-6 sessions and be relieved enough to start active rehab (the StabilizerTM Pressure Biofeedback initially). Their DTS treatments may continue for several further sessions before discontinuing or reducing the frequency. Some patients will improve initially then experience a worsening with continued treatment. If reduction of force/time or active rehab fails to resolve the problem (and surgery is not a serious option) beginning the DTS again after a 1-2 week layoff can often renew the improvement. Typical frequency for treatment is 3-5 times per week. (My experience suggests it can also be an excellent supportive/palliative treatment for those cases where pain relief is marked but prone to exacerbations even in the face of active rehabilitative measures. This is not to suggest 'therapy dependence' but some patients may be best served with a supportive type of care).
|Holladay Physical Medicine - 4211 Holladay Blvd. Salt Lake City, UT - 801-272-8471||Please read the Disclaimer|