Introduction The efficacy of traction for disc protrusion with neurological deficit, as in published trials, has been disappointing. Yet it is common for patients to experience relief of symptoms during short periods of traction. My thesis is that if traction is helpful, the patient needs to have it every day and preferably a few times a day.
Methods This is a pilot study of a simple form of traction equipment which the patient uses at home. The criteria for inclusion of patients in the study has been; (a) diagnosis of disc protrusion with nerve root involvement made on the basis of history and clinical examination (before radiography); (b) evidence of neurological deficit on examination, and (c) findings on MRI Scan consistent with the diagnosis.
Seventy one (71) were admitted to the trial, 43 males and 28 females; age range 23 to 60. Prior to referral several patients had already been advised to have surgery; two were actually booked-in for surgery (and both of these improved sufficiently to avoid surgery). Pain intensity and level of disability are detailed. Previous treatment is detailed.
Results The majority of patients had significant improvement, as gauged by pain VAS, resumption of work and resumption of recreational activities. Only one patient required surgery.
Discussion The home-traction was always supplemented by a gradually upgraded exercise program. Once the patient had been instructed in the use of the home equipment, they would be reviewed at only weekly or fortnightly consultations during the acute phase, hence as the treatment was essentially dependent upon self-help measures at home, the overall cost of this program of treatment for disc protrusion is inexpensive. This pilot study justifies a controlled clinical trial of gravity traction.
