Low back pain (LBP) is one of the most costly diseases in the developed world. This study aimed to investigate the effects of underwater traction therapy on chronic low back pain. The primary objective was to prove that underwater traction therapy has favorable effects on LBP. Our secondary objective was to evaluate whether it also leads to improvement in the quality of life. This is a prospective, multicenter, follow-up study. A total of 176 patients with more than 3 months of low back pain enrolled from outpatient clinics were randomized into three groups: underwater weight bath traction therapy and non-steroidal anti-inflammatory drugs (NSAIDs); weight bath; and only NSAIDs. The following parameters were measured before, right after, and 9 weeks after the 3-week therapy: levels of low back pain in rest and during activity were tested using the visual analogue scale (VAS), the Oswestry Low Back Disability Questionnaire, and the EuroQol-5D-5L Questionnaire. The VAS levels improved significantly ( p < 0.05) in both underwater weight bath traction therapy groups by the end of the treatment, whereas the improvement in the third group was not statistically significant. Furthermore, the improvements measured in the groups receiving traction therapy were persistent during the follow-up period. There were no significant changes in the Oswestry Index or the EuroQol-5D-5L without VAS parameters in any of the groups. Based on our results, for patients suffering from LBP pain who underwent underwater weight bath traction therapy, there were favorable impacts on the pain levels at rest or during activity. Clinical trial registration ID: NCT03488498, April 5, 2018

Background:Chronic low back pain established for more than 3 months is one of the most common problems in the world. The prevalence could reach the 33%.Objectives:To investigate the effects of underwater traction therapy on chronic low back pain.The primary objective was to prove the hypothesis that underwater traction therapy has favourable effect of LBP using the change in the clinical parameters. Our secondary objective was to evaluate whether it also leads to the improvement in the quality of life.Methods:A prospective, multicenter, comparative (intervention arm vs. control arm), randomized follow-up study.Participants aged between 18 and 85 years with more than 3 months low back pain and selected from outpatient clinics.The participants were randomized to three groups: underwater weight bath traction therapy, weight bath and non-steroidal anti-inflammatory drugs (NSAIDs) medication and only non-steroidal anti-inflammatory drugs (NSAIDs) medication.During the traction therapy ankle weights were used.The following parameters were measured before, right after, and nine weeks after the three-week therapy: level of low back pain in rest, level during activity tested using the Visual Analog Scale (VAS); specific questionnaire on back pain (Oswerty); questionnaire on quality of life (EuroQual-5D) and clinical parameters.Results:141 participants aged 57.67 (±13.04) years. All of the investigated parameters improved significantly (p<0.001) in the underwater weight bath traction therapy groups by the end of the treatment compared to the base period, and this improvement was persistent during the follow-up period. There were no significant changes in the measured parameters in the control group except for the Oswestry Disability Index, which may also be the result of that group receiving pain-relieving drug therapy.Conclusion:Based on our results, underwater weight bath traction therapy, might have favourable impact on the clinical parameters and quality of life of patients suffering from chronic low back pain.References:[1] Alrwaily M, Almutiri M, Schneider M. Assessment of variability in traction interventions for patients with low back pain: a systematic review. Chiropr Man Therap. 2018 Sep 17;26:35. doi: 10.1186/s12998-018-0205-z. eCollection 2018. Review. PubMed PMID: 30237870; PubMed Central PMCID: PMC6139896.[2] Kurutz M, Oroszváry L. Finite element analysis of weightbath hydrotraction treatment of degenerated lumbar spine segments in elastic phase. J Biomech. 2010 Feb 10;43(3):433-41. doi: 10.1016/j.jbiomech.2009.10.004. Epub 2009 Nov 1. PubMed PMID: 19883918.[3] Oláh M, Molnár L, Dobai J, Oláh C, Fehér J, Bender T. The effects of weightbath traction hydrotherapy as a component of complex physical therapy in disorders of the cervical and lumbar spine: a controlled pilot study with follow-up. Rheumatol Int. 2008 Jun;28(8):749-56. doi: 10.1007/s00296-008-0522-y. Epub 2008 Jan 12. PubMed PMID: 18193231.Disclosure of Interests:None declared