Evidence-informed management of chronic low back pain with traction therapy

No effect of traction in patients with low back pain: a single centre, single blind, randomized controlled trial of Intervertebral Differential Dynamics Therapy®

“…As a consequence, a comparison of our results with previous studies is difficult. Nevertheless, the results of the current study seem to support the conclusions of recent reviews [5,7], in which no uniform evidence of the efficacy for traction therapy as a treatment for LBP was reported. However, it should be stressed that in this study the IDD Therapy was used as an add on therapy to the standard graded activity program.…”

“…Finally, a decrease in the use of pain medication was reported in both groups. A constant point of discussion in recent reviews [5,7] is the low quality of the selected studies and insufficient homogeneity between trials, making a meta-analysis impossible. It was emphasized that most available studies have several methodological problems, thus potentially biased results.…”

“…Non-invasive and probably cost-effective therapies that have received interest recently are traction-based therapies, as can be seen in the special issue of The Spine Journal [7]. However, reports of high-quality RCTs to evaluate traction therapy are scarce [5,7].…”

“…However, reports of high-quality RCTs to evaluate traction therapy are scarce [5,7]. For example, reported studies lacked a randomized comparison group [2,19], had a retrospective design [10,11,15,16], sample sizes were too small [6,10,11], heterogeneous patient groups were studied [3,6,19] or the authors were commercially related to the evaluated therapy [11,16].…”

“…Moreover, within this particular field there is still controversy since various different traction techniques and corresponding protocols exist. In a total of ten RCTs a categorization of traction therapies was made based on temporal (sustained or intermittent) and force (focused or dispersed) variables [7], but the most effective or most appropriate intervention could not be determined [7]. A larger systematic review by Clarke et al [5] (24 RCTs) concluded that for patients with LBP, who may or may not have sciatica, traction as a single treatment is no more effective than placebo, sham, no treatment or other treatments.…”