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Case Reports
. 2024 Dec;23(4):205-214.
doi: 10.1016/j.jcm.2024.08.005. Epub 2024 Oct 4.

Self-Administered Traction as an Adjunct in the Chiropractic Treatment of Low Back Pain: A Case Report

Dana Muligano  1 , Andrew Serlin  2 , Tessaundra Sidden  2 , Gregory D Cramer  2
Affiliations
Case Reports

Self-Administered Traction as an Adjunct in the Chiropractic Treatment of Low Back Pain: A Case Report

Dana Muligano et al. J Chiropr Med. 2024 Dec.

Abstract

Objective: The purpose of this case report is to describe self-administered lumbar traction as a component of the treatment of a patient with low back pain (LBP).

Clinical features: A 41-year-old male chiropractic student presented with an exacerbation of intermittent LBP of approximately 2 years duration. Pain intensity was 4 to 8/10 on a verbal pain scale the day after exertion and 10 on the Patient Reported Outcomes Measurement Information System (PROMIS) 3a. Pain interference was 15 on the PROMIS-8a. The Oswestry Disability Index was 30%. Radiographs showed mild bilateral arthritic changes throughout the lumbar spine and sacroiliac joints. Diagnoses of acute exacerbation of recurrent, mechanical low back pain with thoracic and lumbar segmental dysfunction, lumbosacral spondylosis without myelopathy, and bilateral sacroiliac joint arthritis were made.

Intervention and outcomes: The student received 14 treatments over 5 weeks consisting of spinal manipulation and therapeutic exercises in conjunction with clinician-supervised, self-administered traction. After 14 treatments, the patient was discharged, reporting resolution of LBP (pain intensity [PROMIS-3a] = 4; pain interference [PROMIS-8a] = 8; Oswestry 2%; and increased range of motion). Pain resolution remained for more than 2 years without additional treatment (pain intensity = 3; pain interference = 8; Oswestry 0%; continued increased range of motion).

Conclusion: The patient reported long-term benefit from a course of spinal manipulation and therapeutic exercises in conjunction with novel self-administered traction with flexion.

Keywords: Case report; Chiropractic; Low back pain; Spine; Traction.

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Figures

Fig 1
Fig 1
Anterior-posterior (AP) (A) and right lateral (B) views of the lumbar spine and pelvis of the patient. The lateral view shows mild anterior spondylophytes indicating mild degenerative changes at several vertebral levels (arrowheads). The AP view shows mild degenerative changes of the sacroiliac joints bilaterally (arrowheads).
Fig 2
Fig 2
The self-administered traction device used in this case (Liift Device), viewed from the right side of the unit. (A) Components of the device. 1 = Device Base, 2 = Carriage Arm, 3 = Knee Bolster, 4 = Activation Arm, 5 = Handle, 6 = Center Link. (B) Patient in the neutral position. The patient lies on their back with the knees flexed around the knee bolster (3 in image A). (C) Patient in the full distraction with flexion position. The patient pulls the handle (5 in image A) to the chest, which elevates the knees and pelvis, creating distraction and flexion of the lumbar region.
Fig 3
Fig 3
Results of the pain intensity (PROMIS 3a) and pain interference (PROMIS 8a) outcomes. The scale for Pain Intensity (PROMIS 3a) is from 3 (no pain) to 15 (very severe pain). The scale for Pain Interference (PROMIS 8a) is from 8 (“Not at all” level of interference of activities due to pain) to 40 (“Very much” interference). The timepoints on the x-axis are as follows: 0 = Initial Exam, 1 = Following Care (14 Treatments), 2 = 29 Month Follow-Up.
Fig 4
Fig 4
Results of the Oswestry Disability Index outcomes. The scale ranges from 0% for no disability to 100% complete disability. The timepoints on the x-axis are as follows: 0 = Initial Exam, 1 = Following Care (14 Treatments), 2 = 29 Month Follow-Up.
See this image and copyright information in PMC

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