Effectiveness of lumbar traction with routine conservative treatment in acute herniated disc syndrome

Abstract

Objective: To assess the effectiveness of lumbar traction with routine conservative treatment in acute herniated disc syndrome. Design: Randomized double blind controlled trial. Setting: Outpatient clinic of physical medicine and rehabilitation. Method: 120 participants who met the diagnostic criteria of acute herniated disc syndrome were randomized into two groups. The study group received treated traction, and the control group received sham traction. All patients had routine conservative treatments (consisting of NSAIDs, instruction of proper back activity and precaution, back exercise, and heat modality). The main outcome measurement was the Oswestry score, which was collected on the first day and at 4th week of the treatment. At the end of study, all patients recorded global improvement and satisfaction. Results: Of 120 patients divided into two groups equally, 12 and 6 cases in the control and intervention groups dropped out of the study. The mean (SD) change of the Oswestry score were 19.25(15.9) and 25.25(16.68) in control and intervention groups respectively. There was no significant difference between the two groups with the p-value of 0.067 and 95%CI of -0.42 12.43. Approximately 89% of patients in each group had improvement of their symptoms, and 90% in each group were satisfied with lumbar traction. Co-intervention with heat modality, NSAIDs use and back exercise did not differ between the two groups. Conclusion: The data do not support the benefit of traction for patients with acute herniated disc syndrome. The patient can be conservatively treated at home with proper instruction.