Distraction Manipulation of the Lumbar Spine: A Review of the Literature

• Published in: Journal of manipulative and physiological therapeutics Vol. 28; no. 4; pp. 266 - 273
• Main Authors: Gay, Ralph E., Bronfort, Gert, Evans, Roni L.
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.05.2005
• Subjects: Biomechanical Phenomena; Chronic Disease; Humans; Lumbar Vertebrae; Manipulation, Spinal - adverse effects; Manipulation, Spinal - methods; Pelvic Pain - therapy; Spinal Diseases - therapy; Treatment Outcome; Chiropractic; Low Back Pain; Review; Manipulation; Intervertebral Disk Displacement
• ISSN: 0161-4754; 1532-6586
• DOI: 10.1016/j.jmpt.2005.03.012

The purpose of this study is to review the literature concerning distraction manipulation of the lumbar spine, particularly regarding physiological effects, clinical efficacy, and safety. A search of the English language literature was conducted using the MEDLINE, Embase, CINAHL, Chiropractic Research Archives Collection, and Manual, Alternative, and Natural Therapies Information System databases. A secondary hand search of bibliographies was completed to identify older or nonindexed literature. Articles were identified, which described the characteristics of distraction manipulation beyond a simple description or the results of treatment with distraction manipulation. Data were extracted on the basis of relevance to the stated objective. Thirty articles were identified. Three were uncontrolled or pilot studies, 3 were basic science studies, and 6 were case series. Most were case reports. Lumbar distraction manipulation is a nonthrust mechanically assisted manual medicine technique with characteristics of manipulation, mobilization, and traction. It is used for a variety of lumbar conditions and chronic pelvic pain. The primary rationale for its use is on the basis of the biomechanical effects of axial spinal distraction. Little data are available describing the in vivo effect of distraction when used in combination with flexion or other motions. Despite widespread use, the efficacy of distraction manipulation is not well established. Further research is needed to establish the efficacy and safety of distraction manipulation and to explore biomechanical, neurological, and biochemical events that may be altered by this treatment.