J. Phys. Ther. Sci.

Original Article 27: 481–483, 2015

Influences of spinal decompression therapy and

general traction therapy on the pain, disability, and
straight leg raising of patients with intervertebral
disc herniation

Jioun Choi, MS, PT1), Sangyong Lee, PhD, PT2), Gak Hwangbo, PhD, PT3)*
1) Department of Rehabilitation Science, Graduate School Daegu University, Republic of Korea
2) Department of Physical Therapy, Youngdong University, Republic of Korea
3) Department of Physical Therapy, College of Rehabilitation Science, Daegu University: 12, 15

Jillyang, Republic of Korea

Abstract. [Purpose] The purpose of this study was to identify how spinal decompression therapy and general
traction therapy influence the pain, disability, and straight leg raise (SLR) ability of patients with intervertebral
disc herniation. [Subjects] The subjects were 30 patients with chronic lumbar pain who were divided into a spinal
decompression therapy group (SDTG, n=15), and a general traction therapy group (GTTG, n=15). [Methods] The
SDTG used a spinal decompression device, and the GTTG used a lumbar traction device. Both groups received
conservative physical therapy three times a week for four weeks. A visual analog scale (VAS) was used to measure
the degree of pain the patients with chronic lumbar pain. The Oswestry Disability Index (ODI) was used to measure
the degree of functional disability. A goniometer was used to measure the patients’ SLR ability. [Results] Both
SDTG and GTTG showed statistically significant decreases in VAS and ODI scores and a statistically significant
increase in SLR angle. A comparison of the two groups found no statistically significant differences. [Conclusion]
Spinal decompression therapy and general traction therapy are effective at improving the pain, disability, and SLR
of patients with intervertebral disc herniation. Thus, selective treatment may be required.
Key words: Spinal decompression therapy, Pain, Straight leg raise
(This article was submitted Jul. 25, 2014, and was accepted Sep. 2, 2014)

INTRODUCTION hydration and reduces pressure on the nerve root by remov-

ing the force applied to the vertebral pulp3).
Eighty percent of adults experience lumbar pain at least Spinal decompression therapy is another method that
once in their lifetime, and 80% of structures causing lumbar has recently been used as a conservative treatment for in-
pain are related to intervertebral discs1). Disc herniation is tervertebral disc herniation. Spinal decompression therapy
multifactorial, often related to degenerative processes and reduces the pressure on the intervertebral disc by suppling
mechanical effects, and mostly occurs due to light external nutrients and oxygen to the intervertebral disc. This creates
injuries of the spine, such as spinal bending and stretching, a state of non-gravitation or negative pressure by adjusting
spinal rotation exercises, and abrupt posture changes2). Both the direction and angle of traction to suit the location of the
surgical and conservative treatment methods are considered intervertebral disc, which is the target of the treatment. This
for intervertebral disc herniation. Conservative treatments in turn reduces the pressure inside the intervertebral disc by
include medication, exercise therapy, and physical and re- gradually and softly increasing a specific part of the inter-
habilitation methods. Among them, one of the most widely vertebral disc through the decompression of a precise part
used methods is traction therapy. Traction therapy reduces of the lesion4).
the pressure caused by gravity and soft tissues, and sufficient Although studies of various treatment methods for inter-
tension extends spinal separation and the intervertebral disc. vertebral disc herniation have been conducted, comparisons
Negative pressure within the intervertebral disc increases its of spinal decompression therapy and general traction therapy
remain inadequate. This study aimed to identify how spinal
decompression therapy and general traction therapy, which
*Corresponding author. Gak Hwangbo (E-mail: hbgak@ are non-surgical treatment methods, influence the pain, dis-
daegu.ac.kr) ability, and straight leg raise (SLR) ability of patients with
©2015 The Society of Physical Therapy Science. Published by IPEC Inc. intervertebral disc herniation.
This is an open-access article distributed under the terms of the Cre-
ative Commons Attribution Non-Commercial No Derivatives (by-nc-
nd) License <http://creativecommons.org/licenses/by-nc-nd/3.0/>.
482 J. Phys. Ther. Sci. Vol. 27, No. 2, 2015

SUBJECTS AND METHODS Table 1. Comparison of the VAS, ODI and SLR within each
group
The subjects of this study were 30 patients (male: 9, Group Pre Post
female: 21) who complained of radiating pain caused by
VAS (point) SDTG** 6.2±1.7 4.3±1.5
chronic lumbar pain. The subjects had suffered from continu-
GTTG** 5.7±1.4 4.6±1.5
ous lumbar pain, as diagnosed by an orthopedic specialist, for
over three months, and were selected from among patients ODI (%) SDTG** 30.1±15.1 20.3±14.1
who visited S Hospital, located in Daegu Metropolitan City, GTTG** 30.2±14.4 23.3±12.0
Korea. On average, the spinal decompression therapy group SLR (degree) SDTG** 53.5±11.3 62.3±10.5
(SDTG, n=15) was 41.3±7.3 years of age, 162.3±8.9 cm in GTTG** 58.1±9.7 63.3±8.7
height, and 58.3±12.2 kg in weight, and the general traction VAS: visual analog scale, ODI: Oswestry disability index, SLR:
therapy group (GTTG, n=15) was 44.0±4.1 years of age, straight leg raise, SDTG: spinal decompression therapy group,
162.7±8.4 cm in height, and 59.1±11.3 kg in weight. No sta- GTTG: general traction therapy group, **: p<0.01
tistically significant differences were found in their general
characteristics. Ethical approval for the study was granted by
the Youngdong University Institutional Review Board. All by the maximum score of 45 points. A SLR test was per-
subjects read and signed consent forms in accordance with formed to determine whether the nerves under pressure due
the ethical principles of the Declaration of Helsinki. Those to intervertebral disc herniation had tension5). For the SLR
who had undergone an operation on a lumbar vertebra, had test, each patient lay on his/her back and relaxed by stretch-
spinal tumors or infections in the intervertebral disc, inflam- ing both legs. While slowly raising the subject’s straight leg
matory diseases such as rheumatism, fractures, or other on the affected side, the tester used a goniometer to measure
contraindications for manual therapy, were excluded from the angle when lumbar pain or radiating pain in the legs oc-
the study. curred.
All subjects were treated three times each week for four The paired t-test was conducted to compare values before
weeks. The SDTG were treated with a spinal decompression and after the treatment within each group to identify the
therapy device (MID 4 M Series, WIZ Medical, Korea) for pain, disability, and SLR of patients with chronic lumbar
20 minutes each time. The GTTG were treated with a lum- pain. The independent t-test was performed to compare
bar traction therapy device (OL 110, Dong Bang Medical, differences between the two groups. This study performed
Japan) for 20 minutes each time. Hot packs (20 minutes), statistical analyses using SPSS 12.0 for Windows, and the
interferential current therapy (15 minutes), and ultrasound (5 level of statistical significance was chosen as α=0.05
minutes) were used to treat both groups during the conserva-
tive physical therapy. RESULTS
Each subject of the SDTG, which received the spinal
decompression therapy, lay on his/her back on the device’s The SDTG and GTTG showed statistically significant
bed and had the pelvic and thoracic regions fixed with an air declines in the VAS and the ODI socres (p<0.05), and a sta-
belt. The slipping of the fixed parts was prevented by fixing tistically significant increase in the angle of SLR (p<0.05).
the patient’s head with a strap. The region of the cervical On the other hand, the comparison of the two groups found
vertebrae was stretched by applying the robotic jog system, no statistically significant differences (p>0.05) (Table 1).
and a sacrum treatment device that supports the sacrum was
used to maintain lumbar lordosis. Traction started with a DISCUSSION
strength level of 5 to 6; the power level was increased by a
certain ratio during each phase. When pain occurred due to Spinal decompression therapy resolves problems with the
an increase in traction, the existing power level of traction disc and removes the pressure applied to the disc by supply-
was lowered or maintained. The ratio of the hold time to the ing nutrients and oxygen to the disc. This creates a state of
rest time was set at 2:1, and standard and divided compres- non-gravitation or negative pressure within the spinal canal
sion methods were used simultaneously. Each subject of the and reduces pressure inside the intervertebral disc by softly
GTTG, which received lumbar traction therapy, lay on his/ increasing a specific part of the disc through the decompres-
her back on a traction table and had a knee support placed sion of a precise part of the lesion6).
under each knee. Traction was first applied at one third of Borman et al.7) reported that a group treated with general
the subject’s weight. Then, the traction was increased after physical therapy and intermittent traction therapy showed
each treatment, up to 50% of the subject’s weight. When an statistically significant declines in ODI and VAS scores.
increase in traction caused pain, the existing traction was Meszaros et al.8) reported that traction therapy for 10 patients,
lowered or maintained. who had a SLR angle of 45° and complained of lumbar or
A visual analogue scale (VAS) was used to evaluate the nerve root pain, resulted in an increase in SLR angle after
degree of pain. The Oswestry Disability Index (ODI) was the treatment. Gose et al.9) noted that spinal decompression
employed to evaluate the degree of disability. Nine questions therapy decreased pain and increased mobility and showed
were scored from 0 to 5 according to functional performance statistically significant effects in MRI images. Gionis and
with higher scores indicating higher degrees of disability. Groteke10) reported that after spinal decompression therapy,
Percentage (%) values were obtained by adding the score 86% of 219 patients reported pain reduction. Ramos and
measured from each item and dividing the sum of all items Martin6) reported that spinal decompression therapy yielded
 483

statistically significant effects on MRI images. Moreover, with intervertebral disc herniation. In conclusion, physical
in a study by Yang11), a group that received spinal decom- therapists may be required to select an appropriate treatment
pression therapy showed statistically significant declines in method considering the condition of a patient, cost, and time.
VAS and ODI scores. Kang12) conducted spinal decompres- Follow-up studies should be conducted on the long-term ef-
sion therapy and manual therapy for patients with lumbar fects of these therapies, increasing the treatment period and
intervertebral disc herniation, and reported that after the the number of treatments.
treatment, the SLR angle showed a statistically significant
increase. Lee et al.13) reported that a group that received REFERENCES
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