Autotraction treatment for low-back pain syndromes

Autotraction (AT) is a form of exercise for low back pain. The patient lies on a specially designed bench with the pelvis anchored and while grasping an overhead bar, pulls him or herself. The patient should not feel any pain. To ensure painless pulling efforts during treatment, the table allows three-dimensional adjustments to the alignment of the patient's trunk. Although the method was originally designed for patients with acute pain, it has been found that 3-6 half-hr outpatient sessions provide relief from pain in 50-60% of patients with long-lasting low back pain with or without sciatic nerve involvement. This includes patients with verified lumbar disc herniation and those who have been refractory to previous conservative or surgical treatments. The aim of passive forms of traction and of conventional exercise regimens is to decrease intervertebral disk pressure; in contrast studies have demonstrated that autotraction is associated with sharp rises in intervertebral disc pressure. This mechanism of action still needs to be verified. It has been suggested that relief of pain with autotraction may be due to favorable microscopic changes at the disc-nerve interface or to decongestion of engorged epidural veins.