It’s Only Natural
Chapter IV
Intermittent Motorized Traction
And Allied Therapies
As we look at a picture of a spine,
we see a group of thirty three irregularly shaped bones sitting one on
top of the other, the smallest at the top, largest at the bottom, and between
each a cushion or disc shaped like a doughnut with a nice wad of jelly
in the middle. The main part of this doughnut consists of tough cartilaginous
material that is hard and unyielding. The center part of the doughnut (the
jelly) consists of a substance called the nucleus pulposus, a gelatinous
material surrounded by a membrane sheath, which acts as a shock absorber
to give resiliency to an otherwise inflexible spinal component.
The spine is not straight front to back, but is shaped like a letter S.
This adds to the shock-absorbing effect of the spine by providing a spring-like
action that absorbs much of the pressure and stress on the lowest spinal
segments.
Despite this wonderfully designed structure, the spinal discs, like all
other parts of the body, are susceptible to wear and tear. This degeneration
would cause few problems were it not for the serious consequences that
can arise when the degeneration narrows the intervertebral foramen (the
opening through which the spinal nerves pass from the spinal cord to the
periphery).
The upper portion of this foramen (opening) is formed from a surface of
the vertebra above and the lower portion from the adjacent segment below.
The spinal disc separates the two vertebrae in such a manner that the opening
is adequate for the nerve and allied tissue to function freely (Fig. 4).
The size of this opening is thereby controlled by the integrity of the
spinal disc. If the spinal disc between these two vertebrae deteriorates,
the vertebrae are jammed together and the opening for the spinal nerve
becomes smaller. This causes pressure on the nerve and allied parts, producing
a pinched nerve. Although, theoretically, this may occur at any
level of the spine, it most commonly takes place in the lower lumbar (low
back) and/or cervical (neck) regions.
The Low-Back Disc Syndrome
The lowest part of the spine must
carry the weight of the entire upper trunk of the body. It is this area-the
4th and 5th lumbar vertebrae and the first sacral segment-that receives
the greatest stress. And it is here that spinal disc degeneration occurs
most commonly .
Injuries to this portion of the spine are relatively common. Almost any
form of heavy lifting produces its greatest strain at this level. Many
types of falls cause injury destructive to this area. It isn't surprising,
therefore, that treatment of disc compressions in this area comprises a
considerable part of our low-back work.
The neck vertebrae are only slightly less frequently affected than those
of the low back. There are three common causes of disc degeneration in
the cervical spine.
The first is arthritis, which apparently affects neck discs more readily
than those of the other spinal levels. This may be because the neck discs
are much smaller than the others and therefore more easily damaged by arthritic
calcium deposits. The second most common cause of cervical disk narrowing
is the later consequences of whiplash injuries. With the increase in the
number of automobiles, rear end collisions have been growing by leaps and
bounds; the injuries to the spine caused by this accident tend to produce
cervical disc problems some time after the accident. Such narrowing may
not show up for several years after the original accident and, therefore,
all physicians should be very careful in discharging such accident patients
too soon after the injury.
The last cause of cervical disc problems is the general neck trauma (injury)
caused by a variety of falls or accidents. When we discover a neck disc
lesion through X-ray where there has been no whiplash injury and the patient
is free of arthritis, we can usually trace the patient's trouble to some
neck injury that occurred previously, often during childhood. This early
injury may have been quite minor, but the neck is delicate and such minor
assaults often show up later as cervical disc compressions.
Disc Treatment
Most disc problems can be treated
satisfactorily by the use of traction and various other modalities designed
to help the traction perform its needed task. Most of you are probably
familiar with the regular hospital traction generally used for these patients.
In this type of therapy for the low back, weights are attached to the patient's
ankles by a system of ropes and pulleys. Up to fifteen pounds is placed
on each leg, and it is necessary for the patient to remain in bed for a
considerable period while under this therapy. Recent studies on this type
of traction found that patients given it did not recover any faster
than those who were treated without it. These results confirm our own experience
with this type of steady traction for the low back.
A similar form of traction is used for the neck, except that a halter is
attached to the chin and head, a rope that goes over pulleys is connected
to this and a weight is attached to the end of the rope. We have found
this type of traction to be useful as a home treatment in some varieties
of cervical disk compression but only in conjunction with other therapies
that we use at the Healing Research Center.
In all low back patients and in many cervical (neck) patients we find that
this type of steady traction has several disadvantages. Most of these disadvantages
are overcome by the use of intermittent motorized traction (IMT), the method
used in our Centers.
One of the most obvious disadvantages of orthodox steady traction is the
inconvenience to the patient. Not everyone has the time to spend two or
three weeks flat on his back in bed, not to mention the cost involved.
Because hospital traction is applied to the ankles in low-back syndromes,
the knee and hip are both placed under tension before the force reaches
the lumbar area. Stretching in these joints dissipates much of the applied
force and thus as little as one or two pounds of traction force is actually
delivered to the injured disc.
Also, when a steady traction is applied to an area, the musculature goes
into spasm to protect the part from this abnormal pressure. Often this
muscular spasm not only increases the patient's pain, but also acts as
an effective counteracting force to diminish still further the traction's
usefulness.
Because the need for effective traction therapy was so great and the accepted
methods so inadequate, many fertile minds went to work in search of a better
way. From this work evolved the theory and mechanism of motorized intermittent
traction. In IMT, a belt is applied immediately around the hip area, and
a nylon rope is attached to this belt by a special "tail," which
is secured to either side of the affected disc area. This rope is attached
to a computer-controlled motor unit that can be adjusted to intermittently
pull and release the rope at any chosen poundage. The holding time of the
traction and the resting time between tractions are also variable so that
they may be set for the best possible patient response.
A special table for this unit enables the upper part of the patient to
remain fixed while the lower portion of the table (on rollers) is free
to move, thereby assuring an absolute minimum amount of friction during
the treatment. The feet and knees are elevated by a special stool that
provides the most restful posture as traction is applied.
Treatments are usually given for twenty minutes at a time, two to three
times a week, depending on the severity of the case. Pressure may vary
between fifty and eighty pounds.
Because of the ingenious use of the belts described above, which enable
the major part of the traction to be applied directly to the area of involvement,
twenty to fifty times more pressure can be applied to the vertebral area
than by regular steady hospital traction. Also the alternate pull and release
of this form of traction doesn't allow sufficient time during the pull
cycle for a build-up of the muscle spasm that is a frequent component of
the more static forms of traction, thus effectively preventing counteracting
muscular forces. With the use of IMT, the patient is kept ambulatory and
only the most severe cases must refrain from their regular employment.
Cervical Traction
This type of traction can be used
just as readily for the neck as for the low back. In cervical traction,
the patient is reversed on the table, the sliding component of the table
secured, the position of the motor head raised to produce the proper angle
for the neck and then an appropriate neck halter and spreader bar are used
to secure the patient. The hold period of traction pressure is usually
reduced because the neck muscles are more sensitive than those of the low
back and greater care must be taken to prevent a spastic reaction. The
poundage ranges anywhere from twenty to forty-five, thirty-five for women
and forty-five for men.
The average low-back disc patient will notice improvement after the third
or fourth treatment, though in some resistant patients, it may take six
to eight treatments before observable improvement becomes evident. Cervical
patients are more variable in their response. Some show improvement with
the first traction, while some old whiplash patients may require up to
ten treatments before real help is felt.
Other Modalities
The usual form of therapy we use for
low-back disc patients consists of diathermy to relax the musculature,
intermittent traction to open the disc area and take pressure off the spinal
nerves, and finally ultrasound treatments directly over the affected discs
to stimulate their regeneration and reduce the inflammation always found
in these areas. Recently, we have added the phenomenal MicroLight 830 to
this program. This Low Reactive Light Laser Therapy has revolutionized
the pain control of these patients in our Center. While at the time of
this writing, this hand held wonder is still in the investigational stage,
we have found it to be without peer in bringing long desired relief to
many cervical and low back patients. See the section later in this book
for a complete run down on this "magic" little unit.
Because we at the Healing Research Center believe that all chronic conditions
are aggravated by improper nutrition, we recommend that our low-back patients
follow our basic maintenance diet. In addition we supplement this diet
with vitamin C, vitamin E, manganese phytate, and any other special nutrients
that we have found are important to the patient's recovery from such maladies.
In the last forty years, I have handled thousands of these low back cases,
yet I can count on the fingers of one hand those that required surgery
when the treatment outlined above was used. Of course, the earlier in the
condition we are able to treat the patient, the quicker and more complete
will be the results but even in most advanced cases, the intermittent traction
therapy and the other modalities are not without considerable success.
Whiplash Injuries
Intermittent cervical traction is particularly beneficial in all types of old whiplash injuries. These patients usually begin to exhibit symptoms many years after the original accident, and often they have nearly forgotten the causal incident. Problems usually begin as numbness or tingling in one hand, particularly at night. It may even awaken the patient with an arm that has "gone to sleep." When the patient is up and around, his head and neck are in motion and there is no constant pressure on the affected nerve in the neck. But when he goes to sleep or perhaps sits down to read a book, the lack of motion of the head and neck may put sufficient pressure on the spinal nerve to produce the sensations down the arm. These symptoms are caused by vertebral pressure due to thinning discs or calcium deposits. Both problems are usually rapidly improved by IMT, the MicroLight laser and the other modalities we us.
Arthritis
Intermittent cervical traction is
also useful in certain arthritic problems of the neck and upper back. The
procedure must be done carefully, but it seems that gentle pressure to
counteract the daily effects of gravity will alleviate these troublesome
symptoms, even in some of the older and more chronic cases.
We have even used cervical traction to good advantage in many cases of
cerebral arteriosclerosis (hardening of the arteries of the brain). While
certainly not specific, it seems the mild rhythmic stretching of the neck
structures increases the circulation to the brain and helps relieve many
of the distressing symptoms of cerebral anoxia.
Cautions to be Observed
IMT is an active form of therapy in
which care must be taken not to begin treatments with too much pressure.
We always start with mild pressures and gradually build up the tension
along with the patient's ability to accept it. Some patients can take two
hundred pounds of pressure in the low back; others feel that fifty to sixty-five
is too much.
After every IMT treatment on the low back, it is very important that the
patient remain on the table for at least five minutes before going on to
the next therapy. The patient usually doesn't feel the full effect of the
traction until he tries to arise after the treatment. Very often while
under treatment, the patient says that he hardly feels any pulling at all.
Yet when he tries to move after traction, he soon finds that his muscles
and ligaments have been stretched and they needs a little time to adjust
before he can walk easily. This is also true in neck patients, so all our
intermittent traction patients are asked to rest five minutes after their
IMT treatment.
Except for a little muscle stiffness after the first or second treatment,
the patient will usually feel no discomfort from this type of traction.
If the patient does experience discomfort after a few treatments, the therapy
should be discontinued. Even though IMT is the therapy of choice in most
low-back disc cases and in many neck problems, not every patient can accept
it readily. For these patients, other forms of therapy must be instituted.
It's been our experience that patients who can't take IMT readily, do respond
satisfactorily to some of the less energetic forms of physical therapy.
This is especially true now that we have the Low Level Laser to offer them.
Although IMT is relatively simple, it is most effective and nothing else
quite takes its place. It is not commonly available, however, in most hospitals
or doctors offices and very few of our patients had heard of it before
their treatments at our Center. Few doctors in the manipulative field use
this therapy. It is even rarer in the offices of the medical profession.
Cost may be a factor why this method is so little used; the equipment is
quite expensive and many physicians may believe that they wouldn't treat
enough patients to justify the expense. At the Healing Research Center
we do not place cost first when it comes to the welfare of our patients
and so we are often the first to offer such advanced therapies.
For low-back disc problems or for neck troubles that don't respond to manipulation,
don't be talked into surgery until you have investigated the possibility
of our intermittent motorized traction and the modalities that go along
with its use.