Lumbar traction is the process of applying a stretching force to the lumbar vertebrae through body weight, weights, and/or pulleys to distract individual joints of the lumbar spine. The word traction is a derivative of the Latin word "tractico", which means "a process of drawing or pulling, and various forms of spinal traction have been described, since the time of Hippocrates, for the relief of pain.
James Cyriax popularized lumbar traction during the 1950s and 1960s as a treatment for disc protrusions, and until today, it is still a common modality for treating patients with back pain and leg pain. Although its effectiveness is still being questioned by a few clinical trials, there are three benefits of lumbar traction described by James Cyriax: distraction to increase the intervertebral space, tensing of the posterior longitudinal vertebral ligament to exert centripetal force at the back of the joint and suction to draw the disc protrusion towards the center of the joint. Some other effects attributed to traction include widening of the intervertebral foramen and distraction of the apophyseal joints.
Clinically Relevant Anatomy
The lumbar spine is made up of five individual vertebrae which are numbered L1 to L5 and together they create the concave lumbar curvature in the lower back. Found along the body’s midline in the lumbar (lower back) region, the lumbar vertebrae make up the region of the spine inferior to the thoracic vertebrae in the thorax and superior to the sacrum and coccyx in the pelvis.These vertebrae carry all of the upper body’s weight while providing flexibility and movement to the trunk region. They also protect the delicate spinal cord and nerves within their vertebral canal.
Balance problems can make you feel dizzy, as if the room is spinning, unsteady, or lightheaded. You might feel that you're going to fall down. These feelings can happen whether you're lying down, sitting or standing.
Many body systems including your muscles, bones, joints, vision, the balance organ in the inner ear, nerves, heart and blood vessels must work normally for you to have normal balance. When these systems aren't functioning well, you can experience balance problems.
Many medical conditions can cause balance problems. However, most balance problems result from issues in your balance end-organ in the inner ear (vestibular system).
What is Benign Paroxysmal Positional Vertigo?
Vertigo is a very specific kind of dizziness: the feeling that you’re going around and around or that the inside of your head is spinning. Benign paroxysmal positional vertigo (BPPV) is the most common cause of this condition.
Each part of the name describes a key part of the inner-ear disorder:
• Benign means it’s not very serious. Your life is not in danger.
• Paroxysmal means that it hits suddenly and lasts a short time.
• Positional means you trigger the vertigo with certain postures or movements.
It's common, and usually can be treated in a doctor’s office.
In rare cases, the problem can be serious if it increases your chances of falling. If you get these attacks often, it could point to other medical conditions. They’re often hard to diagnose, though.
How are the spine and its discs designed?
The vertebrae are the bony building blocks of the spine. Between each of the largest parts (bodies) of the vertebrae are the discs. Ligaments are situated around the spine and discs. The spine has seven vertebrae in the neck (cervical vertebrae), 12 vertebrae in the mid-back (thoracic vertebrae), and five vertebrae in the low back (lumbar vertebrae). In addition, in the mid-buttock, beneath the fifth lumbar vertebra, is the sacrum, followed by the tailbone (coccyx).
The bony spine is designed so that vertebrae "stacked" together can provide a movable support structure while also protecting the spinal cord (nervous tissue that extends down the spinal column from the brain) from injury. Each vertebra has a spinous process, which is a bony prominence behind the spinal cord that shields the cord's nerve tissue. The vertebrae also have a strong bony "body" in front of the spinal cord to provide a platform suitable for weight-bearing.
The spine is almost always under pressure when upright, and therefore prone to the wear-and-tear that leads to osteoarthritis.
This degenerative condition can cause minor to debilitating pain. Understanding how osteoarthritis causes back pain can help patients stop or slow the disease's progression and also reduce pain.
Osteoarthritic Changes in Vertebrae
Facet joints connect the vertebral bone. On the back of each vertebra there are two upper and two lower facet joints. Facets are small, boney projections with smooth, flat surfaces that are normally covered in protective articular cartilage. The facet joint, where two facets meet, is wrapped a fluid-filled sac called a facet capsule.
As you age, your chance of developing osteoarthritis, which is caused by wear and tear, increases. The joint damage associated with osteoarthritis causes swelling, pain, and deformity. Here is information about how osteoarthritis affects the foot and ankle and information you can use to help you manage this debilitating condition.
Arthritis is a general term for a group of more than 100 diseases. The word "arthritis" means "joint inflammation." Arthritis involves inflammation and swelling in and around the body's joints and surrounding soft tissue. The inflammation can cause pain and stiffness.
In many kinds of arthritis, progressive joint deterioration occurs and the smooth "cushioning" cartilage in joints is gradually lost. As a result, the bones rub and wear against each other. Soft tissues in the joints also may begin to wear down. Arthritis can be painful and eventually result in limited motion, loss of joint function, and deformities in the joints affected.
Compression = the application of strong pressure
Fracture = a break in a bone
A compression fracture occurs when part of a vertebra, or bone in the spine, collapses.
The bones of the spine have two main section. The vertebral arch is a ring-shaped section that forms the roof of the spinal canal and protects the spinal cord. You can feel the spinous process, a projection from this arch, when you press on the skin in the middle of your back. The vertebral body is the cylindrical shaped portion of the vertebral one that lies in front and provides the majority of structural support. In a compression fracture, the vertebral body collapses.
The most common type of compression fracture is a wedge fracture, in which the front of the vertebral body collapses but the back does not, meaning that the bone assumes a wedge shape.
A "pinched nerve" is the name given to the uncomfortable sensation, pain, or numbness caused when increased pressure leads to irritation or damage to a peripheral nerve (A peripheral nerve is one that is outside the brain and spinal cord.). Although this condition is often associated with back pain or a neck injury, almost any nerve is susceptible.
WHAT ARE THE FACTORS FOR A PINCHED NERVE?
Anything which increases pressure around a nerve can cause a pinched nerve. Common causes include body position such as leaning on elbows, habitually crossing legs, or poor posture. Over time this may lead to pressure injury to nerves in these regions.
• Disc herniation or bulging discs and arthritis in the spine can cause pressure on nerve roots which leads to the pain or discomfort associated with a pinched nerve.
• Weight gain or water retention can predispose people to developing pinched nerves; thyroid disease (especially hypothyroidism, or low thyroid hormone levels) can contribute to both water retention and weight gain and can increase the risk of certain types of pinched nerves.
• Pregnancy, which is associated with increased weight and occasionally associated with water retention, is also a common risk factor for developing certain types of pinched nerves.
• Repetitive activities (typing and using certain tools) can also increase swelling around specific nerves and lead to symptoms of a pinched nerve.
WHAT CAUSES A PINCHED NERVE?
Pressure on a peripheral nerve can irritate the nerve itself, its protective covering (myelin sheath), or both. When this occurs, the nerve is unable to conduct sensory impulses to the brain appropriately, leading to a sense of numbness. This inflammation associated with the damage or injury can also cause pain or paresthesia (a tingling or prickling sensation) signals to be sent to the brain. In its early stages, many people may describe this sensation as a body part that has "fallen asleep." However, if nerve inflammation persists, this sensation persists rather than resolving after a few minutes.
What Is Bursitis?
Bursitis is the inflammation or irritation of the bursa. The bursa is a sac filled with lubricating fluid, located between tissues such as bone, muscle, tendons, and skin, which decrease rubbing, friction, and irritation.
What Causes Bursitis?
Bursitis is most often caused by repetitive, minor impact on the area, or from a sudden, more serious injury. Age also plays a role. As tendons age they are able to tolerate stress less, are less elastic, and are easier to tear.
Overuse or injury to the joint at work or play can also increase a person's risk of bursitis. Examples of high-risk activities include gardening, raking, carpentry, shoveling, painting, scrubbing, tennis, golf, skiing, throwing, and pitching. Incorrect posture at work or home and poor stretching or conditioning before exercise can also lead to bursitis.
Just as your favorite pair of jeans can become worn and threadbare in the knees, your tendons can also develop chronic injury through wear-and-tear.
There are 3 tendons that connect the hamstring muscles (in red) to the sit bone in the pelvis.
Why does chronic tendinopathy occur?
There are 3 tendons in the back of the thigh that connect the hamstring muscles to the ischial tuberosity (the sit bone) in the pelvis. When people engage in sports or activities that subject these tendons to repetitive motions, the elastic collagen proteins in the tendon become injured and start to break down, causing degeneration of the tendon.
More than 30 million children and teenagers participate in organized sports today. About 288,000 of those are injured each year playing baseball. Today, young athletes face pressure to focus on one sport often playing year round and participating on multiple teams. Without taking time off or changing sports during the year, baseball players commonly experience arm soreness and are likely to develop overuse injuries. If not properly managed, these overuse injuries can lead to more serious problems.
Baseball players most often injure their shoulders or elbows. Shoulder-related injuries range from tendonitis of the muscles that keep the joint (the rotator cuff) stable to cartilage tears within the joint itself. Elbow problems include tendonitis of the muscles on top of or below the forearm and strains of the ligaments on the inside of the elbow.
Overuse baseball injuries
Overuse injuries can include tendonitis, inflammation of muscles, fractures, sprains, strains, cartilage tears, and more. These baseball injuries can prevent players from performing their best and make playing impossible in some cases. Baseball and softball players should condition with exercises to prevent injury and maximize performance.
Baseball conditioning exercises target several causes of baseball and softball-related injuries, including decreased rotator cuff or scapular strength, poor flexibility/ROM, and insufficient warm-up.
Carpal tunnel syndrome is essentially a pinched nerve in the wrist. There is a space in the wrist called the carpal tunnel where the median nerve and nine tendons pass from the forearm into the hand (Figure 1). Carpal tunnel syndrome happens when swelling in this tunnel puts pressure on the nerve.
Pressure on the nerve can happen several ways, including:
• Swelling of the lining of the flexor tendons, called tenosynovitis
• Joint dislocations
• Fluid build-up during pregnancy