Traction as a treatment for me. Any thoughts?

[andrewking]

for the past 3 months i have been suffering from severe neck pain, i have taken traction for 5 times as per doctor advice, i reported to doctor that my pain is not yet cured, because when i lift my head, i have a severe sharp pain on top neck. Doctor advised me to take a mnri scan, which costs around 120 dollars. luckily after a period of 3 days gap the sharp pain has gone. Now my question is again after 1 and half months , i feel pain in the center of my back. should i take traction without consulting the doctor or i should not take it. Becos my expenses are increasing day by day due to this back pain. suggestions plz.

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[physiobob]

You should consult your local physiotherapist for an assessment and advice. You doctor is not the best person to deal with what might be a simple musculoskeletal issue. In fact some studies on low back pain management found that GP advice was less successful then placebo!

[Aisha_kb]

Absolutely... You need to consult with your physio and let him/her decide on what is the best treatment for you.
Also, you have to bear in mind that, what may work the first time may not necessarily work the second time round. Correct ergonomics and APPROPRIATE EXERCISE is what is needed along with whatever modality that is used...

[asha]

It would be best for you if you trace a mckenzie trained therapist in your locality. You could through the official website mckenziemdt.org

[sdkashif]

It is difficult to comment upon your condition as you are here to inquire as a patient. For a proper pt condition presentation a history or Subjective Examination and a clinical examination or objective examination is very necessary. Only after that a suitable plan of treatment can be outlined. It is a better to consult a local physiotherapist there so that you condition is properly assessed.

The commonest cause of neck pain is usually a cervical disc syndrome. However, other serious causes of neck pain should be analysed and ruled out. Briefly they can be categorized as under:

Arthritic:

Rheumatoid Arthritis
Osteoarthritis
Pyogenic Arthritis
Tuberculous Arthritis
Ankylosing spondylitis

Neoplasms:

Primary spinal tumours
Secondary spinal tumour or metstases

Musuloskeletal:

Cervival sprain and strains
Cervival disc syndrome
Cervical spondylosis
Cervical myofascial pain syndromes
Throracic Outlet syndrome
Cervical Sponylolisthesis

Fractures:

Spinal fractures & injuries and dislocations in cervical region


A spinal traction is not indicated in all conditions and has only recommedation in which it is suitable.

[alophysio]

Hi,

Please consult a trained physiotherapist who has had post-graduate training in manual therapy. It may cost more to see this person - don't let this put you off - because it should save you money in the long run.

There is a journal article published in the British Medical Journal (Cost effectiveness of physiotherapy, manual therapy, and general practitioner care for neck pain: economic evaluation alongside a randomised controlled trial - Ingeborg B C Korthals-de Bos, Jan L Hoving, Maurits W van Tulder, Maureen P M H Rutten-van
Mölken, Herman J Adèr, Henrica C W de Vet,BartWKoes, Hindrik Vondeling, Lex M Bouter - VOLUME 326, 26 APRIL 2003) that explains what i am talking about. Here is a summary of the article

Abstract

Objective: To evaluate the cost effectiveness of physiotherapy, manual therapy, and care by a general practitioner for patients with neck pain.

Design: Economic evaluation alongside a randomised controlled trial.

Setting: Primary care.

Participants: 183 patients with neck pain for at least two weeks recruited by 42 general practitioners and randomly allocated to manual therapy (n=60, spinal mobilisation), physiotherapy (n=59, mainly exercise),
or general practitioner care (n=64, counselling, education, and drugs).

Main outcome measures: Clinical outcomes were perceived recovery, intensity of pain, functional disability, and quality of life. Direct and indirect costs were measured by means of cost diaries that were kept by patients for one year. Differences in mean costs between groups, cost effectiveness, and cost
utility ratios were evaluated by applying non-parametric bootstrapping techniques.

Results: The manual therapy group showed a faster
improvement than the physiotherapy group and the general practitioner care group up to 26 weeks, but differences were negligible by follow up at 52 weeks.

The total costs of manual therapy (€447; £273; $402) were around one third of the costs of physiotherapy (€1297) and general practitioner care (€1379). These differences were significant: P < 0.01 for manual therapy versus physiotherapy and manual therapy versus general practitioner care and P=0.55 for general practitioner care versus physiotherapy.

The cost effectiveness ratios and the cost utility ratios showed that manual therapy was less costly and more effective than physiotherapy or general practitioner care.

Conclusions: Manual therapy (spinal mobilisation) is more effective and less costly for treating neck pain than physiotherapy or care by a general practitioner.

So please go to see a physiotherapist with post-graduate training for you neck pain. If there aren't any around, a good physiotherapist without post-grad training is ok so long as they don't just give you exercise only (see the study) or advice only (like a GP would). Rather, they should use their hands (manual therapy) in more ways than just a massage. A properly trained Mackenzie physiotherapist would fit into this category but it is not the only way to treat necks.

Good luck!

BTW, you can't tell that i am post-graduate trained can you??!! I really recommend post graduate training for all physios. It has helped in so many ways!

[ginger]

Alophysio, I agree strongly that the prospects of cervical pain and dysfunction improvement increase dramatically , when manual mobilisation treatments are used, provided the method and skill are up to scratch. Having post graduate education is not a good indicator of those variables In my opinion.
Mention of "physiotherapy " in your quoted study is odd to say the least.. As if there is such a thing. Those who practice as physiotherapists only provide treatments, all different, all weighted according to the skill and understanding of therapist.To imply by the notation "physiotherapy' that a standard exists denoting fluid empathy between all therapists such that treatments thus described , are identical , is impossible and ludicrous .
This does unfortunately , put a shadow over the otherwise , quite acceptable and pragmatically well oiled idea that manual treatments are more usefull for pain relief than exercise. An idea I entirely egree with and find daily examples of.
Andrew, don't be too dismayed by the list of possible causes suggested by one poster above, with due respect , these causes are rarities. His suggestion that most neck pain is disc related is not supported by either current literature, or the indicators present to most therapists who regularly use hands on manual therapies to treat neck problems. Most neck pain is completely treatable , however does require you to find someone with manual therapy skill , rather than a stand back and give exercise type. Anyone seeking to "fix" your problem with modalities ( ultrasound, electrotherapies , traction , diathermy, laser etc ) is wasting your time and money.These kinds of treatments are still to be found in third world countries and in the clinics of poorly trained therapists , but are unlikely to be of ultimate benefit.
Manual therapists are skilled in provision of movement related treatments that undo the protective tightness associated with a protective cascade of tightness and irritation.These reponses are ubiquitous in the assemby of normal physiological mechanisms that provide security for your spine and nervous system. Tbey are not pathological, just strong and irritating as well as potentially long term if left untreated. a good therapist needs only hands to turn off these responses and return your neck to painfree movements .
See a physiotherapist who is skilled with his or her hands, it is there you will find your best chance of a positive outcome.

[alophysio]

Agreed! Well put. I would've just said "agreed" but it didn't let me!