Mechanical Traction as a Means of Reducing Subluxations of the Lumbar Lordosis
Troyanovich, Stephan J
Introduction
From its beginnings to the present, the chiropractic profession has been interested in methods to restore normal alignment (structure) to the spinal column with the ultimate purpose of restoring normal function to the spine and nervous components housed inside. Interestingly, mechanical traction has been used by chiropractors to reduce spinal misalignments in spite of the fact that chiropractic is a profession founded on the principle of “by hands only” interventions. In this brief article, the use of mechanical traction as a means to reduce subluxations of the lumbar lordotic curve is traced from the profession’s origin to the modern era.
Is There a Normal Lumbar Alignment?
Although what constitutes “normal” alignment may incite heated arguments among different factions of the profession, emerging evidence has demonstrated that the lumbar lordosis resembles the geometric configuration of an ellipse with approximately 65 percent of the lordotic curve located at L4-L5-S1.1 Additionally, several radiographie studies have demonstrated that there are discrete differences in the Lordotic alignment of the lumbar spines of normal healthy subjects and low-back pain patients.2,3
Even in the absence of this information, early chiropractors attempted to restore lordotic curvatures to the lumbar spine using mechanical traction. Doctors of chiropractic of the modern era now use the findings from the above-cited studies (and others) as normative data toward which they attempt to remodel their patients’ spines with the aid of mechanical traction devices.
Lumbar Extension Traction
The use of traction for subluxation correction can be traced to chiropractic’s original “mixer” practitioner, Solon Massey Langworthy, DC, a 1901 graduate of D.D. Palmer’s chiropractic school. Langworthy, one of Palmer’s original 12 chiropractic disciples, established a thriving practice and chiropractic school (American School of Chiropractic and Nature Cure) in Cedar Rapids, Iowa, in the early 1900s. In a recent article published in the journal Chiropractic History, Troyanovich and Gibbons4 recount the important contributions made by this colorful chiropractic pioneer, such as:
* Publication of the profession’s first regular journal (Backbone) in 1903
* Co-authorship and publication of the profession’s first textbooks (Modernized Chiropractic, Volumes 1 &2)
* Establishment of the first national chiropractic association, and
* The invention and patenting of several revolutionary adjusting tables and spinal traction devices to aid in subluxation correction.
One of Langworthy’s inventions was known as the “Amplia Thrill” traction table. He received a patent for the device in October 1908,5 and it is depicted in Fig. 1. Although the device had the capability to perform both cervical and lumbar traction, this paper will be limited to the lumbar traction capabilities of the invention.
Fig. 2 depicts one of the most interesting features of the Amplia Thrill traction table. A semi-circular yoke was attached to the table on tracks that would allow the yoke to move along the length of the table. The yoke could be locked into place anywhere along the table at the discretion of the operator. Attached to the semi-circular yoke was a movable slide fitted with a large tubular screw. At the end of the screw, a leather strap was threaded through an opening to create a loop. This looped strap or girth could encircle the body anywhere along the length of the table. By turning the tubular screw, the thorax, lumbar spine, or pelvis could be pulled laterally or upward at any angle. This would allow a sustained force to be applied to reduce antalgic postures observed in acute low-back injuries, or to apply extension (as in backward bending) traction forces to the lordotic curve of the lumbar spine.
More recently, Steve Foster, DC, of Greeley, Colorado, has created a device to induce lumbar extension traction in an erect kneeling position in a method he describes as five-point traction. His invention was created circa 1995(6) and is depicted in Fig. 3. Roger Coleman, DC, of Othello, Washington, created a method whereby extension traction of the lumbar spine can be induced in a patient who is standing.7 The Coleman device and method further allow the patient to perform active extension exercises while in the device, which may add to the clinical effectiveness of the method. Coleman’s invention is depicted in Fig. 4.
Finally, Fig. 5 demonstrates the pre-treatment and post-treatment Lumbar spine radiographs of a patient treated with the Coleman method. The patient was a male truck driver in his mid-30s, referred for chiropractic treatment by a neurosurgeon for a herniated disc at L5-S1 with concurrent right radiating lower-extremity pain. The patient received a course of treatment over an eight-week period consisting of spinal manipulation, Coleman standing lumbar extension traction, and McKenzie-type lumbar extension exercises. The patient’s symptoms resolved over this period, and he returned to work without restrictions.
Conclusion
Lumbar extension traction has been used from the time of the earliest chiropractic pioneers until the present as a means to restore normal alignment to the lordotic curve of the lumbar spine. Although founded on the principle that chiropractic is a “by hands only” method of care, chiropractic innovators have devised multiple mechanical devices to assist in the reduction of the chiropractic lesion.
Copyright American Chiropractic Association Dec 2003
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