Low back pain resulting from lumbar
disc herniation is a common reason for referral for
physical therapy. There is no evidence to support the management of lumbar
disc herniation and derangement using mechanical
traction combined with lumbar extension exercises. Therefore, the purpose of this case report was to describe and discuss the use of mechanical
traction in conjunction with lumbar extension exercises for a patient with a lumbar
herniated disc. The patient was a 49-year-old male referred to
physical therapy with a medical diagnosis of a lumbar
herniated disc at L5-S1 with compression of the L5 nerve root confirmed by MRI. The patient's chief complaint was
pain over the left lumbosacral and central lumbar region with
radiating pain into the left buttock accompanied by
numbness and tingling in the left lower leg and foot. The patient was seen for a total of 14 visits. The first 5 days (2 weeks) of
therapy consisted of lumbar extension exercises. For the following nine visits (over a 3-week period), mechanical
traction was added as an adjunct to the extension exercises. Outcome measures included the Oswestry Disability Questionnaire,
Back Pain Function Scale (BPFS), and the Numeric
Pain Rating Scale (NPRS). Results from initial evaluation to discharge (Oswestry: 36% to 0%; BPFS: 33/60 to 57/60; NPRS: 7/10 to 0/10) demonstrated that the patient no longer experienced
low back pain and improved in terms of functional status and
pain-related disability. The patient no longer complained of
numbness and tingling in the left lower extremity and the goals for the patient had been attained. The data from this case report suggests lumbar extension exercises in conjunction with mechanical
traction facilitated the patient's improvement in
pain and return to prior level of function.