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Flexion-Distraction Technique: A Scientific Breakthrough in Disk Herniation Treatment
The flexion-distraction technique originally developed by Dr. James Cox in the early 1970s has now become a revolutionary way to treat intervertebral disc herniation/lower back injuries. A seventh-generation version of this same table has recently been introduced. It’s applied on a special distraction/manipulation table that has the ability to apply long Y-axis distraction to the cervical spine, thoracic spine, or lumbar spine. Now, the joint can be distracted and placed into flexion, extension, lateral flexion, circumduction, and rotation. Those are the physiological ranges of motion of a joint. So, in principal, if we can place a joint through its physiological ranges of motion, it will be a healthy joint. |
Three federally funded research studies – in a partnership between National University of Health Sciences and Loyola University’s Stritch School of Medicine - of the biomechanics and clinical outcomes with flexion-distraction manipulation were concluded. From these studies, specific concepts of how the flexion-distraction technique treats disc herniations have evolved. First, it increases the intervertebral disk space height by up to 2mm. Second, it has a decompression component where it drops the pressure inside the nucleus pulposus of the disk from a positive pressure of 25 mm of mercury to a negative pressure of -39 to -192 mm of mercury pressure. That drop creates a centripetal force – a suction or “vacuum effect” – that returns the disk bulge back between the vertebral bodies. Third, it increases the area of the intervertebral foramen through which the nerve passes by up to 28 percent. Other research has shown that as we use distraction-manipulation, abnormal flex patterns caused by disk herniation are improved. Some recently published case report studies show the relief of cervical and lumbar spine stenosis and disk herniation in patients undergoing distraction-manipulation.
Reference: Dubourg G, et al. A pilot study on the recovery from paresis after lumbar disc herniation. Spine, 2002. 27(13):1426-31.
Treatment Protocol
The table utilizes a smooth hydraulic and/or manual component to enable the lumbar spine to separate from the cervical and the thoracic regions. According to the level of comfort, a patient is placed upward or downward when being treated for a low-back herniation - capabilities which are not seen in other similar types of traction-decompression tables. The optimal distraction can be maintained for a static or intermittent level of pressure according to the degree of pain. Treatments can require 20 minutes, but no longer than 30 minutes depending on each individuals’ needs.
Therapeutic ultrasound and electric muscle stimulation are used in various stages of the treatment from the acute inflammatory stage to the rehabilitative muscle strengthening stage. These therapies, when used in conjunction with flexion distraction help facilitate the healing process.
Exercise and rehabilitation programs are implemented with each phase of care, with emphasis from the early stages on range of motion exercises and stretching, to clinical proven programs of core stabilization that help build back stability and functional strength.
Diets and supplements are individualized to help reduce inflammation of acute lower back pain. As treatment progresses other nutrients can also be used to help repair and strengthen discs, ligaments, tendons, and muscles.
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