The effect of adding lumber traction to the classical management of sciatica secondary to lumbar disc herniation in Omdurman military hospital October2017-March 2018

Abstract

Background and Objectives traction is commonly used for the treatment of low back pain (LBP), predominately with nerve root involvement. Most people with low back pain have symptoms resulting from nonspecific causes. About 5% to 10% of people with low back pain have sciatica. Sciatica is caused by a herniated disc involving nerve root compression. The most important symptom of sciatica is lumbosacral radicular leg pain radiating below the knee and into the foot and toes. Aim : to study the effect of traction on sciatica patient secondary to disc herniation by using special test ( Pain level using Visual Analog Scale (VAS), lumbar range of motion measured by goniometer, functional disability using Oswestry Disability Index (ODI), manual muscles testing and lower limb manual muscles testing, straight leg raising test). Material and Methodology A total of 40 participants with lumbar sciatica secondary to disc herniation were randomly allocated into two groups 20 will be in group A and 20 will be in group B. Group A: sciatica traction with traditional physiotherapy (TENS,US). Group B: traditional physiotherapy (TENS, US), 12 sessions was done to all patients. Visual analogue scale, back range of motion, manual muscle test (back, lower limb), lumber function index that were assessed pre, and 4 weeks post interventions. A brief description of the aim of the research had given to the participants and a written consent obtained and the privacy of the participants had been taken in consideration. Results: when comparisons between groups was done, The current study founded statistical insignificant reduction in pain in two experimental groups (p= 0.585), and demonstrated statistical insignificance improved functional performance in two experimental groups (p=.0.705), also lumber flexion, extension, right rotation, left rotation and right lumber lateral bending range of motion showed insignificant improvement in two groups. Back flexion, extension, rotation muscle manual testing showed insignificant improvement in tow groups, also manual muscle test for lower limb right and left hip flexion, extension, abduction, adduction, internal rotation, external rotation, right and left knee flexion, extension right and left ankle dorsiflexion, planter flexion showed insignificant improvement in two groups. Left ankle inversion, eversion showed insignificant improvement in two groups. There demonstrated statistical significant improved in back left lateral flexion, in group A (0.00). Group (A) results better improvement in right ankle inversion, eversion as compared to group B. Conclusion: The traction group receiving lumbar traction in addition to US and TENS therapy group (A) had same effects of the group (B) regarding to pain, functional disability, back and lower extremity manual muscle testing. And there are improvement the right ankle inversion, eversion, back left lateral flexion in group (A) as compared to group B.