AJCC 2003

October 2003

Cervical and Lumbar Traction Belong

in Every Chiropractic Office

by Scott J. Heun, D.C.

CBP® has over 60 papers published in the Index Medicus, many in review for publication, and data being collected for a great deal more. The scientific support the chiropractic profession has craved for so long has become an actuality. The publication of the Normal Spinal Model gave the profession the foundation to establish normal versus abnormal, and to quantify it. Though it was always speculated and at times debated that subluxation could be established as a real pathological entity afflicting the human body, the science remained elusive. In other words, the chiropractic philosophy we all were taught had little replicable or practical application. That is no longer the case.

As we learn more about the effect of abnormal posture on the nervous system and the health of the human organism, we have begun to realize that all too often in chiropractic practice, we are only scratching the surface when it comes to patient care. In most instances, we are reducing the frequency of care at a time when the body is only beginning to change in a positive way. There are few patients who actually begin care unless there are symptoms involved. The ideal of chiropractic care being preventative has not yet materialized. The fact is most doctors focus their attention on symptoms alone as the patients do not remain under care long enough to advance beyond the resolution of their symptoms.

Regardless of your technical approach to the patient-whether Activator, Gonstead, Diversified, PST or any of the other mechanical approaches to spinal adjusting or manipulation-all have significant limitations. These techniques do not permanently alter the structure of the spine. Make no mistake, the introduction of mechanical forces during manipulation and adjusting of the spine is still a very important practice and should continue. The limitations of the application of high speed low amplitude forces into the spine and skeleton, however, needs to be understood.

The benefit of manipulation is increased mobility, reduced pain, improved local circulation, and perhaps improved nerve conductivity and changes in proprioception. I am sure there are many positive effects of which we are still ignorant. Regardless, as ethical chiropractic practitioners, we owe it to the patient population to offer the best approach to patient care. It is time to look seriously at the positive effects of improving posture to the normal spinal model with the appropriate application of traction and the implementation of Mirror Image® postural exercise.

The patients must understand the nature of their problems, be offered choices for care based upon their understanding of the problem(s) they present and be taught the relationship between structure and function and the effect on not only their health but on their lives as well. This all falls under the heading of functional philosophy. The patients’ willingness to stay long enough for their structures to improve or be corrected is the result. The definition of the number of visits a patient sees the doctor is called retention. In a recent study published in JMPT Increasing the Cervical Lordosis With Chiropractic Biophysics Seated Combined Extension Compression and Transverse Load Cervical Traction with Cervical Manipulation: Nonrandomized Clinical Control Trial, Harrison et al. demonstrated substantial positive change in the cervical lordosis in 38 visits over 14.6 weeks. This number of visits is approximately three times the national average retention. What is your retention, and are you currently offering care which will structurally change the patients’ postures?

By judiciously applying the appropriate type of traction to your patients, you provide the opportunity to improve their postures, reduce nerve system stress and have a positive impact upon their overall health. The challenge is one of overcoming quasi-political bias towards technique, or philosophical confusion as to the role chiropractic has to play in health care. I contend that all patients deserve the opportunity to improve their health maximally. With appropriate teaching of functional philosophy, adjusting, traction and exercise along with life style and ergonomic changes (the application of the current science and technology of chiropractic), the patients we serve can achieve a higher quality of life than they would achieve without our care.

Consider re-evaluating your present clinical application of chiropractic technology. Consider looking critically at the application of cervical, thoracic and lumbar postural traction and Mirror Image® Exercises to complement your current clinical approach. Practicing with definable, defendable and replicable scientifically based techniques is far more fulfilling and even fun than the alternative. Knowing that your postural exam, radiographic exam and re-exam, as well as your clinical applications, are backed by peer reviewed research is empowering. Evaluating and re-evaluating with reliable and reproducible technology promotes confidence and improves retention when coupled with appropriate teaching and motivating. I challenge you to critically analyze your chiropractic platform. No reasonable chiropractor could object to positively changing the patient’s biomechanics towards an accepted norm.

I encourage you to attend the Lumbar Rehabilitation and Cervical Rehabilitation seminars offered by CBP® Seminars as soon as possible. You will find the technical certainty empowering, and the patients you serve will be offered the best chiropractic science has to offer.