Expert: Dr. J. Shawn Leatherman - 2/20/2009

Question
Hello Dr,
Referring to my first post (same title), dated 11/15/2008. You mentioned in your 2nd post that the traction I used may or may not be effective. I have a few questions.

1) Can you please explain why the above traction may not be effective in treating me problem?
2) What type of traction treatment do you recommend?
3) Are there any exercise I can do to help hydrate the bad discs?

Thank you.
Lee

Answer
Dear Lee,

I would really need to see your x-ray or know the exact measured dimensions to make a specific recommendation on what type of traction would be appropriate for your neck curve.  The reason is that you can have a few different presentations of a curve reversal such as an "s" shaped curve or a "C" shaped curve.  Within that context, you can also have forward or rearward head movement in relation to the normal positioning of the head on the shoulders.  This is called anterior or posterior translation.  The data I would need is:

Millimeters of head translation
Measured angle of the Atlas
Measured angle of spinal curve from C2 to C7
Where the apex of the curve is...what segment of the spine.
Also does your neck lean to one side or the other...how many millimeters

All of these parameters need to be considered when placing a patient into traction, as well as the traction needs to be placed at or just below the apex of the curve.  Then the angle of the traction needs to be altered depending on what segment of the spine the traction is applied to.  For instance if traction is applied to the C7 vertebra the angle of pull would be 0 degrees.  As you move up the spine the angle increases...if the traction is placed at C5 the angle of pull would be 10-15 degrees.  There are specific rules to follow when performing these applications and that is why I suggested you check the credentials of your chiropractor on the www.idealspine.com website.  

These are the reasons I said that the traction may or may not be effective...if you don't apply the most appropriate form of traction, then you will not get the best results.  However, the traction you had described will definitely help to restore some of your lost curve, you just might not get all of the curve back.  What I would look for in a 9-12 week program would be more than a 50% improvement.  For instance the optimal curve measures 43 degree, but anything over 35 degrees can be considered normal.   So, if your curve measures -4 degrees then you would need  47 degrees of improvement to hit optimal configuration.  If you are able to obtain 50% of that, then you have a 23 degree improvement which would leave you with an overall neck curve measurement of 19 degrees.  Although this is not in the normal range it is definitely a clinical success.  At that point you need to make the decision on whether or not you want to continue traction to reach the normal range or not, and the doctor needs to re-evaluate the traction to determine if you need to remain in the same configuration or be changed to a different form.

Concerning exercises, there are no specific exercises to regain hyrdration to the disk other than light compression exercises, and these will likely not give you appreciable results.  All you do to perform it is sit on a therapy ball with proper posture (upright without slumping, and bounce lightly up and down for 15 minutes)  This will serve to lightly compress and then distract the disc which will pump fluid into the disc material from the bone marrow...the property is called imbibition.  However, I would recommend that you should be doing head retraction exercises to activate the musculature on the back side of the neck.  Head and next extension exercise against resistance would also be beneficial.  Chiropractors that perfom rehab should have these machines in office and be able to guide you through the process.

Hope this helps Lee.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net