Why is ‘Flexion Distraction’ such a great tool in the fight against low back pain and sciatica?

Posted Sep 21, 2020 by Pinnacle Spine & Sports

By Dr Jack Rogers | BChiroSc, MChiroprac

Lower back pain and sciatica are two of the most common things we see here at Pinnacle Spine & Sports, pretty much on a daily basis. Every day we use a range of evidence-backed treatment techniques to get you out of pain as fast as possible.

One of those techniques is “flexion distraction”. Using a specialised table that you won’t find in every clinic, flexion distraction, or “traction therapy” applies a gentle mobilising force to damaged areas to provide fast and effective relief. Whether it be a bulging disc, degenerative lower back issues or sciatic pain, flexion distraction offers a unique approach backed by research (and lots of happy patients).

Flexion distraction is a gentle, rhythmic, traction mobilisation technique for the lumbar spine (low back). It is used to effectively treat a wide range of spinal pain conditions including:

  • disc injuries
  • sciatica
  • facet joint syndromes
  • arthritis pain
  • post-surgical Back pain
  • spondylolisthesis (forward slippage of a vertebra)
  • ligament and soft tissue aggravations

Flexion distraction is a highly effective treatment protocol, as it can be easily graded to the tolerance of each individual patient. Frequency and the extent of traction can easily be assessed by the practitioner during the treatment and modified accordingly.

The clinical effects of flexion distraction include:

  • Raises Lumbar disc height to remove tension on the annular fibres and spinal nerve by making more room and increasing circulation
  • Reduces pressure within the nucleus pulposus of the intervertebral disc by up to 192mmHg
  • Enlarges the area of the intervertebral foramen (hole where the nerves exit the spine) by up to 28% to relieve pressure on spinal nerves
  • Restores joints to their normal motion and function
  • Stimulation of joint receptors to have a reflex inhibition of pain signals and muscle spasm
  • Assists drainage of waste products and chemical pain mediators out of the disc and spinal canal, and improved diffusion of circulation and nutrients into the disc

Is low back pain or sciatica degrading your lifestyle? Is it stopping you from being able to work effectively, look after the kids, hit the golf course or give 100% at the gym? Flexion distraction could be the best thing for you.


Effects of flexion-distraction manipulation therapy on pain and disability in patients with lumbar spinal stenosis. Jioun Choi MS, Sangyong Lee, Chunbae Jeon. J. Phys. Ther. Sci.

27: 1937–1939, 2015

A randomized clinical trial and subgroupanalysis to compare flexion–distraction with active exercise for chronic low back pain. Maruti Ram Gudavalli, Jerrilyn A. Cambron, Marion McGregor, James Jedlicka, Michael Keenum, Alexander J. Ghanayem, Avinash G. Patwardhan. Eur Spine J (2006) 15: 1070–1082

Bulbulian R, Burke J, Dishman JD: Spinal reflex excitability changes afterlumbar spine passive flexion mobilization. J Manipulative Physiol Ther,2002, 25: 526–532.

The Basic Science Study Regarding the Application of Flexion Distraction in the Lumbar Spine. 1994-1997, Health Resources & Services Administration, Researchers at National University of Health Sciences and Loyola University were led by Ram Gudavali PhD and A.G.Patwardhan PhD.

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