Compression lesion, which causes a ischemic problem for the spinal root tissue and the tissues around it, compression of the spinal cord membranes, etc. is the leading link in spinal pathology.
The muscular defense of spastic muscular blocks was inherited from the animal world and is good only when walking on four limbs, when, after performing its function, it is developed by a wave-like movement of the spine in a step and trot. This movement is easy to see when watching the animals from above - their pelvic girdle and shoulder girdle work all the time in antiphase, which leads to repeated sinusoidal curvatures of the spine to the sides. This is their natural therapeutic gymnastics:

This movement was well felt by everyone who was involved in horse riding. In addition, when the spine is in a horizontal position, the force of gravity acts across it, and on us and all direct erects, this force acts vertically on compression. It remains for us to go down on all fours and fight compression ...
Therefore, it is necessary to constantly engage in the mobilization of the spine and have a technique for relieving the compression load on the spine.
Obligatory and the best tactic to date in all cases:

1. Mandatory MRI examination, for absolutely accurate determination of the spinal status and diagnosis of possible hazards (protrusion and herniation of intervertebral discs, congenital problems of the structure of the spine, traces of old spinal injuries with static disorders). This is the only way to choose the right treatment tactics and avoid the complications of irrational treatment. Routine radiological examinations, and especially manual “predictors” do not provide enough information to make the right decision!
2. If an MRI examination reveals significant morphological changes that can lead to serious complications (spinal stenosis, compression of spinal root tissue or spinal cord, pelvic disorders, peripheral paresis, etc.), a neurosurgeon must be consulted.

Tactics in severe cases (in the acute period) and their non-surgical treatment:

1. The use of drugs (painkillers, vasodilators, vitamin, muscle relaxants, etc.) is justified in the acute period to accelerate the removal of local edema and muscle spasm.
2. The use of blockades (corticosteroid with lidocaine) is ambiguous, it is better to avoid them, but in case of a severe course of the acute period, the use of blockades is justified. This gives the patient the opportunity to take a break from continuous pain.
3. The use of a corset or high support belt is possible to facilitate movement in the acute period. Constant wearing is best avoided, since it causes overheating and swelling of the zone, and also turns off the activity of the muscles that are needed for lymphatic "pumps" and further treatment.
4. Massage with wide coverage to improve lymphatic drainage and help with ischemia.
5. The whole arsenal of reflex therapy methods (massage of the tendon-muscular canals by the projection of pain, corporal acupuncture, auricular acupuncture, etc.)
6. Soft manual osteopathic techniques.
7. Therapeutic gymnastics.
8. Repetition of courses 4-5-6-7 until possible recovery.
9. Traction therapy without forcing with control of the situation only if the pain does not increase.
10. Program of therapeutic prophylactic gymnastics and activity.
11. Periodic MRI examinations in the future to monitor the situation

Tactics for chronic diseases of the spine:

1. Massage with wide coverage to improve lymphatic drainage and help with ischemia
2. The whole arsenal of reflex therapy methods (massage of the tendon-muscular canals by the projection of pain, corporal acupuncture, auricular acupuncture, etc.)
3. Soft manual osteopathic techniques
4. Therapeutic gymnastics
5. Repetition of courses 4-5-6-7 until possible recovery
6. Program of therapeutic prophylactic gymnastics and activity
7. Periodic MRI examinations in the future to monitor the situation.

Traction therapy:
The use of traction therapy devices has been known since antiquity, patients were stretched, hung, etc. We tried many different techniques and devices, here are the conclusions:

• traction therapy is necessary for long-term self-use at home
• the best time for the procedure is right before bedtime to prolong the anti-ischemic effect
• the location of the apparatus, the entrance and exit of the procedure should ensure smooth and relaxed movements, so as not to accidentally cause sudden movement
• the patient himself must regulate the traction force
• the patient must be taught to manage relaxation with the help of breathing
• traction procedure should not be uncomfortable and painful, because it increases muscle spasm
• traction should be carried out with the possibility of adjusting the angle of the neck (for the cervical region) and the possibility of regulating the flexion of the pelvis (rotation in the frontal plane) for the lumbar spine
  There are many options on the market, we trust Comfortrac and Sounders devices, several Chinese manufacturers. These are private issues that we can discuss with you on time.

RESPIRATORY TECHNIQUE WHEN USING TRACTOR THERAPY DEVICES

(Developed and repeatedly tested in our practice).
Observing the patient for his breathing and the development of a state of relaxation during the procedure is an important success factor. The controlling technique in the development of relaxation is breathing. Understanding this technique is easy and easy to learn.
The main principle is: the tension increases during inhalation, and during fast inhalation it grows spasmodically. When you hold your breath while inhaling, the tension of the tissues increases, and with a deep delay it can become longer than the “inhale-exhale” cycle, and it will gradually increase further and further. With a smooth exhalation, the tension of the tissues softens and on the exhalation a little deeper than usual (i.e. without effort, just a little deeper) becomes longer and deeper. With a short expiration delay (10-15 sec.), Relaxation begins to “spread” through the body, involving more and more tissues in relaxation.
A simple breathing technique to achieve sufficient relaxation: (you can begin to exercise while lying down in a comfortable posture on your back with your legs and hands slightly bent at the knees or below the abdomen or along your body. without neck sagging):

• calm normal breath => without delay calm normal exhale => pause 5 seconds, this cycle repeats as many times as the eyes are half closed and the patient relaxes the face, mentally modeling the “pleasant weight” of the face, which relaxes a little “spreading” over the bones of the face
• quiet normal exhalation => without delay, extended by 15-20% more normal exhalation => delay 10 -15 sec (if this requires effort, delay is reduced to a comfortable one). This is the main working breath at the time of the extension procedure. Moreover, if there is a desire to breathe more - do not hinder it - one breath deeper to restore a comfortable state and continue to perform the technique in the same rhythm

Combination of breathing technique with extension procedure:

• the patient is positioned on the device, all necessary fixing belts are attached, the patient’s hands together with the air pump must find a comfortable relaxed position, preferably at the abdomen level and “lying on the body” as much as possible (it’s not rational to keep your hands on the weight, especially if you use a neck traction device)
• gradually increasing the traction of the patient moves to the above described breathing technique
  by increasing the traction the patient reaches the maximum possible for him (according to his sensations) and painless traction effort and stops. Further, he monitors only the breathing and the development of relaxation. After some time (individually and according to sensations, usually 3-5 minutes, but maybe a lot more), the patient has a feeling that the traction has weakened a little - this means that the relaxation worked and gave the musculo-spinal apparatus of the spine a little stretch and relax
• the patient boosts the air pump a little to achieve a slight sensation of thrust appearing, while continuing to breathe in the same technique
• Thus, during one procedure, the patient goes through several such "steps", focusing only on his feelings. The correct result should be the emergence of the feeling of "growth in length" and pleasant relaxation.
• If during the procedure a sensation appears that will be unpleasant, or too strong, it makes sense to relieve the pressure a little (preferably not completely) and continue to calmly practice breathing practice in the same rhythm. After resting for a few minutes, it makes sense to return to the previous position and continue

I would like to once again draw attention to the fact that the use of traction devices should not cause pain, and the devices themselves should not be used for power attempts to “pull by force and right.” It is necessary to clearly understand that forceful actions on stretching can lead to an increase in protective muscle spasm. The main thing is to get a smooth and pleasant feeling of stretching along the axis of the spine with relaxation. Effort you stop in the comfort zone and focus only on your feelings!

TRACTING THERAPY OF THE NECK AND TOP SUPREG DIVISION OF THE SPINE
CONTRAINDICATIONS:

• There are no absolute contraindications.
• Use in the acute stage and at the peak of the pain syndrome should be started with a small impact and very carefully in order to avoid increasing pain
• The presence of severe scoliosis requires consultation with a qualified physician before using the device to avoid destabilization of the existing compensatory state
• The presence of spinal deformity due to spinal injury also requires expert advice in order to avoid destabilization of the existing compensatory state.
  In the case of the problems described above, it is necessary to evaluate the existing protective muscular blocks and the geometrical ratio of the bone elements, which will make it possible to make a decision on the expediency of changing the compensatory design. Although careful application without forcing will relieve muscle fatigue and give the discs and paravertebral muscles the opportunity to "rest" from constant compression.

PREPARATION OF PROCEDURE
The traction device can be installed on the floor on a non-slip mat if the procedure is done at home. In the cabinet, we install the device on the traction table. Also, several low-cost models of neck traction devices are being sold in a sitting position. The angle of inclination (when lying) is set depending on the structure of the neck and the bending of the upper thoracic spine of the patient, again the main criterion is convenience. The higher the angle of inclination, the greater the effort is on the lower cervical and upper thoracic vertebrae and discs, with a low inclination the thrust is distributed more evenly throughout the neck.
The rest depends on the design of the device.

METHODS OF USE OF NECK TRACTIVE DEVICE
The main thing:

• The patient himself dispenses the force of traction, commensurate with her feelings. This unique opportunity allows you to act very accurately and carefully.
• The appearance of pain during the procedure is unacceptable, a pulling sensation is allowed, which should be painless and pleasant
• It should be understood that the effect is on the paravertebral muscles, which are in a long spastic hypertonia and on the ligamentous apparatus of the spine. Therefore, a sharp impact will be perceived by them as provocative and will lead to a defensive reaction, i.e. further increase muscle spasm! On the contrary, a gentle and careful long-term exposure will help them to relax and “believe” that this is a curative rather than damaging procedure.
• The exposure time of less than 10 minutes does not make sense, in our experience in cases of a long history of spinal disease, sessions of 25 to 30 minutes are optimal.
• At the beginning of therapy, the patient can either begin with a minimal impact, or try to find the border of an unpleasant feeling and then “sink a little lower” into a pleasant zone in order to begin therapy. In any case, with the appearance of pain, craving should be eased until the unpleasant pain disappears.
• Traction can be done both continuously and continuously throughout the procedure, and periodically loosening cravings with the pressure release button. However, the frequent changes in the traction effort have no meaning, since provoke muscle spasm
• It is especially important to understand the procedure termination procedure. Do not immediately jump up. and the more intensively bend-straighten the neck after the procedure. If the procedure is done on the floor, it makes sense to gently "roll" on the stomach, stand on all fours and gently climb with the support on the chair. If the procedure is done on a couch or on a massage table, it makes sense to take help.
• You also need to take into account the possibility of orthostatic collapse (especially in vertebral artery syndrome and in all older patients). Lifting after the procedure should be done carefully and gradually to calmly give blood pressure to stabilize.

Use in practice reflex, osteopathic or massage room:

• It makes sense to use the device after an acupuncture session on the paravertebral zones or osteopathic intervention. Massage, as a preliminary aid, is also useful in this case.
• In this case, the use of the apparatus will help both to relieve muscle spasm and compression load, and to fix the result of the manipulative intervention by longitudinal soft traction for a sufficiently long time (from 15 minutes to 1/2 hour).
• Repeated stretching sessions several times during the week will allow you to spend 8 to 12 half-hour sessions per month, which will give lasting results.
• Excellent results can be obtained from patients suffering from vascular dystonia and vertebral artery syndrome. For such patients, this method of therapy can be decisive.
• Preventive use of the device in the office will significantly reduce the number of exacerbations, and then, in many cases, even save the patient from pain symptoms.

Home use:

• Course use traction apparatus in accordance with the method for the treatment of diseases of the spine. A monthly course 2-3 times a week will give a good lasting result.
• Preventive weekly courses every other day in the spring-autumn period of seasonal exacerbations
• Unloading traction therapy for persons with occupational hazards (office workers, programmers, etc., who have to sit at the desk for a long time, which causes tension in the cervical and upper thoracic spine, athletes, drivers)
• Extension procedures for vegetative-vascular dystonia can be performed in short sessions of 10-15 minutes almost daily.
  
  

TRACTING THERAPY OF THE LUMBAR AND LOWER EXTERIOR DIVISION OF THE SPINE
CONTRAINDICATIONS

• There are no absolute contraindications.
• Use in the acute stage and at the peak of the pain syndrome should be started with a small impact and very carefully in order to avoid increasing pain
• The presence of severe scoliosis requires consultation with a qualified physician before using the device to avoid destabilization of the existing compensatory state.
• The presence of spinal deformity due to spinal injury also requires expert advice in order to avoid destabilization of the existing compensatory state.

In the case of the problems described above, it is necessary to evaluate the existing protective muscular blocks and the geometrical ratio of the bone elements, which will make it possible to make a decision on the expediency of changing the compensatory design. Although careful application without forcing will relieve muscle fatigue and give the discs and paravertebral muscles the opportunity to "rest" from constant compression.

PREPARATION OF PROCEDURE
The traction device can be installed on the floor if the procedure is done at home. In the cabinet we use the traction table.
The fixing of the belts is made tightly and without slack. Legs necessarily bent. If it is possible to use a stand under the shins (for example, we use a foam block) to get the thigh and shank position "sitting on a chair", the procedure will be more effective for lower parts of the lower back, because this position leads to rotation of the pelvis relative to the frontal axis and straightening of the lumbar lordosis.
The angle of the neck is regulated by putting a small pillow. It should be borne in mind that the position of the legs "sitting on a chair" in combination with a strong flexion of the neck enhances the effect of stretching, but can be painful. Therefore, you need to adjust the position of the patient, based on comfort and convenience.

METHODS OF USE OF THE LUMBAR TRACTIVE DEVICE
The main thing:

• The patient himself dispenses the force of traction, commensurate with her feelings. This unique opportunity allows you to act very accurately and carefully.
• The appearance of pain during the procedure is unacceptable, a pulling sensation is allowed, which should be painless and pleasant
• It should be understood that the effect is on the paravertebral muscles, which are in a long spastic hypertonia and on the ligamentous apparatus of the spine. Therefore, a sharp impact will be perceived by them as provocative and will lead to a defensive reaction, i.e. further increase muscle spasm! On the contrary, a gentle and careful long-term exposure will help them to relax and “believe” that this is a curative rather than damaging procedure.
• The exposure time of less than 10 minutes does not make sense, in our experience in cases of a long history of spinal disease, sessions of 25 to 30 minutes are optimal.
• At the beginning of therapy, the patient can either begin with a minimal impact, or try to find the border of an unpleasant feeling and then “sink a little lower” into a pleasant zone in order to begin therapy. In any case, the pressure release button should immediately stop the impact if painful sensations appear.
• Traction can be done both continuously and continuously throughout the procedure, and periodically loosening cravings with the pressure release button. However, the frequent changes in the traction effort have no meaning, since provoke muscle spasm
• It is especially important to understand the procedure termination procedure. Do not immediately jump up. and even more so to sit on the machine jerk at the expense of the abdominal muscles. If the procedure is done on the floor, it makes sense to gently "roll" on the stomach, go up on all fours and gently climb. If the procedure is done on a couch or on a massage table, it makes sense to take help.
• It is also necessary to take into account the possibility of orthostatic collapse (especially in vertebral artery syndrome and in all older patients). Lifting after the procedure should be done gently and gradually to calm the blood pressure.

Home use:

• Course use traction apparatus in accordance with the method for the treatment of diseases of the spine. A monthly course 2-3 times a week will give a good lasting result.
• Preventive weekly courses every other day in the spring-autumn period of seasonal exacerbations
• Discharge traction therapy for persons with occupational hazards (manual workers, athletes working with weights, weightlifters, bodybuilders, drivers, etc.)