Cox Flexion/Distraction

What is Cox Flexion/Distraction?

Cox® Distraction Manipulation is a chiropractic adjusting technique, a gentle, chiropractic adjustment procedure for BACK and NECK pain. Its procedures were established by Dr. James M. Cox and have evolved over the past 38+ years due to the many efforts of researchers and fellow chiropractic physicians. Cox® Distraction is a safe alternative to back surgery for those 95% of patients whose conditions don`t demand surgical intervention or back surgery. Cox® Technique may help relieve pain from disc herniations, failed back surgery syndromes, leg pain, sciatica, neck pain, arm pain, ruptured discs, herniated discs, slipped discs, low back pain, facet syndrome, bulging discs, spondylolisthesis, transitional segment, rib subluxations, thoracic spine pain, scoliosis, sprain/strain, disc prolapse, etc. Acute back pain and spinal pain as well as subacute back pain and chronic back pain can be addressed.

Dr. Wolf-Richter took a one year certification course in Chicago and is one of six chiropractors certified in the Cox Distraction Technique in Washington.

Benefits of Cox Flexion/Distraction

Distraction Manipulation creates a "push, pull, pumping" effect on the intervertebral disc space. For patients with a "slipped/bulging/ruptured/herniated" disc (without cauda equina syndrome), Cox® Distraction Manipulation provides the following benefits:

  • allows the nucleus pulposus inside the disc to assume its central position within the anular fibers and relieve irritations on the spinal nerve caused by swelling.
  • increases the intervertebral disc height to remove tension on the anular fibers and nerve by making more room and improving circulation.
  • restores vertebral joints to their physiological relationships of motion (re-aligns the spine).
  • improves posture and movement while relieving pain, improving bodily functions, and creating a state of well being.
Non-Disc Related Benefits:

For patients with other conditions causing back pain (facet syndrome, spondylolisthesis, sprain/strain, scoliosis, transitional vertebra, sacroiliac subluxation, stenosis), Cox® Distraction Manipulation provides all of the above benefits plus the ability to place the spinal joints into normal, painless movements so as to restore spinal motion without pain.

How Does the Cox Distraction Instrument Work

The Lumbar Spine Adjustment

After undergoing a thorough examination, which leads the doctor to a diagnosis of the back condition to be treated, the patient lies on a table that is built to traction the spine and also to produce motions that are normal for the spine. To attain these motions, the table goes "up and down" (flexion and extension), goes "side to side" (lateral flexion), or moves in a circular motion (circumduction). All movements are slow.

The doctor will hold a spinous process (the back part of the vertebra that feels like a "bump" on your spine) to isolate a single segment for treatment. The distraction manipulation is applied manually by the doctor to the patient`s low back at the levels of the spine to be treated or that are painful. Tolerance testing is performed prior to the application of distraction manipulation to be sure it causes no pain to the patient. This technique is designed to help patients with low back pain and leg pain.

The Cervical Spine Adjustment

The patient will lie prone (face down) on the table whose headpiece moves in motions that are normal for the cervical spine (Flexion, Extension, Rotation, Lateral flexion, and Circumduction). This headpiece allows traction to be applied to the cervical or thoracic spines alone or while these motions are being administered. The doctor will hold the appropriate spinous process (back of the vertebra) of the cervical spine to isolate the level of pain or the level of vertebra to be adjusted. This technique is designed to help patients with neck pain, radicular arm pain.


NOTE: This brief description is not meant to fully describe the technique of distraction adjustment, but serves as only an outline for understanding its use.

Research

 The following is a summary of the 1000 cases study:

In the largest collection of cases (1000 cases) treated with distraction manipulation published in the journal, Topics in Clinical Chiropractic (vol. 3, no. 3), positive results show:

  • median number of days to maximum improvement was 29
  • median number of visits to maximum improvement was 12

HOWEVER, these statistics were separated by condition to help clinicians, patients, and insurance companies understand how varying conditions require more (or less) days and visits to see maximum results:

L5 disc herniations:
86% maximally improved in less than 90 days
36% needed more than 20 visits
30% needed more than 30 visits

Vs. 

Sprain/Strain:
91% maximally improved in less than 90 days
29% needed more than 20 visits
8% needed more than 30 visits


Less than 9% of cases reached the chronic stage.
Less than 4% of cases were candidates for surgery after care.

Patient Satisfaction

Responses to care show that the technique was well accepted:

47.1% rated care as EXCELLENT

13.7% rated care as VERY GOOD

9.9% rated care as GOOD

7.4% rated care as Fair

4.1% rated care as Poor

3.5% needed surgery

10% stopped care

4% were examined but not treated