Spinal Traction

Lumbar and cervical (back and neck) traction, or decompression are offered with two different brands of machine offered for each area treated (Saunders and CareRehab (Starr)).

Raney et al (2009) developed a clinical prediction rule (CPR) to identify patients with neck pain likely to improve with cervical traction. The study design included prospective cohort of patients with neck pain referred to physical therapy. A total of 80 patients with neck pain received a standardized examination and then completed 6 sessions of intermittent cervical traction and cervical strengthening exercises twice-weekly for 3 weeks. Patient outcome was classified at the end of treatment, based on perceived recovery according to the global rating of change. Patients who achieved a change greater than or equal to +6 (“a great deal better” or “a very great deal better”) were classified as having a successful outcome. Sixty-eight patients (38 females) were included in data analysis of which 30 had a successful outcome. If at least 4 out of 5 variables were present, the +LR was equal to 23.1 (2.5 to 227.9), increasing the post-test probability of having improvement with cervical traction to 94.8 %.

Cleland and colleagues (2005) described the outcomes of a consecutive series of patients presenting to physical therapy with cervical radiculopathy and managed with the use of manual physical therapy, cervical traction, and strengthening exercises. Ten of the 11 patients (91 %) demonstrated a clinically meaningful improvement in pain and function following a mean of 7.1 physical therapy visits and at the 6-month follow-up. Ninety-one % (10 of 11) of patients with cervical radiculopathy in this case series improved, as defined by the patients classifying their level of improvement as at least “quite a bit better”…

The current evidence on lumbar traction is not as clear. MRI studies have been done before, during and after traction which demonstrate that traction does move disk material away from nerves.

Jeremy McVay and a professor at Brown University have attempted to perform a study using MRI and traction to demonstrate what happens internally with treatment. This study has been stuck in the IRB (institutional review board) stage for years.

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