Posts tagged traction
Will traction help my neck and arm pain?

Arm pain referred from the cervical spine (cervical radiculopathy) often is the result of nerve root compression by either bone or soft tissue in the bony canals of the neck.  These canals protect the nerve roots as they exit from the spinal cord, but can also compress these neural structures leading to pain, numbness, pins and needles, or weakness in the arm and hand.  Physical Therapy interventions including manual therapy and exercise designed to optimize motion and reduce abnormal nerve contact have been shown to reduce pain and improve function in patients with neck and arm pain.  Another form of treatment, mechanical traction, has previously been shown to help in subsets of patients with neck and arm pain.  A recent systematic review examined the available evidence behind using traction for neck and arm pain.

In the journal Physical Therapy, researchers analyzed the available data on mechanical traction and patient's with cervical radiculopathy (Romeo et al. 2018).  Authors included 5 studies in the review and found both manual and mechanical traction improved pain in the short term.  Mechanical traction was shown to improve disability at intermediate follow up periods.  The authors concluded manual or mechanical traction may be helpful when combined with other Physical Therapy interventions in the short term.  Conversely, traction has a smaller effect at improving patient function. 

Consistent with our treatments, manual traction is best utilized as part of an effective short term program to reduce the symptoms of cervical radiculopathy.  Higher level exercises should be utilized once the symptoms are reduced to optimize patient function and prevent recurrence. 

Traction Use for Neck Pain

Traction has a long history of utilization for patients with neck and back pain dating to ancient times.  A more contemporary use of this modality involves using traction to relieve pressure from symptomatic spinal joints, nerves, and soft tissues.  In our experience, this treatment is best utilized in patients with symptoms including radiating arm or leg pain, numbness, pins and needles, as well as, signs of nerve root compression.  These clinical findings have been confirmed by the research attempting to identify a group of patients with neck pain most appropriate for patients the treatment.

A recent review article on the available evidence for use of traction in patients with neck pain was conducted in the journal Spine (Yang et al. 2017).  7 randomized, controlled trials were included in the analysis.  As we many trials on spinal pain there was a "wash out" effect on many of the results.   The differences in subjects between studies, some showing benefit but other without benefit,  prevented authors from making conclusions about the participants as a whole.  In general, traction provided short term benefit to patients with neck pain but these effects were less or not significant at follow up.  This study adds to our existing knowledge on traction by confirming our thoughts on a specific group of patients most appropriate for this treatment, as well as, its' use as temporary relief prior to transitioning to a long term exercise program.