Traction

Traction is used to alleviate pain and improve circulation for various conditions, including a disc bulge or herniation, nerve root impingement, joint hypomobility, subacute joint inflammation, and paraspinal muscle spasms



Be sure to perform a neuro exam prior to beginning traction, in order to recognize any neurological abnormalities or changes with application of traction.  Mechanical traction provides joint distraction at the apophyseal joints of the spine (temporary effects).  Also, traction creates widening of the foramen (to reduce pressure on a compressed nerve), reduction of disc protrusion (thought to occur through tensing of the posterior longitudinal ligament and/or through proposed suction action at the intervertebral joint), soft tissue stretch, muscle relaxation (through decreasing pain and/or depressing the monosynaptic stretch reflex and/or acting on the GTO's to inhibit alpha motor neurons from firing, which would decrease the amount of contraction in the muscle), and joint mobilization. 

​

Treatments should start with low forces and shorter durations, and work up to therapeutic ranges for a given condition. Lumbar weight should increase approximately 5 lbs each session, and cervical weight should increase 2 lbs each treatment. 

​

When setting the patient up on a traction machine, ensure the straps are tight along the ASIS and at the level of the lower ribs.  Adjust the table in a way that allows for no lumbar lordosis, and that they will not move along the table (e.g. insert arm rests, unlock table, etc).  Make sure the patient has the emergency shut off button, should they need it.  Always start with static hold for the first session, and move on to intermittent in subsequent sessions. 

 



Contraindications

Peripheralization of symptoms with manual traction, acute injury or inflammation, fracture, cord compression, post surgery, rheumatoid arthritis, Down's Syndrome, Marfan's, uncontrolled hypertension (especially for inversion traction)



Precautions

Patients with hypermobility, claustrophobia, structural disease or condition affecting bones, tumor, infection, osteoporosis, prolonged steroid use, pregnancy, hiatial hernias, and femoral artery compromise





 

Lumbar Traction Parameters

Initial Treatment        30-45lbs                                  Static Hold                   5-10min

Joint Distraction         50% body weight                      15/15                       20-30min 

Muscle Spasm            25% body weight                         5/5                         20-30min

Soft Tissue Stretch    25% body weight                       60/20                      20-30min



Cervical Traction Parameters​

Initial Treatment           8-10lbs                                Static hold                   5-10min

Joint Distraction        7% of body weight                   15/15                      20-30min

                                     (no more than 30lbs)                                    

Muscle Spasm             12-15lbs                                     5/5                         20-30 min

Soft Tissue Stretch     12-15lbs                                   60/20                      20-30min