The Resource Manual 

Basics of Mechanical Traction

Indications 

• Disk bulge or herniation

• Nerve root impingement

• Joint hypomobility

• Subacute joint inflammation

• Paraspinal muscle spasm

Contraindications

• Fracture

• Cord compression

• Post surgery

• —Acute injury or inflammation (less than 72 hours post injury)

• —Hypermobile or unstable joint (Rheumatoid Arthritis, Down's Syndrome, Marfan’s Syndrome)

• —Peripheralization of symptoms

Precautions

• —Structural disease or condition affecting bones

• Tumor

• Infection

• Rheumatoid Arthritis

• Osteoporosis

• Prolonged systemic steroid use

• Pregnancy

• Hiatal hernia

• Femoral artery compromise

• —Displacement of a fragment of annulus

• —Medial disc protrusion

• —Patients that cannot tolerate prone or supine positions

• TMJ problems

• —Claustrophobic patient

Parameters

Lumbar Traction:

• Position

  • Supine (most common)

    • Better for facet dysfunction

    • Promotes flexion

  • Prone:

    •  Works well for disc problems

    • Promote extension

• Belts

  • Directly on skin 

  • Use of towel roll under buckles for comfort

  • Pelvic belt just below iliac crests

• General recommendations:

  • Short hold and relax for joint dysfunction

  • Intermittent with long hold times for disc protrusions

  • Static when area inflamed or aggravated

• Treatment duration/frequency

  • Initial session: BRIEF, assess tolerance, 5-10 minutes

  • Typical tx: 20-30 minutes

  • Every day to 3x/wk

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Cervical Traction:

• Position:

  • Sitting

  • Supine (most common)

  • Amount of flexion:

    • Mid cervical (C2-5) 10-20 degrees

    • Lower cervical (C5-C7): 25-35 degrees

  • Neutral to slight extension 0-5 deg: upper c-spine

  • Max separation at approx 24 degrees of flexion

• Duration

  • Initially short: 5 minutes

  • Increase to 20-30 minutes

  • Frequency: Every day to 3x/wk