Traction is defined as, “…the act of pulling a body part.” Therefore, it is commonly used in many regions including legs, arms, low back, mid-back, and the neck. We will be limiting this discussion to cervical or neck traction, and the question of the month is, “…does it help patients with neck pain and headaches?” Though I’m assuming you already know, the answer is YES! You may want a little “proof,” so here it goes!
1. REDUCES DISK PROTRUSIONS: In 2002, a medically based study found traction to be very effective in the treatment of cervical radiculopathies (pinched nerves in the neck that radiate pain into the arms). A 2008 study using MRI (images) described the effect traction had on the disk protrusions in the neck reporting 25 of 35 (or 71%) were reduced while in traction with a 19% increase in the spacing (disk height) and improved neck range of motion after the traction was applied. They postulated that by pulling the vertebrae in the neck apart, there was a suction-like effect pulling the disk material back in place.
2. RECOMMENDED BY GUIDELINES: Around the world, guidelines have been published giving doctors information that allows us to know how well certain forms of treatment work for different conditions. In a 2008 publication, it was reported that, “Clinicians should consider the use of mechanical intermittent cervical traction, combined with other interventions such as manual therapy and strengthening exercises, for reducing pain and disability in patients with neck and neck-related arm pain.”
3. CLINICAL PREDICTION RULES: These help us determine who is most likely to benefit from a certain type of treatment (in this case cervical traction and exercise). If 3 of 5 variables are found, the likelihood of success with traction & exercise was reported to be 79%, and if 4 of the 5 are found, 90%. The 5 variables are: 1. Radiating neck to arm pain in certain positions; 2. Positive shoulder abduction sign; 3. Age >55years old; 4. Positive limb tension test; 5. Relief of symptoms using manual distraction test (if pain is relieved while the neck is being pulled).
4. INTERMITTENT AND CONTINUOUS TRACTION: Either way, significant improvement in neck and arm pain, neck mobility, and nerve function occurred with both approaches.
5. TRACTION VS. SURGERY: In this study, patients with radiating arm pain and positive neurological findings on exam were offered a course of traction before surgical options. They reported 63 of 81, or 78%, of the patients experienced significant or total relief, 3 could not tolerate traction and 15 simply didn’t respond. They concluded that when neck and arm symptoms with neurological deficits were present for 6 weeks, that 75% will respond to neck traction over the next 6 weeks.
There are MANY additional studies available that show well beyond doubt that cervical traction is a GREAT option in the management of neck and arm pain and sometimes headaches. Next month, we will discuss “HOW TO” apply cervical traction.