Traction Therapy For Back Pain

'Is It A Stretch To Believe It Can Really Relieve Back Pain?'

The Short Answer –

Using Traction therapy for back pain or ‘spinal traction’ as it sometimes referred to, is a process by which the spine is decompressed either manually or mechanically.

There is evidence that it can provide short-term pain relief, although not necessarily as safely as some other similar therapies.

In this review we look at traction therapy and ask how likely it is to work for you and your back pain….

Understanding Traction Therapy

Spinal traction is no easy option. Traction is physically brutal and carries danger, although traction can help back pain in some cases.

Perhaps rather than simply addressing the role of traction therapy for back pain, we should be asking ‘is traction worth the risk for reducing back pain’.

The theory of traction is very similar to inversion therapy, but without tipping you upside down.

Over time the push of gravity downwards is said to cause your spine to ‘compress’, essentially squashing down the padding between your vertebrae and shortening your spine.

When this happens, it is thought that some of the nerves in your back become trapped and this can cause a lot of back pain.

A photo of the bottom half of a man receiving traction for his lower back pain

With inversion therapy, you are suspended either completely or partially upside down for a short period of time, allowing your natural weight and gravity to pull you spine back out.

Traction also involves an attempted straightening of the spine only this time you are not suspended upside down.

Instead it can be done while lying on your back with various stretching devices, used to ‘pull’ the spine back in to it’s ‘original’ position.

Traction itself can be performed either manually by a physiotherapist/ chiropractor or mechanically using a specially designed table.

In the 1st instance, the therapist aims to pull your spine physically back out to it’s original length and ‘decompress it’, mostly with their own hands.

In the case of mechanical traction, a special table is used to strap your body down and then gradually pull it from both ends. Again, the aim is to gradually pull your spine back out and release any compressed nerves/ tissues.

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What Can Traction Help?

Traction, when effective, can help with the following –

  • Sciatica
  • A pinched nerve
  • A herniated disc
  • A slipped disc
  • Bone spurs (growths)
  • Degenerative disc disease
  • Facet disease
  • Foramina stenosis

Benefits Of Traction Therapy

The main benefit of spinal traction is that it can relieve back pain and doesn’t require surgery. Unfortunately, much like inversion therapy, the pain relief is likely to be fairly short-term since just as you straighten and elongate your spine, so gravity will push it back again.

Unfortunately, there is no ‘natural’ method of propping your vertebrae up to stop them re-compressing as soon as you are back on your feet.

A photo of a man getting suspended traction with his legs in the air, held up by straps

Side Effects/ Dangers Of Traction Therapy

In one sense, traction does not carry the inherent risks of spinal surgery, so Is a good alternative. And because you are not being tipped upside down as you are during inversion, there are less restrictions on who can do it.

However, if you look at the common concerns around the forcefulness of chiropractic treatment, the same could be levelled at spinal traction.

The idea of being strapped on to a machine and slowly ‘stretched’ may seem a bit like a scene from Frankenstein, but the reality is not dissimilar.

You are literally pulling yourself apart.

There is therefore always the inherent danger that you seriously injure other areas of your body, particularly your pelvic area which is being put under similar pressure.

The alternative is the manual manipulation. This is the same process as can be carried out by chiropractors or physiotherapists.

Once again, we have to consider the sheer brute force required to push and pull or ‘decompress’ your spine.

Unlike inversion therapy, where gravity and your body decides how far is ‘too far’ to be pulled, with traction it is down to the therapist to take a rational guess as to how hard/ far they can try to stretch you.

This may not be surgery, but it is no ‘easy’ option either. The other key disadvantage with traction is the benefits are likely to be short-lived, requiring regular intervention.

Is Traction Likely To Work?

As with any treatment for pain, what works for someone will not work for everyone. It becomes a case of weighing up costs vs benefits and making a decision based on what you have already tried and how bad your pain is.

When it comes to the science behind traction, it is a very mixed picture.

On the one hand, the physical differences before and after traction are measurable and clear, as noted in the Journal Of Orthopaedics and Sports Physical Therapy

However, what benefit this has is highly questionable. As pointed by out in the updated Cochraine Review of 32 relevant studies on traction and lower back pain (August 2013), 

“The included studies show that traction as a single treatment or in combination with physiotherapy is no more effective in treating LBP than sham (pretend) treatment, physiotherapy without traction or other treatment methods including exercise, laser, ultrasound and corsets. These conclusions are valid for people with and without sciatica. There was no difference regarding the type of traction (manual or mechanical).”

In other words, across 32 randomized, controlled trials, the Cochrane review found no direct evidence for the clinical benefit of traction on LBP (lower back pain), including sciatica.

One of the biggest problems was that so often spinal traction was given in combination with physio or another form of stretching therapy.

This meant that even if it did show a positive outcome, it was impossible to distinguish what was stretching and what was traction.

In late 2018, The Journal Of Physical Therapy Science attempted to finally isolate the effect of traction. 

The result was positive and also offered regular traction as a better option than occasional therapy, but with just 15 people in each group, no firm conclusions could really be established.

What has been established though is that, whatever pain relief that is achieved is generally a short-term event with regular follow-ups required to maintain any benefit (Clinical Rehabilitation) 

This is logical as while decompressing the spine may well ease back pain, normal activities will soon start to push it back down.

The Final Word –

Traction has been recommended as a treatment for many years, with very little concern for the actual evidence backing it up.

More recent research however, has provided some limited proof of it’s effectiveness or at least of it’s ability to provide temporary pain relief.

The real decision you have to make (and no-one can make it for you), is to which options for pain relief you feel most comfortable trying.

And most specifically, how you feel about trying to pull your spine open to decompress it.

In theory, inversion therapy achieves a similar result, but has more conclusive data behind it and is easier to do (with an inversion chair) by yourself at home. This is potentially vital if you are going to be doing it regularly.

Letting gravity and your own weight decompress your spine always sounds a more natural route to take.

And there are other benefits to inversion therapy as well, but also many different side effects with being turned down with impacts on blood pressure, heart conditions to name just a few.

Indeed, if you are significantly overweight, traction may be your only for this type of therapy, because inversion is to risky.

Ultimately, though traction is just one option of many covered here for your back pain. As always, the best option is to talk to your doctor and try those you like the sound of.

Eventually you will find a few that work really well and should finally keep you (relatively) pain free.

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References –

1. Geraldine I. Pellecchia, MA, PT. (1994). Lumbar Traction: A Review of the Literature. Journal Of Orthopaedics and Sports Physical Therapy
2. Wegner I, Widyahening IS, van Tulder MW, Blomberg SEI, de Vet HCW, Brønfort G, Bouter LM, Heijden GJ. (Aug 2013). Traction for low-back pain. Cochrane Reviews.
3. Hyunju Oh, PhD, PT, SeokJoo Choi, Sangyong Lee, PhD, PT, Jioun Choi, PhD, PT, and Kwansub Lee, PhD, PT. (Nov 2018). The impact of manual spinal traction therapy on the pain and Oswestry disability index of patients with chronic back pain. The Journal Of Physical Therapy Science.
4. Yu-Hsuan Cheng, Chih-Yang Hsu, Yen-Nung Lin (Aug 2019). The effect of mechanical traction on low back pain in patients with herniated intervertebral disks: a systemic review and meta-analysis. Clinical Rehabilitation.

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