Traction is a mechanical force applied to the

body in a way that separates the joint surfaces

and elongates surrounding soft tissues. Traction
can be applied manually by the clinician,
mechanically by a machine, and by the patient
using body weight and gravity as a force.
Can be applied to peripheral joints and spine.

Effects of tractions Joint

• distraction (nerve root compression)

• Reduction of disc protrusion
(herniated nucleus pulposus)
• Soft tissue stretching (tendons,
ligaments, muscles)
• Muscle relaxation (interrupts pain-
spasm-pain cycle)
• Joint mobilization (increased joint
mobility caused by joint related pain)
Clinical indications for the use of spinal
traction
1. Disc bulge/herniation/herniated nucleus
pulposus (best applied soon after injury)
2.Nerve root impingement (best applied soon
after onset of symptoms)
3. Joint hypomobility (hypomobilty caused by
multiple segments)
4.Subacute joint inflammation (reduce
pressure on inflammed joints and promote fluid
exchange)
5. Paraspinal muscles spasm (interrupt pain-
spasm-pain cycle)
Contraindications of spinal traction
1. Where motion is contraindicated
(unstable fracture, cord compression,
post op spinal surgery)
• Have you been instructed not to
move your neck or back? If so, by
whom?
• If wearing a brace or corset: Have
you been instructed not to remove
your brace at any time?
• How recent was your injury or
surgery?
2. Acute injury or inflammation (trauma,
surgery, RA, OA)- injury within 72
hours.
• When did your injury occur?
• When did your pain start?
• Palpate and inspect the area to
detect signs of inflammation,
including heat, redness, and
swelling.
3. Hypermobile and unstable joints (C1- Precautions for the use of spinal traction
C2, RA, Down's syndrome, marfan
1. Structural diseases and conditions
syndrome, fracture, dislocation)
affecting the bones of the spine
• Tumor, infection, rheumatoid
• Have you dislocated a joint in this area?
arthritis, osteoporosis, prolonged
• Do you have rheumatoid arthritis or
systemic steroid use.
Marfan's syndrome?
• Do you have any disease affecting
• Are you pregnant?
your bones or joints?
• Do you have cancer, an infection in
your bones, rheumatoid arthritis, or
4. Peripheralization (worsening of
osteoporosis?
symptoms) of symptoms
• Do you take steroid medications? If
so, how long have you taken them?
• Let me know immediately if you
• Only low force traction should be
notice increased pain or other
used
symptoms farther down your arms
or legs. Stop the traction if this
occurs.
2. When pressure from the belts maybe
hazardous
5. Uncontrolled hypertension-10 minutes
• Pelvic belts- may apply
of cervical traction at 10% body weight
excessive pressure to abdomen
causes increases in blood pressure (9
to pregnant patients or those
mm Hg increase in systolic pressure,
with hiatal hernia and femoral
and 5 mm Hg increase in diastolic
artery compromise
pressure) and heart rate (7 beats per
• Thoracic belts- excessive
minute [bpm] increase)
pressure on ribs with patients
osterporosis Cervical traction-
• Do you have high blood pressure? If
patients with cerebrovascular
so, is it well controlled with
compromise as indicated by a
medications?
positive vertebral artery test
• Resting BP of 140/90: Treatment
• Are you pregnant?
should be discontinued if systolic or
• Do you have a hiatal hernia?
diastolic BP increases by more than
10 mm Hg. or if heart rate increases • Have you had any trouble with
by more than 10 bpm. blocked arteries?
• Do you have pain in your calves
when walking a short distance?
This is a sign of intermittent
claudication,
3. Displaced annular fragments (traction
will not be effective)
• Has magnetic resonance
imaging (MRI) or CT scan of
your spine been performed?
Please bring me the report(s)
from that (those) test(s).
4. Medial disc protrusion (traction may
aggravate symptoms)
6. Claustrophobia or Other Psychological
Aversion to Traction
7. Inability to Tolerate the Prone or Supine
Position
• Does lying on your back with your
knees bent for 15 to 20 minutes cause
any problems for you?
• Does lying on your stomach for 15 to 20
minutes cause any problems for you?
8.Disorientation

• Has an MRI or CT scan of your

spine been performed? Please Precautions For The Use Of Cervical
bring me the report(s) from that Traction
(those) test(s) 1. TMJ problems- Do you have problems with
your jaw?
5. When Severe Pain Resolves Fully With
Traction 2. Dentures- Do you wear dentures? Do you
have them in now?
• If severe pain resolves fully
with traction, this may indicate
that the fraction has increased
rather than decreased
compression on a nerve root,
causing a complete nerve block.
• After a few minutes of traction:
Have your symptoms changed?
• If the patient had severe pain
and reports that the pain has
decreased: Has the pain
completely gone away, or is it
just less severe?
• Test sensation, reflexes, and
strength before treatment.
• Also, if the patient reports
complete resolution of severe
pain during treatment, check
these again, and assess for any
changes.