Cervical Traction
Strongest evidence for the benefits of traction is in cervical applications
Benefits of the use of cervical traction is supported in cases of osteoarthritis, cervical radiculopathy, disc herniation, and tension headaches
Physiological effects
- increasing vertebral separation
- reducing cervical muscle activation
- reducing nerve conduction disturbances
- increases reflex arc strength
- increasing blood flow
- restoring cervical lordosis
Note: there are studies which contradict supposed physiological effects of cervical traction. Remember, evidence-based practice involves utilizing the supporting literature and the patient's goals/response to treatment using the therapist's experience to discriminate the utility of treatment
Mechanical Techniques
- Free weights or a machine applies the traction force
- Therapeutic range in the cervical spine is 25 to 30 pounds
- Over-the door traction uses a weighted water bag to apply a cephalad force through the mandible and occiput
- this type may be contraindicated with patients who have a documented temporomandibular dysfunction
- cervical muscles are more active in sitting than supine due to the effect of gravity on postural muscles.
- the maximum net traction force is 20# - weight of head. On average, this results in approximately 6# of overall cervical traction force
- there is some evidence that ROM and disc dysfunction symptoms improve in cases of whiplash or spondylosis with over-the-door traction
- Home supine units are generally more expensive, yet seem to have more consistent favorable results.
Demonstration of home cervical traction device (Approximately 7 minutes)
- LESS traction force is required in the upper vs. the lower cervical spine.
Angle of pull
- research is variable regarding the ideal angle of pull
- general guidelines suggest 25 degrees of cervical flexion during traction application
- polyaxial traction allows for unilateral pulls on the cervical spine, thus more specifically targeting area of impairment/dysfunction
Case Demonstration of Mechanical Cervical Traction (Approximately 5 minutes)
