Cervical and Lumbar Traction Therapy

Cervical and lumbar traction (Spinal Traction) is a physiotherapy technique using a precise pulling force to "stretch" the structures of the spine and the surrounding tissue, helping to reduce the compressing force on the discs and on the exit holes of the nerves, so that it may relieve referred pain, numbness, or weakness arising from a nerve being compressed. This technique suits those with pain in the neck or back from a degenerative state, repeated posture, or a disc compressing a nerve. The result, however, depends on the cause and the severity of the condition. The team of rehabilitation physicians at PYONG Rehabilitation Penthouse assesses every case beforehand, adjusts the pulling force and the posture to suit the individual, and combines other treatments, such as a programme of exercise to reinforce the stability of the spine, and also PMS, therapeutic ultrasound, and dry needling as indicated. Those receiving the service have the convenience of a location in the heart of the city, Gaysorn Tower, floor 11, near BTS Chidlom.

What is cervical and lumbar traction (Traction)?

Traction is the use of a continuous or rhythmic pulling force on the neck or the lower back, in order to increase the space between the vertebrae, release the compression of the disc, and reduce the compression of the exit holes of the nerves. The idea is that when the narrow space is "opened" more, referred pain, numbness, or weakness from the compression may decrease. This technique is done with a traction device controlling the pulling force, the time, and the posture precisely, under the care of trained medical staff. Traction is usually used as "part" of a plan of treatment, paired with therapeutic exercise, correction of posture, training of the core muscles, and other rehabilitation technology as necessary, so that the result matches the goals of real use in the daily life of each person.

Why have Traction at PYONG Rehabilitation Penthouse

• A rehabilitation physician oversees every step: from screening for contraindications, setting the pulling force, and adjusting the posture, through to choosing the supporting therapy
• Comprehensive technology and programmes of treatment: such as combining Traction with Peripheral Magnetic Stimulation (PMS), Therapeutic Ultrasound, and Dry Needling, to reinforce the reduction of pain and the recovery of the muscle/nerve as effectively as possible
• A convenient location: Gaysorn Tower, floor 11 (BTS Chidlom), easy to reach, suited to continuous appointments

How cervical and lumbar traction works (the mechanism + the steps of the service)

The main mechanism: a suitable pulling force helps reduce the compression of the disc and of the joints between the vertebrae, so that the exit of the nerve becomes wider, which may reduce the irritation of the nerve and the referred pain, particularly in a state of compression from a disc and from certain kinds of degeneration.

The steps in summary (Step-by-step):

1. See the rehabilitation physician: taking the history, examining the nervous system, assessing the risk (such as severe osteoporosis, infection of the tissue of the spine, tumour, and so on), and setting the plan
2. Trying the pulling force: beginning with a low pulling force, testing the suitable posture (lying on the back/front for the lower back, the head and neck for the neck)
3. The actual traction: adjusting the pulling force and the time in intervals or keeping it constant, according to the response (in general 10–20 minutes per session), under watch for symptoms
4. Ending with therapeutic exercise/exercises for the particular area, and advice on the way of living
   The sensation during it: a feeling of tight stretching, but it should not be severely painful. If there is a great deal of pain, dizziness, or increased numbness or weakness, the carer must be told immediately

The symptoms/conditions suited to cervical and lumbar traction

• Neck pain referred to the arm/numbness of the hand from a nerve in the neck being compressed (cervical radiculopathy)
• Back pain referred to the buttock and leg/numbness of the leg (sciatica) from a nerve in the lower back being compressed (lumbar radiculopathy)
• A disc of the spine protruding or compressing a nerve (neck/lower back)
• Spinal stenosis in some cases the doctor considers suitable
• Pain in the neck and upper back from posture/working at a screen, together with tightness and stiffness of the joints of the neck
• Back pain from stiffness of the joints of the spine (facet-related)
• Degeneration of the spine with age with referred pain alongside
• Symptoms returning after use/long travel (under individual risk assessment)
• After certain kinds of surgery on the spine, "when the safe stage is reached" and the doctor considers it appropriate
• Older adults with referred pain from a nerve being compressed, but the risk of osteoporosis must be screened first

The academic evidence on Traction

The overall picture of the evidence indicates that cervical traction, when "combined with therapeutic exercise", may give a better result than exercise alone in patients with cervical radiculopathy. A randomised trial in 2014 reported that adding mechanical traction reduced pain better at long-term follow-up (JOSPT (opens in a new tab)). For back pain referred down the leg (lumbar radiculopathy), the latest review and meta-analysis suggest that traction may help reduce pain in the short term when used together with standard physiotherapy (PubMed (opens in a new tab), PMC (opens in a new tab))

Traction should be used together with a programme of therapeutic exercise and changes of habit

How often should it be done

The frequency of Traction depends on the cause and the response of the symptoms. In general, in the early stage of treatment, appointments may be made 1–2 times a week continuing for 2–4 weeks, together with a programme of therapeutic exercise at home every day, after which it is assessed again in order to adjust the plan, reduce or increase the frequency, or change the form of care. Where a state is suspected in which a nerve may be compressed, active recovery is emphasised through exercise to reinforce the stability of the body and correct the posture of work, and other equipment is used to help rehabilitation as appropriate. The rehabilitation physician, however, is the one who sets the frequency, the length, and the combination of the treatment with other techniques for the individual, after assessing the safety and the goals of treatment of the person receiving the service.

The result expected

Short term (the first session to the first week): in many cases, the person receiving the service may feel less tight, move the neck/back more easily, and have the referred pain somewhat reduced afterwards (temporarily), particularly when it is done alongside suitable exercises. However, if there is more pain, dizziness, or severe numbness, it should be stopped and the team told immediately.

Long term (4–6 weeks and beyond): more lasting change depends on combining it strictly with a programme of therapeutic exercise and changes of habit. In selected groups, such as cervical radiculopathy, a clearer reduction of pain and disability may be seen when it is done together with continuous exercise, while in the group with back pain not referred down the leg, no benefit of traction on its own is usually seen according to the present evidence.

Contraindications and points to be careful of in the procedure

Before every session, the doctor screens for contraindications and risk factors in detail. The states that are forbidden/should be avoided include infection of the spine, a tumour/spread to the spine, a fracture or the period after an acute accident, instability of the ligaments of the joints of the spine, compression of the spinal cord (myelopathy), severe osteoporosis, pregnancy (particularly traction of the lower back with a harness), high blood pressure that is still not controlled, disease of the blood vessels of the neck (vertebrobasilar insufficiency), and other states the doctor considers unsafe, including certain kinds of hernia/restrictive lung disease, and so on.

Note: if there is a pacemaker/electronic device in the body, although traction itself is not a magnetic field, if PMS or other technology is to be combined with it, the doctor will consider the suitability for the individual.

The cost

The service charge for cervical/lumbar traction is 2,000 baht per session (THB), or it may be included in a physiotherapy programme according to the plan the doctor sets. Those who have not received the service before must have their spine and nervous system assessed by a doctor beforehand, for safety and to set the suitable indication (the rate for the assessment follows the clinic's regulations).

Frequently asked questions (FAQ)

1) How does cervical and lumbar traction differ from "bone setting"?

Traction is controlled stretching with equipment, adjusting the force and the time systematically, different from making the joint "crack". The techniques and the goals differ, and the doctor uses traction as part of a plan of treatment, not as a treatment on its own.

2) Is it painful, and how long does it take?

In general there is a feeling of tight stretching; it should not be severely painful. It takes on average 10–20 minutes per session, depending on the position and the response of each person.

3) If there is a disc compressing a nerve, can it help?

In selected groups (such as cervical radiculopathy and some cases of lumbar radiculopathy), traction may help reduce pain in the short term when done alongside a programme of therapeutic exercise. The long-term result depends on the rehabilitation as a whole (JOSPT (opens in a new tab), PubMed (opens in a new tab))

4) Who should not have it?

Those with an infection/tumour of the spine, a fracture, instability of the ligaments, a contraindication involving the blood vessels of the neck, pregnancy (particularly traction of the lower back), severe osteoporosis, or high blood pressure that is still not controlled, and so on. A doctor must always assess beforehand (StatPearls (opens in a new tab))

5) How should I prepare?

Wear comfortable clothing, do not wear jewellery on the neck/waist, and tell them in full about your underlying conditions, medicines, and any device in your body (such as a pacemaker), particularly if other technology is to be combined with it.

Choosing a place to treat pain and conditions of the brain from a clinic cared for by a team of specialist physicians with expertise, such as PYONG Rehabilitation Clinic and PYONG Rehabilitation Penthouse, helps the patient receive effective and safe care, with modern technology, so that the patient has the chance to recover and return to a better quality of life quickly. Anyone interested can make enquiries at