Intermittent and/or sustained traction may encourage migration nucleus of the disc or portions of the nucleus to a more centralized position. The use of traction may reduce impingement of meniscal structures in the spinal joints (facets), joint lining (synovial fringes), or bone fragments, which may be impinged between the facet joint surfaces.
The spinal muscles are stretched during spinal traction. The degree of stretch is influenced by the angle of the traction is performed. Intermittent traction tends to be more effective at reducing muscle spasm than sustained traction. Traction can be used to temporarily reduce pressure on spinal nerves that may be compromised between the vertebrae secondary to a bulging disc, facet joint cyst, or secondary to compression from openings along the side of the spine. The reduction of extremity paresthesia, pain or tingling during the course of traction suggests that there may be reduction of nerve pressure.
There are numerous traction techniques and devices available to physicians and therapists. The chosen approach should depend on the patient's physical condition, the spinal disorder being treated, the individualâ€™s tolerance for traction, and the spinal level(s) to be treated. The application of therapeutic traction may be manual or mechanical. Traction may be applied as a continuous force or intermittently. Sustained traction for prolonged periods of time is not utilized very often.
Manual therapeutic traction refers to a hands' on approach. To perform manual traction of the neck the patient lies in a supine or face up relaxed and comfortable position on the table. The attending physician or therapist carefully positions their hands in such a way as to support the patient's head and neck during distraction. The force that is manually applied is gentle and controlled. During neck (cervical) traction the physician or therapist may change the angle of the head and neck to localize the effects of the traction.