In response to a rapidly changing professional landscape, individuals are spending increasing amounts of time sitting down, using their phones, and not exercising on a regular basis. This is resulting in postural issues and orthopedic challenges that manifest in various ways, including pain in the lower back and neck – up to one quarter of patients discharged from physical therapy clinics are currently estimated to suffer from lower back pain 1. Specific medical conditions, such as sciatica, herniated discs, or muscle spasms, alongside stress, exacerbate these difficulties, affecting patients’ range of motion and daily functioning. Traction exercises may be very effective at relieving associated pain and improving patient mobility by creating space in between vertebrae, straightening gravity-incurred spinal curves, decreasing muscular tension, and improving blood flow 2,3. While effectively implemented by chiropractors and physical therapists, these may also be learned, practiced, and performed by patients themselves at home.
Home traction exercises take on a variety of forms tailored to patient clinical presentation, comorbidities, age, and desired outcomes. For example, a recent study found that home traction exercises for the neck provided pain relief for a 30-year-old patient suffering from cervical radiculopathy 4. Following three weeks of therapy, the patient experienced improved neck pain and radicular symptoms, as well as reduced numbness in his hand; in addition, he regained nearly normal range of cervical motion. Cervical traction as such is a frequently recommended intervention for neck pain which can be performed at home on a regular basis as a long-term preventive measure.
Additional recommended exercises to stretch out the neck and back include lying down leg presses, prayer yoga poses, and various back stretches using chairs or desks as support – all of which require minimal equipment and are easy to implement 5. In general, positions are to be held for 10-15 seconds and repeated as often as needed for pain relief. The exercises themselves are recommended to be repeated 2-3 times per day or throughout the day, as needed.
This being said, some studies found no differences in outcomes in between home traction exercises and machine-mediated decompression 6, as reported outcomes differ across patient population and setting. Furthermore, there remains a number of clinical conditions for which traction is contraindicated. For example, patients with osteoporosis, degenerative joint disease, spinal fractures, joint hypermobility, or spinal root impingement, as well as patients who have undergone spinal fusion surgery, artificial disc placement, or who are pregnant should obtain approval from a clinician prior to performing home traction exercises. In addition, stretches should be discontinued if patients, regardless of background, experience pain, light-headedness, or numbness or tingling.
While at-home traction exercises are designed for immediate relief for a particular ailment, these should be performed alongside adopting healthy habits, including maintaining a straight posture, adequate nutrition, and plentiful exercise. Traction exercises are non-invasive, simple to learn, free, and reproducible, offering an excellent sustainable solution to treating pain or limited range of motion in a broad range of patients. As such, patients with a variety of forms of neck or back pain can and should continue to benefit from home traction exercises for better overall health.
References
1. Jette, A. M., Smith, K., Haley, S. M., Davis, K. D. & Beattie, P. Physical therapy episodes of care for patients with low back pain. Phys. Ther. (1994). doi:10.1093/ptj/74.2.101
2. Saunders, H. D. THE JOURNAL OF ORTHOPAEDIC AND SPORTS PHYSICAL THERAPY Lumbar Traction*. (1979).
3. Kang, J. Il, Jeong, D. K. & Choi, H. Effect of spinal decompression on the lumbar muscle activity and disk height in patients with herniated intervertebral disk. J. Phys. Ther. Sci. (2016). doi:10.1589/jpts.28.3125
4. Garg, P. Home Care Neck Traction for a Patient With Neck Pain and Cervical Radiculopathy Symptoms: A Case Report. J. Chiropr. Med. (2019). doi:10.1016/j.jcm.2018.11.006
5. Self-Traction Techniques | My Doctor Online. Available at: https://mydoctor.kaiserpermanente.org/ncal/article/self-traction-techniques-506677.
6. Thackeray, A., Fritz, J. M., Childs, J. D. & Brennan, G. P. The Effectiveness of mechanical traction among subgroups of patients with low back pain and leg pain: A randomized trial. J. Orthop. Sports Phys. Ther. (2016). doi:10.2519/jospt.2016.6238