Neck pain commonly causes disability and work loss (Bot et al., 2005). Other complaints such as stiffness, headaches, and upper extremity symptoms of impaired coordination, decreased muscle strength, paresthesia (Child et al., 2008) and radiculopathy (Kang et al., 2020) can also accompany neck pain. When radiculopathy is present with neck pain, the possible reason maybe due to a nerve root irritation which may be a result from various pathologies, including herniated intervertebral disc (22% cases), bone spurs, spinal instability, and trauma (Kuligowski, Skrzek & Cieślik, (2021).

One method that could be used to address this sort of neck pain is Cervical spine traction, also sometimes referred to as Traction of the Neck.

This can be defined as

“Cervical traction is administered by various techniques ranging from supine mechanical motorised cervical traction to seated cervical traction using an over-the-door pulley support with attached weights” (Swezey, Swezey & Warner, 1999, p, 1).

Cervical traction is a non-invasive procedure used to provide symptomatic relief for a variety of cervical pathologies, although with everything you don’t want to just go use it on everyone, thats why such Clinical Prediction Rule like Raney et al., (2009), have produced such tools like this one below.

Patient reported periperalization with lower cervical spine (C4-7) mobility testing,

positive shoulder abduction test,

age > 55,

positive upper limb tension test A,

positive neck distraction test (Raney et al., 2009)

Currently beliefs of the mechanism of Traction, is to produce a therapeutic benefit by stretching spinal ligamentous and paraspinal muscular tissues and reducing hydrostatic pressure in intervertebral discs (Gudavalli et al., 2013), thus facilitating the neck healing process (Chen et al., 2022). The real question is could this treatment work for people presenting with pain? Based on the available literature, a multimodal approach with traction as one of the component could be an efficient for cervical radiculopathy (Kuligowski et al., 2021) and traction alone in Young et al., (2009) had no real difference. Thus suggesting when it comes to cervical radiculopathy it does require an individual approach.

References

Bot, S. D., van der Waal, J. M., Terwee, C. B., van der Windt, D. A., Scholten, R. J., Bouter, L. M., & Dekker, J. (2005). Predictors of outcome in neck and shoulder symptoms: a cohort study in general practice. Spine, 30(16), E459–E470. https://doi.org/10.1097/01.brs.0000174279.44855.02

Chen, J., Chen, R., Li, Y., Chen, M., Lv, Z., Zeng, H., & Lian, Q. (2022). Systematic Review and Meta-Analysis of the Evaluation of the Efficacy of Manipulation and Cervical Traction in the Treatment of Radical Cervical Spondylosis. Emergency medicine international, 2022, 3837995. https://doi.org/10.1155/2022/3837995

Childs, J. D., Cleland, J. A., Elliott, J. M., Teyhen, D. S., Wainner, R. S., Whitman, J. M., Sopky, B. J., Godges, J. J., Flynn, T. W., & American Physical Therapy Association (2008). Neck pain: Clinical practice guidelines linked to the International Classification of Functioning, Disability, and Health from the Orthopedic Section of the American Physical Therapy Association. The Journal of orthopaedic and sports physical therapy, 38(9), A1–A34. https://doi.org/10.2519/jospt.2008.0303

Gudavalli, M. R., Potluri, T., Carandang, G., Havey, R. M., Voronov, L. I., Cox, J. M., Rowell, R. M., Kruse, R. A., Joachim, G. C., Patwardhan, A. G., Henderson, C. N., & Goertz, C. (2013). Intradiscal Pressure Changes during Manual Cervical Distraction: A Cadaveric Study. Evidence-based complementary and alternative medicine : eCAM, 2013, 954134. https://doi.org/10.1155/2013/954134

Kang, K. C., Lee, H. S., & Lee, J. H. (2020). Cervical Radiculopathy Focus on Characteristics and Differential Diagnosis. Asian spine journal, 14(6), 921–930. https://doi.org/10.31616/asj.2020.0647

Kuligowski, T., Skrzek, A., & Cieślik, B. (2021). Manual Therapy in Cervical and Lumbar Radiculopathy: A Systematic Review of the Literature. International journal of environmental research and public health, 18(11), 6176. https://doi.org/10.3390/ijerph18116176

Raney, N. H., Petersen, E. J., Smith, T. A., Cowan, J. E., Rendeiro, D. G., Deyle, G. D., & Childs, J. D. (2009). Development of a clinical prediction rule to identify patients with neck pain likely to benefit from cervical traction and exercise. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 18(3), 382–391. https://doi.org/10.1007/s00586-008-0859-7

Swezey, R. L., Swezey, A. M., & Warner, K. (1999). Efficacy of home cervical traction therapy. American journal of physical medicine & rehabilitation, 78(1), 30–32. https://doi.org/10.1097/00002060-199901000-00008

Young, I. A., Michener, L. A., Cleland, J. A., Aguilera, A. J., & Snyder, A. R. (2009). Manual therapy, exercise, and traction for patients with cervical radiculopathy: a randomized clinical trial. Physical therapy, 89(7), 632–642. https://doi.org/10.2522/ptj.20080283