Neck Pain: The Truth On Traction
The amount of people working in a desk bound jobs is increasing worldwide. Unfortunately, these jobs tend to go hand-in-hand with a greater chance of suffering from prolonged neck and back pain. Maybe for this very reason, currently the most common source of musculoskeletal disability is chronic neck pain.
Case Study 1
According to a recent study, 34% of the general population experiences neck pain at some time in their life. 14% of this number have symptoms lasting longer than six months.
Due to the number of health care visits, work absenteeism, decreased productivity and disability, neck pain has huge consequences on people’s well being and their health care expenses.
Traction For Neck Pain
There are many methods that clinicians use to treat neck pain. A traditional and conservative method commonly used by physiotherapists is cervical traction. Despite its clinical popularity, previous and current studies, looking at the effectiveness of cervical traction, remain inconclusive.
Impacts Of Traction
In theory, applying a controlled pulling force on the spine causes a number of physiological effects:
– Firstly, enlarges the intervertebral foramen
– Secondly, releases pressure on intervertebral discs
– Thirdly, it releases pressure on nerve roots and blood vessels
– Fourthly, stretched ligaments and paravertebral muscles of the neck region
– Lastly, reduction in effects of abnormalities of the cervical facet joints
In conclusion, a release of muscle tension, nerve tension, and increased blood circulation in the cervical region are expected. This would ultimately result in decrease neck pain.
Case Study 2
The Hong Kong Polytechnic University investigated intermittent cervical traction on 79 patients with chronic neck pain in a more recent study. The patients were placed into two groups at random, and are aged between 20 to 70 years old. For a period of six weeks, one group received cervical traction twice a week, administered by an experienced senior physiotherapist. The second group received placebo-infra-red (heat therapy) treatment twice a week.
The patients were to complete a disability questionnaire after a 6 weeks and also a 3 months interval. They were to score their pain on a scale. Their also measured their range of motion of the cervical spine.
From this study they concluded that there was no significant difference in disability, pain and range of motion between the group that received traction, and the group receiving the placebo infrared treatment. The researchers did state that there were several limitations to the study.
Several other studies in the past have found similar findings that as a treatment method in soltaion, traction does not show significant improvements. Research supporting its benefits and use is somewhat flawed or inconclusive. More methodological randomised control studies should thus be carried out.
In order to maximize the benefit of treatment for patients with chronic neck pain, it is important for clinicians to consider giving a combined and individualized treatment to them instead, of intermittent cervical traction alone. Studies of late are generally leaning to a combined approach of exercise therapy, education, joint mobilisation and manipulations as being the most effective method of treating neck pain
Chiu, T.T., Ng, J.K., Walther-Zhang, B., Lin, R.J.H., Ortelli, L., Kuan, S (2011) A randomized controlled trial on the efficacy of intermittent cervical traction for patients with chronic neck pain; Clinical Rehabilitation:1–9