Traction in chiropractic is a technique that gently stretches the spine to create space between vertebrae, reducing pressure on discs and nerves. It works by pulling the spine along its length, which widens the gaps where nerves exit and can help shift bulging disc material back toward its normal position. Chiropractors use traction for neck pain, lower back pain, herniated discs, and pinched nerves.
How Spinal Traction Works
The core idea behind traction is simple: pulling the spine apart slightly reduces the compressive forces that squeeze discs and irritate nerves. When vertebrae separate even a small amount, the openings where nerves pass through (called foramen) get wider, which can relieve radiating pain down the arms or legs. The stretching also creates tension in the spinal ligaments, which may help push herniated disc material back into place.
Beyond the mechanical effect, the reduction in pressure inside the disc appears to improve blood flow, oxygen delivery, and nutrient uptake to damaged disc tissue. This is why traction is often used not just for immediate pain relief but as part of a longer healing strategy for disc problems.
Manual vs. Mechanical Traction
Chiropractors deliver traction in two basic ways. Manual traction involves the practitioner using their hands to pull and position your body, controlling the force and angle in real time. It tends to be shorter in duration, with the chiropractor adjusting based on how your muscles and joints respond during the session.
Mechanical traction uses a motorized table or device that applies a controlled, sustained pull. You’re typically positioned on your back with your knees bent and secured to the table with straps around your chest and hips. The machine cycles between pulling and relaxing, often with about 60 seconds of traction followed by 30 seconds of rest. Sessions usually last around 20 minutes. Because the force is consistent and programmable, mechanical traction is the more common choice for disc-related problems that need repeated, precise treatment.
Cervical Traction for Neck Pain
Cervical traction targets the neck. The pulling force is calibrated as a percentage of your total body weight. Research comparing different force levels found that traction at about 10% of body weight produced the best combination of pain relief and improved neck mobility, with the fewest side effects. For someone weighing 160 pounds, that’s roughly 16 pounds of pulling force.
Lower forces (around 7.5% of body weight) were gentler but less effective. Higher forces (15% of body weight) caused noticeably more reactions, with 11 out of the participants in the high-force group experiencing side effects compared to just 3 in the lightest group. The takeaway: more force doesn’t mean better results, and your chiropractor should start conservatively.
Lumbar Traction for Lower Back Problems
Lumbar traction focuses on the lower back and is one of the most common applications, particularly for herniated discs. A meta-analysis of clinical trials found that mechanical traction significantly reduced pain scores compared to standard physical therapy alone, with an average pain reduction of about 1.4 points on a 10-point scale. Patients also showed meaningful improvements in daily function, measured by a disability questionnaire that tracks activities like walking, sitting, and sleeping.
The forces used for lumbar traction are higher than for the neck, typically starting at less than half your body weight and increasing to roughly half your body weight plus 10 pounds as you build tolerance. Horizontal traction has been shown to be especially effective at increasing disc height in the lower lumbar spine, particularly in the back portion of the discs, which is where most herniations occur.
Spinal Decompression vs. Standard Traction
You may see clinics advertising “non-surgical spinal decompression” as something distinct from traction. Decompression tables use computerized systems that adjust the pulling force in real time, theoretically allowing the spine to stretch without triggering a reflexive muscle contraction that could resist the pull. Standard mechanical traction uses simpler, steady-force motors.
In practice, the distinction is less clear-cut than the marketing suggests. While decompression devices are designed to bypass muscle guarding, there’s limited evidence that muscle tension actually plays a significant role in altering how much the vertebrae separate during traction. Both approaches aim to reduce intradiscal pressure, and the clinical outcomes appear similar. Decompression tables are typically more expensive, which is reflected in what you’ll pay per session.
What a Session Feels Like
During a traction session, you’ll feel a pulling sensation along your spine. It shouldn’t be painful. Most people describe it as a deep stretch. You’ll be lying on your back, often with your knees bent to keep the lower back relaxed. If you’re getting cervical traction, a harness or cradle fits around your chin and the base of your skull.
The most common side effects afterward are muscle soreness, temporary increases in stiffness, and tiredness. These reactions are transient. In studies tracking post-treatment responses, the majority of side effects lasted less than 24 hours and were rated mild, around a 3 out of 10 in severity. Some people feel immediate relief, while others notice gradual improvement over several sessions.
Who Should Avoid Traction
Traction is not appropriate for everyone. Several conditions make spinal traction risky or outright unsafe:
- Fractures or dislocations: Any broken bone or unstable joint in the spine is an absolute reason to avoid traction in that area. This includes healed fractures where ligament damage has left the joint unstable.
- Bone tumors or spinal infections: Malignancies involving the bone and active bone or joint infections are absolute contraindications.
- Inflammatory arthritis: Conditions like rheumatoid arthritis or ankylosing spondylitis during active flares can cause ligament looseness and bone weakening that make traction dangerous.
- Upper neck instability: Instability at the joint between the first and second vertebrae (where the skull meets the spine) rules out traction to that region entirely.
- Significant bone thinning: Osteoporosis and other forms of bone demineralization don’t automatically disqualify you, but they require extra caution and may make traction inadvisable depending on severity.
- Hypermobile joints: If your joints already move more than they should, adding a stretching force can make instability worse.
Conditions like spondylolisthesis, where one vertebra has slipped forward over another, aren’t automatic disqualifiers but require careful evaluation. Progressive slippage may tip the balance toward avoiding traction altogether. Your chiropractor should take a thorough history and, in many cases, review imaging before starting traction therapy.