Traction therapy is a treatment that uses pulling force to stretch the spine, creating space between vertebrae to relieve pressure on compressed discs and nerves. It’s most commonly used for neck and lower back conditions like herniated discs, sciatica, and pinched nerves. The treatment can be performed by hand, with a mechanical device, or even at home with portable equipment, and a typical course runs 12 to 24 sessions over four to six weeks.
How Traction Works Inside the Spine
Your spinal discs sit between each vertebra and act as shock absorbers. Each disc has a gel-like center that retains water and distributes pressure evenly across the spine. When a disc bulges or herniates, it can press on nearby nerve roots, causing pain that radiates into the arms or legs.
Traction applies a controlled pulling force along the spine, which reduces the pressure inside those discs. Lab studies on cervical (neck) spines have confirmed that increasing the traction force produces a measurable drop in pressure within the disc. This reduction in pressure serves two purposes: it eases compression on nerve roots, and it creates a slight negative pressure environment that can help draw nutrients and oxygen back into the disc, supporting the healing process. Inversion therapy, a gravity-based form of traction, has been shown to separate lumbar discs by up to 4 millimeters at each level, particularly at the two lowest disc spaces in the lower back.
Conditions Traction Therapy Treats
Traction is primarily recommended for people experiencing nerve-related symptoms rather than general back or neck stiffness. The most common indications include:
- Herniated or bulging discs pressing on spinal nerves
- Sciatica (pain radiating from the lower back into the leg)
- Cervical radiculopathy (a pinched nerve in the neck causing arm pain, tingling, or weakness)
- Spinal osteoarthritis that narrows the space around nerve roots
Clinical evidence suggests traction is most effective when leg symptoms are present alongside back pain, and when examination reveals signs of nerve root compression. In one study of patients with sciatica, both back and leg pain decreased by an average of 69%, and disability dropped by 57% within one month of starting treatment.
Types of Traction
Manual Traction
A physical therapist uses their hands to pull and hold the spine in a stretched position. The therapist typically applies force for about 10 seconds, releases for 5 seconds, and repeats the cycle. Manual traction allows the therapist to feel how your body responds and adjust in real time, but one limitation is consistency. The pulling force naturally fluctuates because it depends entirely on the therapist’s muscles, making it harder to maintain a perfectly uniform stretch throughout the session.
Mechanical Traction
A motorized device delivers the pulling force, either as a continuous stretch lasting 20 minutes or longer, or in an intermittent pattern that alternates between pulling and relaxing. For cervical traction, the force typically ranges from 10 to 15 percent of your body weight. For lumbar traction, studies define meaningful force as 35 to 50 percent of body weight, with research showing that about 60 percent of body weight is needed to reduce pressure inside a disc by 25 percent. The key advantage of mechanical traction is that the machine delivers the same force throughout the session without variation.
Computerized Spinal Decompression
Newer devices use computerized sensors to adjust the pulling force in real time, targeting specific spinal segments. The theory behind these systems is that they can stretch the spine without triggering the surrounding muscles to tighten up in resistance. In practice, though, evidence comparing computerized decompression to standard mechanical traction has not shown a clear difference in outcomes. It remains uncertain whether muscle tension during traction significantly affects how well the vertebrae separate.
Inversion Therapy
Inversion tables tilt your body partially or fully upside down, using your own body weight as the traction force. This approach generates a much larger pulling force than horizontal traction tables can achieve. Most clinical protocols position patients at about 50 degrees from horizontal rather than fully inverted. Inversion is not appropriate for people who are pregnant, have significant heart or lung disease, progressive nerve damage, or any condition that worsens in a head-down position.
What a Typical Session Feels Like
For cervical traction, you lie on your back while a padded halter fits under your chin and the base of your skull. Your neck is positioned at a slight forward angle, usually between 15 and 35 degrees. The device then applies a gentle, steady pull. Sessions typically last around 20 minutes. You should feel a stretching sensation but not increased pain. Therapists generally start with lower forces and gradually increase them over subsequent sessions based on how your symptoms respond and what you can comfortably tolerate.
For lumbar traction, you also lie on your back, often with a harness around your pelvis. The table or device pulls from the lower body while your upper body stays anchored. The intermittent pattern of pulling for several seconds, relaxing, and pulling again is common for both cervical and lumbar applications.
Treatment Timeline and Expectations
A standard traction course starts with two to three sessions per week and runs for four to six weeks, totaling roughly 12 to 24 visits depending on the severity of your condition. Initial home traction protocols for cervical issues start at 10 to 12 pounds of force and gradually work up to around 30 pounds as symptoms allow.
Results from clinical trials suggest that patients who complete a course of traction often report around 90 percent overall improvement as perceived by the patient, though this typically occurs alongside other treatments like exercise and manual therapy rather than traction alone. Traction is rarely used as a standalone treatment. It works best as one component of a broader rehabilitation program that includes strengthening exercises and mobility work to address the underlying causes of nerve compression.
At-Home Traction Devices
Over-the-door cervical traction units are the most common home option. You sit in a chair, wear a head halter, and a weighted bag creates the pulling force through a pulley system. Clinical protocols using these devices have patients sit with non-elastic straps securing them to the chair for stability during the 20-minute session. The weight starts low and increases gradually, and patients are instructed to stay as relaxed as possible throughout.
Home devices can be effective for mild to moderate cervical conditions, but the starting weight and progression should be established during supervised sessions first. Patients can generally tolerate moderate to relatively heavy traction loads without worsening symptoms, but the correct neck angle and force level vary from person to person. Getting these parameters set by a professional before transitioning to home use reduces the risk of aggravating your condition.