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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.

According to a recent study, 34% of the general population experiences neck pain at some time in their life, of which 14% having 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 peoples well being, and their health care expenses.

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.

In theory, applying a controlled pulling force on the spine causes a number of physiological effects:
– It enlarges the intervertebral foramen
– It releases pressure on intervertebral discs
– It releases pressure on nerve roots and blood vessels
– Ligaments and paravertebral muscles of the neck region are being stretched
– Effects of abnormalities of the cervical facet joints are reduced

These effects are believed to release muscle tension, nerve tension and increase blood circulation in the cervical region, which ultimately should result in decrease neck pain.

In a more recent study done by the Hong Kong Polytechnic University, intermittent cervical traction on 79 patients (aged between 20 to 70 years old) with chronic neck pain, was investigated. The patients were randomly assigned into two groups. For a period of six weeks, one group received cervical traction twice a week, adminsistered by a experienced senior physiotherapist. The second group recieved placebo- infra-red (heat therapy) treatment twice a week.

At baseline, after 6 weeks, and after 3 months, the patients were asked to complete a disability questionnaire, score their pain on a pain scale, and range of motion of the cervical spine was measured.

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 and therefore more methodological randomised control studies should 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

 

References:

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

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