Q:Can lumbar traction help relieve lower back pain?
A:Though it may provide temporary relief in some people, there's not enough evidence to recommend it.
Commonly used by physical therapists for herniated disks, muscle spasms and other back conditions, traction involves applying force to the spine so that the vertebrae are pulled apart slightly, which may help relieve pressure on disks, ligaments and nerves. It can be done in different ways—through a pulley-type system, for example, or manually.
The effectiveness of traction is debatable. Most studies have been small and poorly designed. And because they've used variable methods, they are hard to compare.
One, from Turkey in 2008, found that traction (15 sessions over three weeks) was as effective as ultrasound and low-level laser therapy in reducing back pain and disability and improving disk herniation—but the study had no placebo group.
A 2010 Cochrane review of 25 studies concluded that traction was no better than a placebo, other treatments, or no treatment.
It's unclear what conditions, if any, traction may work best for; what mode, force and duration is optimal; how long any effect may last; and how it compares to exercise, massage or other physical therapy techniques. Back pain is hard to treat and, as with all modalities, people may vary in how they respond to traction.
Traction may be contraindicated if you have an acute back injury, osteoporosis or other musculoskeletal or spinal condition. Done incorrectly or with too much force, it can impinge nerves and have other adverse effects. We especially recommend against inversion traction (such as done on inversion tables), which can have serious side effects, including increased blood pressure and bleeding into the retina.