Fritz et al. (2014) did a fairly recent RCT on effectiveness of mechanical traction in patients presenting with cervical radiculopathy.
A previous study done by Raney showed that cervical traction was associated with more benefit if patients present with 3 or more of those 5 following factors: (1) Peripheralization with ROM of mobs of low cervical spine. (2) positive shoulder abduction sign [place 1 hand on the head and wait 30 second… if pain decrease, it’s (+)], (3) positive neck traction test, (4) positive ULNT, (5) 55 or older
Based on Raney study, Fritz et. al (2014) did a stratified RCT comparing 3 groups: (1) Exercise alone, (2) Exercise with mechanical traction, (3) Exercise + overdoor traction as home exercise program.
(1) Disability and pain significantly lower in the group with mechanical traction even after 6 and 12 months!
(2) Regardless of symptoms described by Raney, patients still could benefit from cervical traction
Limitation of this study:
(1) Couldn’t blind the therapist/ patient
(2) Number of treatments were up to 10 in 4 weeks
(3) High drop out… so low internal validity
(4) Selection bias… so low external validity
My thought on this:
A tool to consider for neck pain patients. (probably has more of a psychosocial effect)
Short term decrease of pain increases therapeutic alliance and decreases perceived threat. Also since it’s not blinded, the therapist beliefs will have an impact on the patient’s outcome…