As well as spinal manipulation, osteopaths often use other more reserved therapies to help minimise pain whilst improving function in patients with neck pain. Neck conditions including herniated discs, radiating arm pain (“radiculopathy”), facet syndromes, myofascial pain strains, or sprains, and cervical traction is one such option.
Part of the new patient examination, osteopaths may use their hands to mildly pull on the patient’s neck whilst in sitting and/or supine (lying on the back) positions. If this feels better, then cervical traction may be sanctioned either in the office, with an at-home unit, or both. However, cervical traction is not prescribed if there is instability in the spine/ligaments, vertebral artery insufficiency, rheumatoid arthritis, discitis, neoplasm, osteomyelitis, severe osteoporosis, untreated hypertension, cauda equina syndrome, severe anxiety, or myelopathy.
There are varying forms of cervical traction devices, so treatment may be performed while the patient is in a standing, sitting, lying horizontal, or inclined either prone or supine position, and the traction force can be uninterrupted or continuous vs. intermittent or pulsed. Variances including body/head weight and the associated friction against the traction table in lying down types of units, and the angle can often be varied with most types of traction units.
There are positives and negatives to varying types of traction units. Lying down traction may allow for improved relaxation vs. sitting, but due to the friction on the table, more weight may be needed. In the main, when hold times are longer (especially with sustained traction), less weight is used. Some osteopaths recommend starting at 5 lbs. (~2.67 kg) for 15 minutes with a sitting device (sustained traction) and smoothly upping the weight to maximum tolerance while keeping the time constant at 15 minutes.
There are various theories on why traction provides pain relief: it forces rest through immobilisation and by supporting the weight of the head, it separates / opens the facet joints, it improves nutrition to the joint cartilage, stretches ligaments, it reduces the pressure inside the discs, it benefits by reducing pressure on nerve roots, it improves head posture, and/or it stretches the neck muscles to increase blood flow and minimise muscle spasm.
If you have neck pain and manual traction applied to the cervical spine provides pain relief, then your osteopath may choose to introduce this therapy into your treatment plan.