Decompression Therapy

Clinicians who treat the spine use traction all the time. Some use their hands to deliver the traction force (manual traction). Others may use a device to help them out (mechanical traction). And some use both.

When a manual therapist works on the neck of a patient, they hold the head in both hands and gradually add tension to the soft tissues. They add some rotation, some extension or flexion, some lateral flexion, until they find the right angle of pull where the muscles start relaxing. Blood flow will nbow start to improve, pain will decrease and range of motion will improve. Traction does all that and more. It is a powerful form of joint and soft tissue mobilization.

Smart manual therapists use a mechanical traction device to complement their manual work. The reason is, manual work alone has some limitations. One drawback is that in most cases the therapist will need both of their hands to apply the traction force to the cervical spine. Other manual work, like working on a trigger point in the neck muscles for instance, is hard to do at the same time. In other words, we are constrained when performing manual traction; we can only do it and nothing else.

Mechanical traction is similar to manual traction in almost all key aspects of traction therapy. It also offers some significant benefits that create some unique opportunities for the manual therapist.

The main difference is that a mechanical device produces the pulling force to the cervical spine, not the clinician’s hands. This device will not fatigue and will not vary its pulling force. It can adjust its pulling force based on the patient’s muscle tension. It can also deliver a protocol of gradually increasing and then decreasing levels of tension over a set amount of time. In other words, it can replicate what the therapist would normally be doing with their hands.

A typical treatment session for a patient with cervical nerve pain (radiculopathy) may look like this:

• 20 mins of mechanical traction using an evidence based progressive-regressive tension protocol
• 2 mins of high power laser therapy to key pain points (trigger and tender points)
• Mobilization and/or manipulation to the joints and soft tissues
• Possibly another 1 min of high power laser to mitigate the pain response to treatment
• Home exercise instruction