decompression, neck pain

Decompression Therapy

In Decompression, Low back pain, Mechanical Traction, Pain by ywijting

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.

I was trained as a manual therapist. When I work on the neck of a patient, I hold the head in both my hands and gradually add tension to the soft tissues. I add some rotation, some extension or flexion, some lateral flexion, until I find the right angle of pull where the muscles start relaxing. I now know that blood flow will 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.

Mechanical Traction

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 our 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. Another drawback: the therapist’s hands will eventually get tired, especially when using greater amounts of force.

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 I would normally be doing with my hands.

Multimodal Approach

As an example, a typical treatment session for my patient with cervical 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

My advice to my fellow manual therapists who regularly work on the spine: try out adding mechanical traction to your treatment protocol to see what treatment opportunities it opens up for you. I bet you won’t be disappointed.