What is Lumbar Traction in Physiotherapy

Last updated on November 21st, 2023 at 12:50 pm

Most of you must have either experienced or heard of people taking lumbar traction for back pain. This technique helps relieve back pain without medication, and it can also cure complicated pain cases such as sciatica and disc hernia, which would otherwise require painful surgery.

You can find a traction table in any hospital with a physiotherapy unit or any independent physiotherapy centre, but it should always be given under the supervision of a qualified physiotherapist. It is an essential part of the physiotherapy treatment process. In this post, we will explain the basic principle of traction using lumbar traction as an example. So, let’s get started.

What is lumbar traction physiotherapy?

Traction is a broad term that involves applying a distraction to a body part using weight or mechanical pull. When traction is applied to the lumbar area using a traction machine, it is called lumbar traction. Traction is commonly used for neck pain, knee pain, and low back pain. It is also used for the leg after a leg bone fracture and for the hip bone after a femur neck fracture.

However, in this context, we are only concerned with lumbar traction for the lower back.

This is how we can define spinal traction:

Traction is the application of distraction force over the vertebrae to separate two vertebral bodies from each other. In lumbar spinal traction, the pull is applied over the lower back.

How lumbar traction is applied

With time, there has been a significant improvement in the methods of traction application. Slowly, it has evolved towards a more automated and mechanical way, where the force of pull and its duration of application are under control. We can easily change the duration and its force with a button.

Manual lumbar traction

In the past, a different method was used for spinal traction. It involved using weights such as sandbags and bricks that utilized gravity to create a pulling force.

To perform this method, the individual would lie flat on a bed while wearing a lumbar belt with hooks on either side to attach the rope. On the other end of the rope, a calculated weight was hung, creating a pulling force on the back for 20 to 30 minutes.

However, this method had its downsides. Continuous traction for 20 to 30 minutes could sometimes worsen the pain due to muscle soreness. Personally, I do not use manual traction in my practice.

Mechanical traction

The development of a mechanical traction device was driven by the need to avoid continuous pulling. A mechanical traction unit consists of a machine with motors attached to a couch or table that creates a pulling force. The pulling force can be easily controlled through the unit’s control system. One of the most significant benefits of this kind of traction is that it allows for the option of choosing between continuous traction and interrupted traction. In my clinical practice, I prefer interrupted traction over continuous mode. When using lumbar traction, it is important to carefully choose the weight based on the person’s body weight, and the calculation is straightforward.

Lumbar traction weight calculation

The obvious question is how much weight is safe and effective?

Every person that comes to you will differ in terms of weight, height and build. The weight that may be effective for one may be too weight or too light for another. You need to calculate the weight for each and every different person.

Thankfully calculating weight is not difficult. There is a rule of thumb according to which the weight of pull for lumbar traction would be 1/3rd the weight of the body. Research shows that 30% and 60% of the body weight as the force of traction significantly improved the mobility of the lower extremity during the SLR (Straight Leg Raise) test in a group of ten subjects with subjective complaints of low back pain or radicular symptoms with a positive unilateral SLR test below 45′ (1).

Note: The weight of pull for neck/ cervical traction is 1/7th of the weight of the body.

For example, if a person weighs 65 kg, then the force of pull would be roughly 1/3rd of 60 kg, which would be 21.5 kg. So, in this situation, 25 kg would be ideal.

More on mechanical lumbar traction

Continuous pull produces muscle soreness but what when we interrupt it for a short duration of the relaxing period?

Let me be a little more specific with this example, let’s take the total duration of pull as 10 minutes. So in interrupted traction, every 40 seconds there is an interruption of 10 seconds relaxing period. This is only possible in this mechanized way. The mechanized traction unit consists of a motorized traction machine, a bed, one chest piece belt, and a low back piece belt.

The illustration below shows all the important parts, the asset of a mechanized traction machine.

It has a control button from where we can control the hold time (traction) and release time (relaxation) depending on the nature and severity of the case. The detail on this topic is beyond the scope of this article.

How to apply lower back traction at home

Is it possible to get the benefit of lumbar traction physical therapy at home?

Yes! It is possible. You can use the lumbar traction kit specially designed for the home.  Just take care of how much weight /force you are using to apply force. Start with low weight and then progress.

Final word

Traction is widely used for treating low backache. This is why you are sure to find it inside every physiotherapy centre. But, not all backache qualifies for it. The above post is for information purposes only. You should always go for this procedure under the supervision of a qualified physiotherapist only.

Keep reading: 3 Best sleeping position for sciatica for quick relief

Journal Reference:

1. Meszaros, Thomas & Olson, Ronald & Kulig, Kornelia & Creighton, Douglas & Czarnecki, Edward. (2000). Effect of 10%, 30%, and 60% Body Weight Traction on the Straight Leg Raise Test of Symptomatic Patients With Low Back Pain. The Journal of orthopaedic and sports physical therapy. 30. 595-601. 10.2519/jospt.2000.30.10.595.

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Sunit. S. Ekka

Dr Sunit Sanjay Ekka is a physiotherapist in practice for the last 15 years. He has done his BPT from one of the premium Central Government physiotherapy colleges, ie, SVNIRTAR. The patient is his best teacher and whatever he gets to learn he loves to share it on his Youtube channel and blog.

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