Pneumatic Cervical Traction in St. Louis

Old-style traction uses a hanging weight or a hand pulley. The force is harder to control and harder to repeat from one session to the next. It also lands less smoothly.

A pneumatic system sets the force by air pressure. So it can be dialed to an exact level, held, released and repeated the same way each time. In practice, we start well below the level that sets off your symptoms. Then we raise it on purpose over the sessions as you handle it better.

It also allows intermittent traction — cycles of pull and release, not one steady pull. Many people handle the cycles much better. The cycling also seems to help fluid move in and out of the disc, instead of just holding it stretched.

Traction helps most when symptoms have a clear mechanical cause:

• Cervical radiculopathy — neck pain that shoots into the shoulder, arm or hand, with or without numbness
• Narrowed nerve openings from wear and tear
• A bulging disc that irritates a nerve root
• Persistent neck pain with stiff movement and tight, guarding muscles
• Symptoms after a car crash, where whiplash has left lasting mechanical neck pain

A handy clue is position. If your arm symptoms ease when you lift your arm over your head, or when you gently pull your own head up, the nerve root is likely being squeezed. Then traction is worth trying.

Traction is a conservative treatment, and we treat it as one. It is cheap, low-risk and needs no needles or cuts. That makes it a sensible early step. But it does not replace finding out which part is making your pain.

If symptoms last, electrodiagnostic testing (nerve testing) shows for sure whether a nerve root is hit and at which level. From there, targeted options such as a selective nerve root block or cervical epidural steroid injection go straight at the inflammation around the nerve.

Traction also pairs well with the rest of the conservative plan. It often makes physical therapy bearable for people whose neck is too irritated to work with otherwise.

We avoid traction when the spine may be unstable or when pulling could cause harm. That includes after some neck fractures, with major instability, with a spinal tumor or infection, with vertebrobasilar insufficiency (poor blood flow to the back of the brain), with inflammatory arthritis of the upper neck, and with severe osteoporosis.

It is also not the answer for every neck problem. Pain from the cervical facet joints (the small joints at the back of the neck), and not from a pinched nerve root, often does not respond. Sticking with traction that is not helping just delays the treatment that would.