What is traction?

From the Guidelines

Traction should not be used as a primary treatment for low back pain due to lack of strong evidence supporting its effectiveness. When considering the use of traction, it's essential to weigh the potential benefits against the risks and to prioritize interventions with stronger evidence bases, such as self-care education, spinal manipulation, or transcutaneous electrical nerve stimulation (TENS) 1.

Key Considerations for Traction

• Traction involves applying a pulling force to stretch the lumbar spine, which can be done through various methods, including the use of free weights, motorized equipment, or inversion techniques.
• The goal of traction is to create space between joint surfaces or vertebrae, potentially reducing compression on nerves, improving circulation, and decreasing muscle spasm.
• However, the evidence supporting the use of traction for low back pain is limited, and it is not recommended as a first-line treatment by recent guidelines 1.

Alternatives to Traction

• Self-care education books can provide patients with valuable information on managing low back pain, including advice on returning to normal activity, adopting a fitness program, and managing flares.
• Spinal manipulation and mobilization have been shown to be effective in treating low back pain and can be considered as part of a comprehensive treatment plan.
• TENS units can provide symptomatic relief by modifying pain perception and are a non-invasive option for managing pain.

Important Safety Considerations

• Before initiating any treatment, including traction, it is crucial to obtain a proper diagnosis to rule out conditions that may be contraindicated for traction, such as osteoporosis, spinal instability, or inflammatory arthritis.
• Patients should be instructed on the proper use of traction devices and should only use them under the supervision of a healthcare provider.

From the Research

Definition and Purpose of Traction

• Traction is a treatment modality used for the reduction or immobilization of fractures or dislocations 2, 3, 4
• It is used to maintain alignment, decrease muscle spasms, relieve pain, correct, lessen or prevent deformities, expand joint spaces prior to surgery, promote rest to diseased or injured body parts and to promote exercise 2, 3

Types of Traction

• There are different types of traction, including skin and skeletal traction 2, 5
• Skeletal traction is a useful technique for managing proximal femur fractures in austere environments 6
• Skin traction is commonly used, but its effectiveness has been questioned in recent studies 5

Application and Maintenance of Traction

• Nurses need a working knowledge of the various types of traction along with its rationale, correct setup, and maintenance 2, 3
• The correct application and maintenance of traction is crucial to achieve expected patient outcomes and prevent complications 2, 4

Effectiveness of Traction

• The routine use of traction (either skin or skeletal) prior to surgery for a hip fracture does not appear to have any benefit 5
• However, the evidence is also insufficient to rule out the potential advantages for traction, in particular for specific fracture types, or to confirm additional complications due to traction use 5