How many times a day can you do Neck Traction

by Anthony Maritato PT | Jan 7, 2021 | Neck Pain

Neck traction, cervical traction, may be used multiple times within a 24-hour period. [1]

In my physical therapy practice the frequency of use is dependent upon 3 factors.

How acute the symptoms are and what is the specific condition being treated?
What other treatment interventions are being used?
How long does the benefit last from a single use?

An acute flare-up of generalized neck or upper shoulder pain often responds positively to a 10-minute episode repeated up to 4 times a day.

“An example of an acute flare-up might be when you wake up with a “kink” in your neck. Perhaps you fell asleep on a couch and upon waking you realize it is painful to move your neck. The pain has persisted less than a day and for the past several days you were pain free. This would be considered an acute exacerbation.”

For a more chronic condition, I find a single episode of 20-minutes used daily after work or prolonged time sitting at a desk works well to relieve muscle tension, headaches, eye strain, and general fatigue.

“A chronic neck pain condition is commonly defined as pain and limitation persisting for more than 90-days. Perhaps you have tried multiple treatments from exercises to injections, even surgery, but the pain persists.”

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How long should you do Neck Traction?

According to Comfortrac – an acute episode of neck pain may be best treated with 1 to 3 episodes per day for a duration of 10 to 15-minutes per episode. The recommended force is 10 to 20 pounds. [2]

Personally, I have found that patients respond best to lower traction forces initially followed by higher forces during the middle of the treatment before returning to a lower force at the end.

Try 8 to 12-lbs of force during the first 3 minutes followed by increasing the force to 12 to 18-lbs for the next 10 minutes, followed by a reduced force of 8 to 12-lbs for the remaining time.

For more recommendations on the use of a cervical traction unit click here >

Can you sleep with neck traction?

No! It is not advised to sleep with a cervical traction device on your neck.

Most treatment protocols recommend a maximum use time of 20-minutes. Prolonged use beyond this recommendation may result in increased pain, stiffness, and possible injury.

Many clients find the sensation of cervical traction relaxing and as a result, many clients may fall asleep while using the device. It is highly recommended that you set a timer and place the timer next to you while using the device.

How much force (weight) should I use for cervical traction?

A common recommendation is 10-lbs to 25-lbs of traction force.

Different body positions and body sizes will necessitate different forces.

Supine (laying on your back) is the preferred position for cervical traction and often requires significantly less force to produce a beneficial effect.

A larger individual sitting in a chair may require 5 times the pulling force as a smaller individual lying supine because of the effect of gravity and the absolute weight of the larger individual’s head.

Some traction devices allow you to sit upright in a chair. These devices necessitate much higher force loads due to the fact that you must overcome the effects of gravity.

A hybrid approach may work for some clients.

Sitting reclined in a recliner with the device placed behind your head on the recliner may allow patients with spinal stenosis and other low back pain limitations to position in supine without increasing back pain associated with laying flat on your back.

Another common tip is to place a stack of pillows or pillow wedge under your knees if you experience low back pain while lying in supine.

Reclined positions also improve breathing for some while still reducing some of the compressive effects of gravity.

What is the best cervical traction device?

There are 3 main types of cervical traction devices:

1.) A pneumatic cervical traction device is one in which a manual air pump is used to produce the traction force through a sliding carriage or bladder. These are commonly available for purchase from most medical device retailers.

2.) A fully mechanical traction device is one in which a computer and motor controls the traction force. These are often many thousands of dollars and are commonly found in physical therapy clinics and chiropractic offices.

3.) Sling and pulley systems are often the lowest cost option and may be purchased from various retailers.

What is the best position for cervical traction?

Multiple studies have suggested that supine (lying on your back) is a better position to perform cervical traction than sitting upright or standing.

One reason is simply because supine eliminates the compressive force of gravity.

If you are unable to position yourself in supine due to breathing difficulties or low back pain you may choose a seated or standing position.

A less common position for cervical supine is lying prone (on your stomach).

While you can not use many of the devices mentioned above in the prone position you may not need a device as gravity will do the work.

What are the most common conditions to use cervical traction?

Cervical traction has been used in a variety of cervical pathologies: [5]

Cervical disc disease
Cervical spine fracture
Facet joint dislocation
Atlantoaxial subluxation
Occipitocervical synopsis
Spondylosis
Radiculopathy
Foraminal Stenosis
Myofascial tightness

Contraindications: [5]

Significant diseases
Traumatic injury in the acute phase or gross inflammation
Spinal infections: meningitis, arachnoiditis Spinal cancer (traction may increase metastases or promote instability)
Tumors Active infectious disease of the spine or bone disease
Certain types of disc herniation
Midline disc herniation associated with acute torticollis
Extruded disc fragmentation or rupture
Poor treatment response
With peripheralization of symptoms
Conditions that worsen following traction treatments
Weakened or unstable structures
Prolonged systemic steroid use
Vertebral fractures
Joint instability due to trauma or ligamentous laxity: Rheumatoid Arthritis, Marfan’s Syndrome, Down’s Syndrome, Ehlers Danlos Syndrome
Other
Clinical signs and symptoms of spinal cord compression
Vascular compromise
Serious cardiovascular disease.

My Personal Experience In The Clinic – Why I choose ComforTrac over Saunders

I became a licensed physical therapist in 2006 but before that, I was fortunate enough to work in multiple physical therapy clinics as an exercise technician. I have had more than 20-years of experience comparing the Saunders cervical traction unit to the ComforTrac brand device.

For as long as I can remember the Saunders unit was chosen in every clinic but the price was nearly double that of the ComforTrac unit. In a 10-year side by side comparison the ComforTrac unit performed just as well in the clinic and the Saunders unit and neither showed any mechanical failure during that time. While both units are of considerable build quality and best in quality, I personally find the ComforTrac unit to be more comfortable and lighter weight.

My personal recommendation is the ComforTrac unit and I can tell you that I have repeated purchased the ComforTrac unit for my clinics.

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Treatment Protocols: Link