Lumbar traction: a review of the literature.

Lumbar traction is commonly used to treat patients with back pain. Typically, clinicians rely on expert opinion in making decisions about when and how to implement lumbar traction. The purpose of this paper was to review current knowledge of lumbar traction and to identify what, if any, empirical evidence supports the expert opinions. This review found that whereas the mechanical effects of lumbar traction are well substantiated, the results of studies examining clinical effectiveness are conflicting. The failure to conclusively demonstrate the clinical benefit of lumbar traction may be related to the varied diagnostic categories and treatment techniques employed in the studies. Of the 10 types of lumbar traction described in the literature, static and intermittent mechanical traction are the two most commonly used. Indications, contraindications, and treatment techniques for these two types of traction are discussed. Based on the findings of this review, further study is needed to determine optimal treatment duration, frequency, and mode of administering lumbar traction. Also, classification systems to identify patients most likely to benefit from traction need to be developed and validated.