What is mechanical spinal decompression? How traction helps neck and back pain

"What is a mechanical spinal decompression?" is one of the most-watched videos on our YouTube channel. Below, our clinicians explain what this kind of traction is, who it may help, what a session looks like, how it compares with an inversion table, and when it is not a good idea.

What mechanical spinal decompression is

In the video, our clinician calls mechanical traction "a non-invasive technique used to treat neck and lower back pain." The patient lies on the table and is strapped in securely. The machine then creates an outside pulling force on the spine. He describes it as "roughly 30 to 50% of the patient's body weight depending on the condition that we're trying to treat."

That pull gently separates the segments of the spine. The goal, in his words, is to relieve "pressure on the disc or the nerve root itself," so that inflammation and pain go down and the patient can move more easily. You may also hear it called spinal traction, lumbar traction (for the lower back) or cervical traction (for the neck). On our Spinal Traction & Decompression page you can read how we use it.

Who it may help

Our clinician lists the main reasons we use traction:

• Herniated discs in the neck or lower back
• Radiculopathy, "that shooting pain down the arm or down the leg," such as sciatica or a pinched nerve
• Neck and lower back pain caused by severe muscle spasm

Some people with spinal stenosis may also be candidates. Whether traction fits you depends on an evaluation. Read more about lower back pain and sciatica and neck pain.

What a session looks like

In the first clip, a physical therapist sets up lumbar traction. The pull is chosen for the problem being treated, a smaller share of body weight for muscle spasm and a larger share for a disc herniation. The table pulls and holds you "at that desired weight for 45 seconds," then slowly brings you back for 15 seconds, and repeats for about 11 minutes.

In the second clip, the therapist shows cervical traction for "a twinge right in your neck" or "tingling and numbness going down to your hands." A padded piece rests under the base of the skull and pulls with a "very gentle" force, with the same pattern of a longer hold and a short release.

Both therapists make the same point: you need to be cleared first. "We need an MRI before we put you there," one says, and "there are contraindications. Talk to your PT." The settings in these videos are examples. Your therapist sets the force and timing for you.

Inversion table vs. spinal decompression

Many people ask whether an inversion table at home does the same thing. As the description of this video explains, an inversion table turns you upside down so gravity stretches the spine. It is inexpensive, but it can be uncomfortable, the ankle straps can bother people with ankle problems, and hanging upside down is not advised for people with certain eye, heart or blood pressure problems.

Spinal decompression in a clinic is "a form of traction where the segments in your back or neck are systematically and continuously pulled gently apart by a computerized traction system." A computer controls the amount of pull, and the same approach can be used for the neck. With an inversion table, there is less pull the farther you go from the feet. Ask your clinician before you try an inversion table, especially if you have any of the conditions above.

Part of a plan, not a cure

Traction does not repair a disc or reverse arthritis, and not everyone feels better with it. At Precision Care it is one part of a physical therapy plan that also includes exercise, hands-on treatment and learning how to move. If pain stays severe or nerve symptoms continue, a physician may discuss other options, such as an epidural steroid injection. Our article on how to fix lower back pain without surgery covers more of them.

Who should not have traction

Traction is usually avoided, or used only with extra caution, after a recent spinal fracture or spine surgery, with a spinal tumor or infection, with significant osteoporosis, during pregnancy and with some heart or blood vessel conditions. Your clinician screens for these first.

Go to an emergency room if neck or back pain comes with new arm or leg weakness, numbness in the groin or inner thighs, or loss of bladder or bowel control.

Related care at Precision Care

Where to get care in New York City

Lumbar and cervical traction are offered at our Brooklyn and Staten Island offices as part of a physical therapy plan. Traction is not offered at the Midtown Manhattan office. You can request an appointment online or call the office closest to you. An online request is not a confirmed booking until the office contacts you.

Questions patients ask

Educational only, not medical advice. These videos and this article explain common treatments in general terms. They are not a diagnosis or a treatment plan for you. Results vary from person to person. See a qualified clinician about your own symptoms, and call 911 or go to an emergency room for an emergency.

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