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Cervical traction is a non-invasive procedure used to provide symptomatic relief for a variety of cervical pathologies. Though it can lead to temporary symptomatic relief, there is limited data on its long-term safety and therapeutic efficacy. This activity reviews the indications, contraindications, and techniques involved in performing cervical traction and highlights the role of the interprofessional team in caring for patients who utilize cervical traction. Objectives: Describe the conditions that cervical traction is used for. Outline the contraindications to cervical traction. Explain how to monitor a patient undergoing cervical traction. Explain the importance of a well-coordinated interprofessional team in the care of patients that are considering cervical traction. Access free multiple choice questions on this topic.

The practice of spinal traction goes back to the fourth century BC, where Hippocrates first described it as a treatment for kyphosis. It was subsequently implemented in other spinal pathologies including cervical pain and myelopathy. In the 1600s, the Germans employed cervical traction in their medical practice, as an adjunct to open reduction of cervical dislocations, and fractures. In 1929, the Halter device was introduced for the reduction of cervical injuries; then several other devices followed to ensure more efficient traction. To date, there is no accurate description of the mechanism of relief provided by cervical traction. The theory behind its efficiency emphasizes the widening of the intervertebral foramen upon traction, with separation of the facet joint. This will relieve the sustained pressure on the nerve roots, and hence alleviate symptoms of radiculopathy. Other theories suggest that traction allows for cervical muscle relaxation, and is not involved in intervertebral separation.[1][2]

Complications are rare, providing that patients are adequately screened for conditions that are contraindicated. Postprocedural increase in peripheral nerve pain and a decrease in central pain, increase in neurological symptoms, or sudden disappearance of central pain are alarming signs of traction-induced spinal cord compromise.

The application and education of the patient in regards to cervical traction may be done by EMS, physical therapists, physicians, and orthopedic nurses. While the procedure is simple, it is important that the patient be monitored by the nurse and physical therapist for complications and improvement. The nurse and therapist should coordinate reporting with the treating clinician. Complications are rare, providing that patients are adequately screened for conditions that are contraindicated. Postprocedural increase in peripheral nerve pain and a decrease in central pain, increase in neurological symptoms, or sudden disappearance of central pain are alarming signs of traction-induced spinal cord compromise.[11] An interprofessional team approach to evaluation and education of patients requiring cervical traction will provide the best outcomes. [Level 5]