Manual Cervical Traction in Physical Therapy

Hands-On Treatment for Neck Pain

Neck pain can be tough to treat. Your physical therapist may use a technique called manual cervical traction to help decrease your neck pain and improve your mobility.

If you have neck pain, your healthcare provider may refer you to a physical therapist to help decrease the pain and improve your neck range of motion and overall function.

Your physical therapist will work with you to develop a treatment program specific to your condition. He or she may use various treatments and modalities to help decrease your pain and improve your neck pain.

Cervical traction is one treatment that your physical therapist may use to help treat your neck pain. Cervical traction can help separate the bones, discs, and joints in your neck. This can take the pressure off of nerves and can help relax and gently stretch your neck muscles.

There are many different ways to provide a traction force to your neck. Your physical therapist may use a mechanical traction unit, or an over-the-door traction device may be used to provide traction.

Manual cervical traction is another way to provide traction to your neck. In this technique, your physical therapist uses his or her hands to manually pull on your neck and provide a traction force.

Woman rubbing sore neck
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Benefits of Manual Cervical Traction

There are several benefits to using manual cervical as a means to separate the bones and joints in your neck. These include:

  • Easy to alter force based on your symptom response
  • Easy to adjust the angle of your neck while providing traction
  • Easy to provide spinal mobilization while providing traction

Manual Traction Technique

When your physical therapist decides to apply manual cervical traction to treat your neck pain, he or she should explain the procedure to you so you know what to expect. If you have any questions, you should ask your physical therapist before starting.

Manual cervical traction is applied to your neck while you are lying down on your back. You should be resting comfortably on a treatment table, and your head should be near one end of the table. Your physical therapist will then gently hold the back of your neck with one hand. You should feel your therapist's hand near the base of your skull.

Your physical therapist will then cup his or her other hand underneath your chin. This allows your therapist to have good control over the position of your head and neck. Your physical therapist will then gently lean back to provide the traction force to your neck. No forceful tugging of pulling should occur. A slow and gradual traction force is applied and held for 5-10 seconds, and then the traction is gradually released.

You should expect your physical therapist to ask you questions about your symptoms while providing the traction to your neck. If your pain is decreasing while receiving the traction, your physical therapist will likely continue with slow, rhythmic pulls on your neck.

If your symptoms are not changing, your physical therapist may choose to slightly alter the angle of traction to your neck by raising or lowering your neck a few inches. Be sure to tell your physical therapist what you are feeling while he or she is applying the manual cervical traction to maximize the benefit of the treatment.

What Does the Traction Feel Like?

When you receive any type of cervical traction, you should simply feel a gentle pulling sensation in your neck. There should be no pain, and only a light strain should be felt. If you are feeling pain or discomfort, notify your physical therapist. He or she can modify the traction to improve your comfort or decrease your pain. If the pain continues, traction should be stopped and an alternative treatment should be used.

If you benefit from manual cervical traction, your physical therapist may want you to continue traction at home on a regular basis. This can be done by purchasing an over-the-door traction device, or you may wish to purchase or rent a home mechanical unit. Your physical therapist can make recommendations on the best device to fit your specific needs.

Remember that most successful physical therapy programs for neck pain involve active exercise and postural correction. Be sure that your physical therapist is teaching you exercises to help your specific condition.

Cervical traction is used to help separate bones and joint surfaces in your neck to help decrease pressure on spinal nerves and to decrease neck pain. Manual cervical traction is one treatment that your physical therapist may use to control your neck pain and help you quickly return to your normal activity and function.

2 Sources
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  1. Abi-Aad KR, Derian, A. Cervical Traction. In: StatPearls. Updated September 10, 2019.

  2. Cleland JA, Whitman JM, Fritz JM, Palmer JA. Manual physical therapy, cervical traction, and strengthening exercises in patients with cervical radiculopathy: a case series. J Orthop Sports Phys Ther. 2005;35(12):802-11. doi:10.2519/jospt.2005.35.12.802

By Brett Sears, PT
Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy.