April 19, 2018
Self-Traction for Back Pain
Ask the Experts

Self-Traction for Back Pain

by Jeanine Barone  

Q: Can anti-gravity stretches help relieve lower back pain?

A: What you’re referring to is known as self-traction, and though there’s little published evidence confirming that it works, it’s worth a try, at least for some people, after consultation with a health care provider.

Commonly used by physical therapists for herniated discs, muscle spasms, and other back conditions (including scoliosis), traction involves applying force to the spine so that the vertebrae are pulled apart slightly, which may help relieve pressure on discs, ligaments, and nerves. It can be performed in different ways—by a physical therapist who does it manually or relies on a pulley-type system, for example—or you can do it yourself at home without any special equipment.

You’ll also see some health clubs and yoga studios promoting anti-gravity stretching or yoga classes for all sorts of physical benefits, including flexibility and core strength. These activities involve performing different yoga poses and hanging upside down while suspended from an elastic hammock or other equipment.

Studies on traction have been relatively small and short and have had inconsistent findings. In a 2013 review of studies on both manual and machine-delivered traction, the Cochrane Collaboration concluded that there was little if any benefit in terms of reducing pain or improving function in people with low back pain. Furthermore, the reviewers noted that traction caused some people to experience an increase in pain and an aggravation of their condition.

Subsequently, a 2015 study in Neurosurgery Quarterly found that subjects with a herniated disc who repeatedly (20 times a day) hung from a pull-up bar for two months experienced a reduction in pain and a decrease in their herniation as observed on MRI, compared with the control group. But a 2016 clinical trial in the Journal of Orthopedic and Sports Physical Therapy found that adding traction to an exercise program for people with low-back and radiating leg pain had no significant impact on pain or disability.

Despite this, 77 percent of orthopedic physical therapists in the U.S. use traction to treat low back pain, according to a survey published in 2015 in the Journal of Orthopedic and Sports Physical Therapy.

It’s unclear what conditions, if any, traction may work best for; what mode, force, and duration are optimal; how long any effect may last; and how it compares to exercise, massage, or other physical therapy techniques. Back pain is hard to treat and, as with all modalities, people may vary in how they respond to traction.

Traction may be contraindicated if you have an acute back injury or infection, osteoporosis or other musculoskeletal or spinal condition, or are pregnant. Done incorrectly or with too much force, it can impinge nerves and have other adverse effects. We especially recommend against any aerial-type anti-gravity classes or other sort of inversion traction (such as done on inversion tables), especially if you have high blood pressure, heartburn, glaucoma, or neck or spinal injury. In some people, being inverted can dangerously increase blood pressure and bleeding into the retina.

Anyone with chronic back pain should be medically evaluated before starting any exercise program. If, assuming you get the go-ahead, you want to try gentle self-traction, it is easy to do—at home or even in the office, whether lying down on the floor, sitting, standing between two chairs, or leaning on a table or counter. This PDF provides a guide as to how to do self-traction.

Also see What to Do About Low Back Pain.