Mechanical traction for lumbar radicular pain: Supine or prone?

Mechanical lumbar traction is one of the methods used to treat low back pain (LBP). Although therapists prefer the supine position, the patient may also be positioned prone during traction treatment. No studies have compared the effects of lumbar traction in these two different positions for patients with chronic LBP. Therefore, in this study, the author revealed that addition of traction in the prone position resulted in more significant improvements regarding pain and disability.

To compare the mechanical lumbar traction impacts either in the prone or supine position with conventional physical therapy (PT) among patients with chronic low back pain (LBP) and lumbosacral nerve root involvement concerning pain, mobility and disability.

A total of 125 participants were categorized to obtain 15 sessions of PT  with additional mechanical lumbar traction either in the prone or supine position or only PT without traction. The patients were assessed for pain, mobility and disability at baseline and the end of PT sessions using visual analogue scale (VAS), modified lumbar Schober test (mLST), and modified Oswestry Disability Index (ODI), respectively.

Out of 125 patients, 118 completed the analysis. A significant improvement was seen in the VAS,  mLST, and ODI all groups. During the between-group analysis, the prone traction group exhibited considerable better VAS and ODI scores than the PT only group.

Larger immediate improvements were noticed in disability and pain scores after the introduction of traction in the prone position to other approaches. As per the results, with traction the prone traction considered as the first-choice treatment to treat low back pain. Additional analysis is required to validate the lumbar traction benefits in the prone position.