Mechanical Traction for Lumbar Radicular Pain: Supine or Prone? A Randomized Controlled Trial

The aim of the study was to compare the effects of mechanical lumbar traction either in the supine or in the prone position with conventional physical therapy (PT) in patients with chronic low back pain and lumbosacral nerve root involvement in terms of disability, pain, and mobility.

Participants (N = 125) were randomly assigned to receive 15 sessions of PT with additional mechanical lumbar traction either in the supine position (supine traction group) or in the prone position (prone traction group) or only PT without traction (PT only group). Patients were assessed at baseline and at the end of the PT sessions in terms of disability, pain, and mobility. Disability was assessed using the modified Oswesty Disability Index; pain was assessed using a visual analog scale, and lumbar mobility was assessed using the modified lumbar Schober test.

One hundred eighteen patients completed the trial. All groups improved significantly in the Oswesty Disability Index, visual analog scale, and modified lumbar Schober test (P < 0.05). In the between-group analysis, improvements of Oswesty Disability Index and visual analog scale were found significantly better in the prone traction group compared with the PT only group (adjusted P = 0.031 and 0.006, respectively).

Addition of traction in the prone position to other modalities resulted in larger immediate improvements in terms of pain and disability, and the results suggest that when using traction, prone traction might be first choice. Further research is needed to confirm the benefits of lumbar traction in the prone position.