Do not use mechanical or manual traction, as single treatment or in combination with other treatments, in patients with low back pain, in presence or absence of radicular pain.

Type of practice

Other treatments

Topic Area

Physical Therapy

Some systematic reviews and international guidelines show that tractions have no or minimal impact on pain intensity, functionality, overall improvement and return to work in patients with low back pain, in presence or absence of radicular pain. Minimal positive effects, clinically not relevant, have been demonstrated in some studies with reduced samples and high risk of bias. On the contrary, over 20% of the studies considered reported negative effects of traction, such as increased pain, worsening of neurological signs and consequent surgical treatment. On the basis on these evidences, the use of this therapeutic approach is therefore not recommended.


1. Chou R, Huffman LH. Nonpharmacologic Therapies for Acute and Chronic Low Back Pain: A Review of the Evidence for an American Pain Society/American College of Physicians Clinical Practice Guideline. Ann Intern Med. 2007; 147: 492-504.
2. Delitto A, George SZ, Van Dillen LR, Whitman JM, Sowa G, Shekelle P, Denninger TR, Godges JJ; Orthopaedic Section of the American Physical Therapy Association. Low back pain. J Orthop Sports Phys Ther. 2012 Apr; 42(4): A1-57
3. Wegner I1, Widyahening IS, van Tulder MW, Blomberg SE, de Vet HC, Brønfort G, Bouter LM, van der Heijden GJ. Traction for low-back pain with or without sciatica. Cochrane Database Syst Rev. 2013 Aug 19;8:CD003010.



Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.