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No evidence about neck traction for neck pain

PainSci » bibliography » Graham et al 2006
Tags: neck, traction, treatment, head/neck, spine

Two articles on PainSci cite Graham 2006: 1. Does Massage Therapy Work?2. The Complete Guide to Neck Pain & Cricks

PainSci commentary on Graham 2006: ?This page is one of thousands in the bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.

Historically, straightforward tests of traction like those done by Zylbergold in 1985 and Borman in 2008 have had conflicting results, leaving clinicians (as usual) not really sure what works and what doesn’t. This review confirms the poor state of the science, concluding not only that “inconclusive evidence for continuous and intermittent traction exists,” but also that the lack of evidence is due to poor “trial methodological quality.” •sigh•

~ Paul Ingraham

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

OBJECTIVE: To assess whether mechanical traction, either alone or in combination with other treatments, improves pain, function/disability, patient satisfaction and global perceived effect in adults with mechanical neck disorders.

METHODS: We conducted a systematic review up to September 2004 of randomized controlled trials and used pre-defined levels of evidence for qualitative analysis. Two independent reviewers conducted study selection, data abstraction and methodological quality assessment. Using a random effects model, relative risk and standardized mean differences were calculated. The reasonableness of combining studies was assessed on clinical and statistical grounds. In the absence of heterogeneity, pooled effect measures were calculated.

RESULTS: Of the 10 selected trials, one study was of high quality. Our review revealed low-quality trials for mechanical neck disorders, showing evidence of benefit favouring intermittent traction for pain reduction. Continuous traction showed no significant difference for defined outcomes.

CONCLUSION: Inconclusive evidence for continuous and intermittent traction exists due to trial methodological quality. Two clinical conclusions may be drawn, one favouring the use of intermittent traction and the other not supporting the use of continuous traction. Attention to research design flaws and description of traction characteristics is needed.

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