Intermittent Cervical Traction for Treating Neck Pain: A Meta-analysis of Randomized Controlled Trials

Spine (Phila Pa 1976). 2017 Jul 1;42(13):959-965. doi: 10.1097/BRS.0000000000001948.


Study design: A meta-analysis.

Objective: The aim of this study was to perform a comprehensive search of current literature and conduct a meta-analysis of randomized controlled trials (RCTs) to assess the neck pain relieving effect of intermittent cervical traction (ICT).

Summary of background data: Neck pain is a common and disabling problem with a high prevalence in general population. It causes a considerable burden on the health care system with a substantial expenditure. ICT is a common component of physical therapy for neck pain in the outpatient clinic. However, the evidence regarding the effectiveness of ICT for neck pain is insufficient.

Methods: Data were obtained from the PubMed, Cochrane Library, Embase, and Scopus databases from the database inception date to July 02, 2016. RCTs reporting the effects of ICT on neck pain, including those comparing the effects of ICT with those of a placebo treatment, were included. Two reviewers independently reviewed the studies, conducted a risk of bias assessment, and extracted data. The data were pooled in a meta-analysis by using a random-effects model.

Results: The meta-analysis included seven RCTs. The results indicated that patients who received ICT for neck pain had significantly lower pain scores than those receiving placebos did immediately after treatment (standardized mean difference = -0.26, 95% confidence interval = -0.46 to -0.07). The pain scores during the follow-up period and the neck disability index scores immediately after treatment and during the follow-up period did not differ significantly.

Conclusion: ICT may have a short-term neck pain-relieving effect. Some risks of bias were noted in the included studies, reducing the evidence level of this meta-analysis. Additional high-quality RCTs are required to clarify the long-term effects of ICT on neck pain.

Level of evidence: 1.

Publication types

  • Meta-Analysis

MeSH terms

  • Cervical Vertebrae*
  • Humans
  • Neck Pain / diagnosis
  • Neck Pain / epidemiology
  • Neck Pain / therapy*
  • Pain Measurement / methods*
  • Randomized Controlled Trials as Topic / methods*
  • Traction / methods*