Neck Pain and Cervical Traction: What You Need to Know

Neck pain is one of the most common musculoskeletal complaints we see at MotionPlus Osteo in Hamilton, and for good reason. Globally, neck pain affected an estimated 203 million people in 2020, and that number is projected to rise significantly by 2050 (GBD 2021 Neck Pain Collaborators, 2024). Closer to home, research suggests that between 30% and 50% of adults experience neck pain in any given year (Kazeminasab et al., 2022), and for many people it becomes a recurring or long-term issue rather than a one-off episode.

For those dealing with persistent neck pain, particularly when symptoms extend into the arm or are accompanied by pins and needles, one technique that may be considered as part of a broader management plan is cervical traction. Here's what the research currently says about it.

What Is Cervical Traction?

Cervical traction, sometimes referred to as neck traction is a non-invasive technique that applies a gentle, sustained or intermittent pull to the cervical spine (neck). It can be applied manually by a practitioner or with the assistance of a mechanical device (Abi-Aad & Derian, 2023).

The proposed mechanism is that this gentle distraction may help create space between the vertebrae, reduce pressure on intervertebral discs, and ease tension in the surrounding muscles and ligaments potentially offering a window of relief that allows someone to engage more meaningfully with their rehabilitation (Gudavalli et al., 2013; Chen et al., 2022).

Who Might Be Considered for Cervical Traction?

Cervical traction is not appropriate for everyone. In clinical practice, structured tools called Clinical Prediction Rules help guide whether a patient may be suitable for traction-based approaches. One well-cited example is the Raney et al. (2009) criteria, which identified a set of clinical signs including how pain behaves with certain neck movements, age, and specific neurological screening tests that may indicate a patient is more likely to respond to cervical traction alongside exercise.

The key point here is that cervical traction is not a one-size-fits-all approach. It forms part of an individualised assessment, not a standalone recommendation.

Cervical traction is also contraindicated in certain conditions, and a thorough clinical assessment is always essential before it is considered (Abi-Aad & Derian, 2023).

What Does the Research Say?

The evidence around cervical traction is evolving, and it's important to be honest about where the literature currently stands.

When combined with other approaches, the evidence is more encouraging. A systematic review and meta-analysis by Chen et al. (2022) found that a combined approach incorporating cervical traction alongside manual therapy showed meaningful reductions in pain and disability for people with cervical radiculopathy, a condition where nerve root irritation in the neck contributes to arm pain, altered sensation, or weakness (Kang et al., 2020). Similarly, Kuligowski et al. (2021) concluded that a multimodal approach that includes traction may be an efficient strategy for cervical radiculopathy management.

Traction alone shows more modest effects. Young et al. (2009) found that cervical traction used in isolation did not produce significantly greater outcomes compared to other interventions, reinforcing the view that it works best as one component of a broader plan rather than as a standalone approach.

Recent network meta-analyses are also pointing toward combining manual therapy approaches, including joint mobilisation and neural techniques, with structured exercise as the most effective conservative pathway for managing neck-related arm pain (Articular and Neural Mobilization Review, JOSPT, 2025).

A 2024 systematic review and meta-analysis of cervical rotation-traction manipulation found significant reductions in pain scores compared to control groups, though the quality of evidence was noted as low, highlighting the ongoing need for higher-quality research in this area (Cervical Rotation-Traction Manipulation Review, PMC, 2024).

The broader picture is one of cautious optimism: cervical traction has a role in carefully selected presentations, within a comprehensive and individualised management plan.

How We Approach Neck Pain at MotionPlus Osteo

At our Hamilton clinic, we take a structural osteopathic approach to neck pain. Rather than applying techniques in isolation, every assessment begins with understanding the full picture. How your neck is moving, what your work and lifestyle look like, whether your symptoms are local or radiating, and what your goals are.

Depending on the findings, a management plan may include:

• Hands-on manual therapy — including soft tissue work, joint mobilisation, and where indicated, cervical traction techniques

• Targeted exercise prescription — to support long-term neck resilience and reduce the likelihood of recurrence

• Clinical needling — as an adjunctive option for muscle-related tension

• Education and load management — helping you understand what's contributing to your symptoms and what you can do day-to-day

As an ACC registered provider, you don't need a GP referral to be seen and if your neck pain is the result of an accident or injury, we can lodge your ACC claim directly at the clinic.

When to Seek an Assessment

If you've been dealing with neck pain, stiffness, or symptoms that travel into your arm, shoulder, or hand particularly if they've been present for more than a few weeks or keep returning it's worth having a proper clinical assessment rather than waiting it out.

Neck pain that is left unmanaged has a tendency to become recurrent, with research suggesting that 50–85% of those who experience neck pain will report it again within one to five years (Childs et al., 2008).

References

Bot, S. D., van der Waal, J. M., Terwee, C. B., van der Windt, D. A., Scholten, R. J., Bouter, L. M., & Dekker, J. (2005). Predictors of outcome in neck and shoulder symptoms: a cohort study in general practice. Spine, 30(16), E459–E470. https://doi.org/10.1097/01.brs.0000174279.44855.02

Chen, J., Chen, R., Li, Y., Chen, M., Lv, Z., Zeng, H., & Lian, Q. (2022). Systematic Review and Meta-Analysis of the Evaluation of the Efficacy of Manipulation and Cervical Traction in the Treatment of Radical Cervical Spondylosis. Emergency medicine international, 2022, 3837995. https://doi.org/10.1155/2022/3837995

Childs, J. D., Cleland, J. A., Elliott, J. M., Teyhen, D. S., Wainner, R. S., Whitman, J. M., Sopky, B. J., Godges, J. J., Flynn, T. W., & American Physical Therapy Association (2008). Neck pain: Clinical practice guidelines linked to the International Classification of Functioning, Disability, and Health from the Orthopedic Section of the American Physical Therapy Association. The Journal of orthopaedic and sports physical therapy, 38(9), A1–A34. https://doi.org/10.2519/jospt.2008.0303

Gudavalli, M. R., Potluri, T., Carandang, G., Havey, R. M., Voronov, L. I., Cox, J. M., Rowell, R. M., Kruse, R. A., Joachim, G. C., Patwardhan, A. G., Henderson, C. N., & Goertz, C. (2013). Intradiscal Pressure Changes during Manual Cervical Distraction: A Cadaveric Study. Evidence-based complementary and alternative medicine : eCAM, 2013, 954134. https://doi.org/10.1155/2013/954134

Kang, K. C., Lee, H. S., & Lee, J. H. (2020). Cervical Radiculopathy Focus on Characteristics and Differential Diagnosis. Asian spine journal, 14(6), 921–930. https://doi.org/10.31616/asj.2020.0647

Kuligowski, T., Skrzek, A., & Cieślik, B. (2021). Manual Therapy in Cervical and Lumbar Radiculopathy: A Systematic Review of the Literature. International journal of environmental research and public health, 18(11), 6176. https://doi.org/10.3390/ijerph18116176

Raney, N. H., Petersen, E. J., Smith, T. A., Cowan, J. E., Rendeiro, D. G., Deyle, G. D., & Childs, J. D. (2009). Development of a clinical prediction rule to identify patients with neck pain likely to benefit from cervical traction and exercise. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 18(3), 382–391. https://doi.org/10.1007/s00586-008-0859-7

Swezey, R. L., Swezey, A. M., & Warner, K. (1999). Efficacy of home cervical traction therapy. American journal of physical medicine & rehabilitation, 78(1), 30–32. https://doi.org/10.1097/00002060-199901000-00008

Young, I. A., Michener, L. A., Cleland, J. A., Aguilera, A. J., & Snyder, A. R. (2009). Manual therapy, exercise, and traction for patients with cervical radiculopathy: a randomized clinical trial. Physical therapy, 89(7), 632–642. https://doi.org/10.2522/ptj.20080283