Years ago I had traction therapy for a bad back. It really seemed to help. But the last two places I went didn't have traction at all. Isn't this treatment used any more?

Traction is still in use but on a more limited scale now. This is for a couple of reasons. First, there isn't a lot of evidence to really support its use. Studies are limited but what's out there fails to support traction as an effective treatment for low back pain (LBP).

At the same time, doctors, therapists, and chiropractors have newer techniques and technology to treat LBP. Traction may have fallen by the wayside in light of these other more hands-on treatment approaches.

Traction units are also large and take up considerable space in a clinic while only serving a small number of patients. Some therapists find that using manual traction (with their own hands) works as well (if not better) than strapping someone to a machine for 30 minutes.

There is a newer traction system out now called the VAX-D. It has a no-slip surface that eliminates some of the harnessing used in conventional traction. A pelvic harness is used but the upper body is not tied down. Instead, the patient uses a special handgrip to keep the upper body stabilized.

Early reports on the use of this system are favorable. Pain and disability were decreased in a group of 250 low back pain patients. All subjects in the study had degenerative disc disease or a herniated disc. At least two other forms of conservative care had already been tried (before traction) without success.

More study is needed to support the use of VAX-D before you'll see it in more clinics.