Acute neck pain is a relatively common disorder. Neck pain may be a result of, but is not limited to: sprains or strains of cervical tissues, poor posture, cervical spondylosis (degeneration of the spinal column), or cervical disc herniations with radiculopathy (pain, numbness, or weakness radiating from the spine). The pain is typically self-limiting and usually resolves spontaneously after a period of rest without sequelae. Some individuals may experience persistent pain that can be associated with numbness, tingling, muscle weakness, and loss of reflexes. Treatment for such pain may be medical or surgical and usually depends on the source of the pain.
Nonsurgical treatments aimed at relieving pain and restoring motion can include education on how to improve posture and ergonomics, oral medications, soft cervical collars, physical therapy, and cervical traction. Cervical traction is commonly performed to relieve muscle spasms in the neck and shoulders, and to relieve the pain of pinched nerves in the neck. It can be administered by various techniques ranging from supine mechanical motorized or pneumatic traction, to seated traction using over-the-door pulleys with attached weights. Cervical traction equipment is used for individuals with orthopedic impairments who require traction that prevents ambulation during the period of use.
A mechanical cervical traction unit is a device that is used to apply a therapeutic pulling force (static or intermittent) to the cervical spine. Aside from pulleys and weights, these units generally consist of a traction cord, spreader bar, heavy-duty pulley arm, door bracket, and head halter. In general, over-the-door traction is limited to providing less than 20 pounds of traction.
There are several pneumatic in-home cervical traction devices on the market, including the Pronex® pneumatic cervical traction device (Empi, St. Paul, MN) and the Saunders® Hometrac device (Empi, St. Paul, MN). According to the manufacturer's literature, these devices are used in the supine position and utilize individual-controlled air inflation to provide adjustable traction comparable to the forces provided by a physical therapist in the outpatient setting. The Pronex® device cradles the individual's head and neck on two cushions. One cushion supports the occiput, and the other rests against the upper trapezius. When the individual inflates the device, the bellow expands and lifts the head upward. The Saunders® Hometrac device involves resting the individual's head on a padded track. The occiput is supported by a cushion, and the forehead is held in place by a strap. When the device is pumped with air, the track expands to lift the head upward, providing up to 50 pounds of adjustable traction.
Some cervical traction devices can be used with ambulation, such as the Pneu-trac® Traction Collar (Trulife, Jackson, MI). According to the manufacturer, the collar's pressure can be inflated by the individual to fit diagnosis and tolerance. The flexible cervical collar is composed of a tubular, air-inflatable bladder that is secured to the collar. The bladder is filled with air, under pressure from a manually operated air pump, to inflate the bladder so that it presses downwardly against the shoulder region of the individual and continuously around the lower neck region. This expands the height of the collar, applying upward force around the base of the chin, and the left and right mandibular and occipital region of the individual. The collar allows a controlled and uniform amount of traction force to encircle the cervical region of the individual. The goal of the cervical collar is to control the amount of static traction around the neck while allowing the individual to be ambulatory.
Clinical Biomechanics of Posture® (CBP®), formerly known as Chiropractic Biophysics®, are techniques involving full spine and pelvis corrective and rehabilitative procedures. The focus of the correction is on the abnormal curvature of the spine. The technique uses cervical traction combined with spinal manipulation to improve the appearance of an abnormal-looking spine, while using radiograph studies to compare the spinal structure before and after the treatment. The goal of CBP is to relieve cervical pain, with the main focus on optimal posture and spinal alignment and correction.