What traction is
Traction is a controlled pulling force applied to the spine. It can be applied in different ways:
Manual traction
A physical therapist applies a gentle pulling force by hand. The therapist controls the direction, intensity, and duration based on how you respond during the session.
Mechanical traction
A table or device applies the pulling force. Settings such as force, angle, and timing can be adjusted. Mechanical traction can be steady (continuous) or intermittent (cycling between pull and rest). It can be used for lumbar (low back) or cervical (neck) traction.
Traction is intended to create a gentle stretch and unloading of the spine in a controlled position. It is selected based on evaluation findings and used as part of a broader physical therapy plan.
What people mean by “spinal decompression”
“Spinal decompression” usually refers to table-based traction with adjustable force, angle, and cycling. The table applies a controlled pulling force that can be progressed or adjusted based on response.
The term “decompression” is often used in marketing to describe this type of table-based traction. In practice, spinal decompression is a form of mechanical traction. The terms are sometimes used interchangeably, and there is no universal definition that separates them.
At PT 1st, table-based traction (whether called traction or decompression) is used as one part of a physical therapy plan that includes evaluation, exercise, and education. It is not a standalone treatment.
How they compare
This table compares manual traction, mechanical traction, and table-based decompression in descriptive terms. These are not effectiveness claims.
| Approach | How force is applied | Adjustability | Typical setting |
|---|---|---|---|
| Manual traction | By hand | Adjusted in real time by the therapist | During a treatment session |
| Mechanical traction | By a table or device | Settings can be changed between sessions | During a treatment session |
| Table-based decompression | By a table with adjustable force, angle, and cycling | Highly adjustable; settings can be progressed over multiple visits | During a treatment session |
Which one is right for me?
Whether traction or decompression is appropriate for you depends on your evaluation and screening. Your physical therapist will assess your movement, symptoms, and functional needs and check for reasons traction may not be appropriate.
Traction or decompression is not right for everyone. For more on who may not be a candidate, see the spinal decompression service page.
If you have questions about whether traction or decompression therapy may be appropriate for your situation, call the clinic or discuss it with your physician.
Why exercise still matters
Traction or decompression sessions are paired with therapeutic exercise because building strength and movement control supports what you do outside the clinic. Exercise is selected based on your evaluation and progressed as your care continues.
A plan that includes traction or decompression at PT 1st also includes movement-based care, not just table time.
For more on exercise-based care, see: Therapeutic exercise.