A Cochrane review [Abstract] 1 included 7 studies with a total of 958 subjects. Only one trial (n=100), comparing continuous traction to a placebo for chronic neck pain with radicular symptoms, had a low risk of bias. It found no statistically significant difference (SMD -0.16: 95%CI: -0.59 to 0.27) between the groups in reducing pain or improving function. There was low quality evidence that intermittent traction, but not continuous traction, was more effective than exercise, heat and patient education for reducing pain for individuals with neck disorders with radicular findings, degenerative changes or both (1 RCT, n=100; 25 participants in each arm). There was no statistical difference between groups when continuous traction was compared to a non-steroidal anti-inflammatory drug (Naproxen 250 mg) for pain reduction (SMD: -0.26: 95% CI: -0.54 to 0.01; 1 RCT, n=218). There was no statistical difference between groups when intermittent traction was compared to manual therapy for neck disorders with radicular symptoms, headache or both (RR: 0.33: 95% CI: 0.08 to 1.32; 1 RCT, n=50). In one large RCT (n=536) continuous traction was inferior to acupuncture for those with neck disorders with or without radicular symptoms (RR: 4.31: 95% CI: 2.93 to 6.34).
Comment: The quality of evidence is downgraded by limitations in study quality (blinding, concealment of allocation and methods of randomization), by imprecise results (limited study size for each comparison) and by inconsistency (heterogeneity in interventions and outcomes).
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