DTS TRACTION TABLE
OPERATING PROCEDURE
1. Introduction
The DTS Traction Table is a motorized spinal traction system designed to deliver controlled, reproducible, and graded traction forces to the cervical or lumbar spine. It is used in physiotherapy to reduce pain, relieve nerve root compression, decrease muscle spasm, and improve spinal mobility in selected musculoskeletal and radicular conditions. Modern DTS systems allow precise control of force, hold–rest cycles, treatment duration, and patient positioning, thereby improving safety and comfort compared with manual traction.
Traction is adjunctive and should be integrated into a comprehensive program including education, exercise, manual therapy, and activity modification.
2. Therapeutic Rationale and Biomechanical Basis
2.1 Spinal Decompression Mechanics
Traction applies a longitudinal force that:
- Increases intervertebral space
- Reduces intradiscal pressure
- Relieves foraminal narrowing
- Reduces facet joint compression
- Stretches paraspinal soft tissues
2.2 Neurophysiological Effects
- Decreased nerve root mechanosensitivity
- Reduction of muscle guarding via reflex inhibition
- Pain modulation through mechanoreceptor stimulation
Conceptual Graph: Traction Force vs Disc Pressure
Intradiscal Pressure
│ █████████ No traction
│ ███████
│ █████
│███
│█ Adequate traction
└──────────────────────── Traction Force
3. Therapeutic Objectives
- Reduction of radicular and axial pain
- Decompression of nerve roots
- Decrease muscle spasm and guarding
- Improve spinal mobility and tolerance to movement
- Facilitate participation in active rehabilitation
4. Indications
| Region | Indications |
|---|---|
| Cervical spine | Cervical radiculopathy, disc herniation, foraminal stenosis |
| Lumbar spine | Lumbar radiculopathy, disc bulge, facet compression |
| Degenerative | Spondylosis with neural symptoms (selected cases) |
| Muscle spasm | Paraspinal spasm refractory to other measures |
Patient selection is critical; traction is not universally beneficial.
5. Contraindications and Precautions
Absolute Contraindications
- Spinal instability or fracture
- Malignancy of the spine
- Acute inflammatory spine disorders
- Severe osteoporosis
- Recent spinal surgery (unless cleared)
- Progressive neurological deficit
- Cauda equina syndrome
Relative Contraindications / Precautions
- Pregnancy (lumbar traction)
- Severe anxiety or claustrophobia
- TMJ disorders (cervical traction)
- Cardiovascular instability
- Elderly patients (dose conservatively)
6. Equipment Components
| Component | Function |
|---|---|
| Motorized traction unit | Delivers calibrated force |
| Table with split sections | Reduces friction |
| Pelvic/chest harness | Force transmission |
| Cervical head halter (if applicable) | Cervical traction |
| Control console | Force, time, cycle control |
| Emergency stop | Immediate release |
7. Pre-Procedure Assessment and Preparation
Patient Assessment
- Confirm diagnosis and indications
- Screen for red flags
- Assess symptom behavior (centralization/peripheralization)
- Baseline pain and neurological status
Patient Preparation
- Explain goals, sensations, and stop signals
- Obtain informed consent
- Remove belts/objects
- Position comfortably
Equipment Preparation
- Inspect harnesses and cables
- Calibrate force settings
- Verify emergency stop function
8. Patient Positioning
Lumbar Traction
- Supine (preferred) or prone (selected cases)
- Hips flexed 60–90° (reduces lordosis)
- Pelvic harness snug; chest harness stabilizing
Cervical Traction
- Supine with slight neck flexion (15–25°)
- Head halter aligned; avoid jaw pressure
- Trunk stabilized
9. Traction Modes
| Mode | Description | Clinical Use |
|---|---|---|
| Sustained (Static) | Constant force | Disc herniation, nerve root compression |
| Intermittent | Cyclic hold–rest | Degenerative conditions, muscle spasm |
10. Dosimetric Parameters (Critical)
Lumbar Traction
| Parameter | Typical Range |
|---|---|
| Initial force | 25–30% body weight |
| Progression | Up to 40–60% (selected cases) |
| Hold : Rest | 60:20 sec (intermittent) |
| Duration | 10–20 minutes |
Cervical Traction
| Parameter | Typical Range |
|---|---|
| Initial force | 8–12 kg (or 10–15 lbs) |
| Progression | Up to 18–25 kg (selected) |
| Hold : Rest | 30:10 sec |
| Duration | 10–15 minutes |
Conceptual Graph: Force Progression Over Sessions
Traction Force
│ █████████ Later sessions
│ ███████
│ █████
│███ Initial sessions
│█
└──────────────────────── Sessions
11. Operating Procedure (Step-by-Step)
- Position Patient correctly and apply harnesses
- Select Mode (static or intermittent)
- Set Initial Force conservatively
- Gradually Ramp Up to target force
- Monitor Symptoms continuously
- Maintain Treatment for prescribed duration
- Gradual Ramp Down before release
12. Monitoring During Traction
Monitor for:
- Symptom centralization (desired)
- Increased peripheral pain (reduce/stop)
- Dizziness, nausea, anxiety
- Harness discomfort or slippage
Stop immediately if neurological symptoms worsen.
13. Post-Treatment Care
- Assist patient off table slowly
- Reassess pain and neurological signs
- Encourage brief walking or gentle movement
- Document response and plan progression
14. Dosage and Treatment Course
| Phase | Frequency |
|---|---|
| Acute | 2–3×/week |
| Subacute | 1–2×/week |
| Trial period | 4–6 sessions |
Discontinue if no meaningful improvement after a reasonable trial.
15. Integration with Rehabilitation
Traction should be followed by:
- Directional preference exercises (e.g., McKenzie-based)
- Core stabilization
- Postural education
- Activity modification
Traction creates a window of opportunity; exercise sustains gains.
16. Advantages and Limitations
Advantages
- Controlled, reproducible force
- Reduced therapist strain
- Useful for selected radicular symptoms
Limitations
- Not effective for all back/neck pain
- Risk if improperly selected or dosed
- Passive modality—requires active follow-up
17. Safety, Hygiene, and Quality Control
- Inspect harnesses and cables routinely
- Clean contact surfaces between patients
- Maintain calibration logs
- Staff training in emergency release procedures
18. Documentation Standards
Record:
- Region treated and positioning
- Mode and force parameters
- Duration and cycles
- Symptom response (pre/post)
- Adverse events (if any)
19. Clinical Pearls
- Start low; progress based on symptom response
- Centralization is a positive sign
- Supine lumbar traction is generally better tolerated
- Avoid prolonged courses without reassessment
- Always pair traction with active rehabilitation
Conclusion
The DTS Traction Table is a valuable adjunctive intervention for carefully selected patients with spinal pain and radicular symptoms. When applied with precise dosing, vigilant monitoring, and integration into an active rehabilitation strategy, traction can reduce symptoms and facilitate functional recovery.
References
- Krause M, et al. Lumbar traction: a review of randomized trials. Phys Ther.
- Fritz JM, et al. Traction for low back pain with radiculopathy. Spine.
- Cameron MH. Physical Agents in Rehabilitation.
- Magee DJ. Orthopedic Physical Assessment.
- Kisner C, Colby L, Borstad J. Therapeutic Exercise: Foundations and Techniques.