Lumbar traction is commonly used to treat patients with back pain. Typ
ically, clinicians rely on expert opinion in making decisions about wh
en and how to implement lumbar traction. The purpose of this paper was
to review current knowledge of lumbar traction and to identify what,
if any, empirical evidence supports the expert opinions. This review f
ound that whereas the mechanical effects of lumbar traction are well s
ubstantiated, the results of studies examining clinical effectiveness
are conflicting. The failure to conclusively demonstrate the clinical
benefit of lumbar traction may be related to the varied diagnostic cat
egories and treatment techniques employed in the studies. Of the 10 ty
pes of lumbar traction described in the literature, static and intermi
ttent mechanical traction are the two most commonly used. Indications,
contraindications, and treatment techniques for these two types of tr
action are discussed. Based on the findings of this review, further st
udy is needed to determine optimal treatment duration, frequency, and
mode of administering lumbar traction. Also, classification systems to
identify patients most likely to benefit from traction need to be dev
eloped and validated.