From Michelle Cameron MD: Clinical modalities; lumbar mechanical traction

Cameron’s book on physical agents for rehabilitation echo’s many of the tried & true clinical suggestions that I and others in the ‘decompression industry’ also recommend.  

“Optimal patient positioning: try to achieve a comfortable position allowing and muscle tension to relax, allowing separation of the vertebra. The relative degree of flexion or extension can determine which surfaces are most effectively separated. The flexion position can result in greater posterior separation, the extended in more anterior and the neutral in a centralized effect. Unilateral symptoms can be addressed with the force being offset more to one side”.

“For most application prone or supine is chosen. Though supine may be more common Prone positioning is most advantageous if flexion is a problem OR if the symptoms are helped or reduced by extension. Greater lumbar paraspinal muscle relaxation and less EMG activity have been reported with the Prone posture vs. supine. Clinically, symptoms of discal origin are also most reduced in the prone position”.

“The split-table reduces the amount of traction force lost to ’friction’. Initially the table should remain locked so it doesn’t move as the patient moves into ideal ‘treatment-position’. The sections should then be slowly unlocked to control the speed at which the subsequent force is applied”.