Impact of traction therapy on bone in women with chronic back pain

Nearly 10% of the world’s population suffer from lower back pain (LBP) (1, 2). Lumbar traction therapy is a non-invasive treatment for LBP that involves gently stretching the spine to relieve pressure on the vertebral discs and nerves (3). In a first-time study, researchers investigated the influence of long-term application of traction forces on the size of vertebrae, bone mineral density (BMD), and bone turnover markers in women LBP (4).

Impact of traction therapy on bone in women with chronic back pain

The BIOMEDICA free soluble RANKL (sRANKL) ELISA assay and bioactive Sclerostin ELISA assay were utilized in the study to quantify soluble RANKL and bioactive Sclerostin levels in human serum.

Soluble RANKL HS ELISA assay kit (cat. no. BI-20462)

• Highly sensitive – measurable concentrations in healthy individuals
• Only ELISA that measures free, uncomplexed soluble RANKL
• Widely cited in more than 325 publications

 

Bioactive SCLEROSTIN ELISA assay kit (cat.no. BI-20472) 

• Reliable – validated according to international guidelines
• Specific – high quality antibodies targeting the receptor binding region
• Low sample volume – 20 µl of serum/plasma per well 
• Citations

 

Bone remodelling after application of traction forces to the lumbar spine in women with chronic low back pain. Ratajczak M, Kusy K, Skrypnik D, Waszak M, Krutki P. Bone Joint Res. 2025 Aug 4;14(8):674-684. doi: 10.1302/2046-3758.148.BJR-2024-0465.R1. PMID: 40754314; PMCID: PMC12318618.

Abstract

Aims: The aim of the study was to investigate the effect of systematic lumbar traction, applied in 20 sessions over four weeks, on the size of vertebrae, bone mineral density (BMD), and bone turnover markers in women with chronic low back pain (LBP).

Methods: A total of 30 women with low back pain underwent 20 sessions of lumbar traction with a load of 25% to 30% of their body weight. Total body and lumbar spine BMD was measured using dual-energy X-ray absorptiometry, and bone turnover markers were determined using enzyme-linked immunosorbent assay (ELISA) with serum samples collected before the first traction session and 72 hours after the last traction session.

Results: After traction, decreased BMD and T-scores, a decreased mean vertebra width, and an increased mean height of L1-L4 segments were observed. The concentration of cross-linked C-telopeptide of type I collagen (CTXI) increased, while the concentration of receptor activator for nuclear factor κ B ligand (RANKL) decreased significantly after four weeks of traction. Sclerostin and procollagen 1 N-terminal propeptide (P1NP) concentrations remained unchanged.

Conclusion: Our study is the first to show the influence of traction forces on BMD and markers of bone metabolism. Future research with a longer follow-up period after traction is needed to better explore the direction of change.

 

Literature

1. The global epidemic of low back pain. Lancet Rheumatol. 2023 Jun;5(6):e305. doi: 10.1016/S2665-9913(23)00133-9. PMID: 38251593.
2. Low back pain, WHO, 2023.
3. What Is Traction Therapy, and How Does it Work? ERA Health.
4. Bone remodelling after application of traction forces to the lumbar spine in women with chronic low back pain. Ratajczak M, Kusy K, Skrypnik D, Waszak M, Krutki P. Bone Joint Res. 2025 Aug 4;14(8):674-684. doi: 10.1302/2046-3758.148.BJR-2024-0465.R1. PMID: 40754314; PMCID: PMC12318