BlueCross BlueShield of Tennessee Medical Policy Manual

Cervical Traction Devices for Home Use


Cervical traction is noninvasive traction, used to stretch the soft tissues of the neck and to separate the spinal joint structures in order to relieve neck pain.

A variety of cervical traction devices are available for use in the home:





Traction devices are classified as Class I devices by the U.S. Food and Drug Administration (FDA). 510(k) clearance is not required, although registration with FDA is required. The FDA has described orthopedic devices as follows: “A non-powered orthopedic traction apparatus is a device that consists of a rigid frame with non-powered traction accessories, such as cords, pulleys, or weights, and that is intended to apply a therapeutic pulling force to the skeletal system.”

According to Centers for Medicare & Medicaid Services (CMS), the 2009 Local Coverage for Determination (LCD) for CIGNA Government Services, states that “Cervical traction applied via attachment to a headboard or a free-standing frame has no proven clinical advantage compared to cervical traction applied via an over-the-door mechanism.”

Randomized controlled studies continue to be deficient, and the poor quality of published articles also provide little evidence of the efficacy for the use of ambulatory cervical traction, inflatable cervical traction collars, or pneumatic cervical traction devices. In addition, there is a lack of documentation in published articles for specific duration and frequency of these devices that would aid in net health outcomes. Therefore, these devices are considered investigational.


American Association of Neurological Surgeons. (March, 2013). Treatment of subaxial cervical spinal injuries. In: Guidelines for the management of acute cervical spine and spinal cord injuries. Retrieved August 30, 2016 from

Borman, P., Keskin, D., Ekici, B., & Bodur, H. (2008). The efficacy of intermittent cervical traction in patients with chronic neck pain. Clinical Rheumatology, 27 (10), 1249-1253. (Level 3 evidence - Independent study)

Cai, C., Ming, G., and Ng, L. (2010). Development of a clinical prediction rule to identify patients with neck pain who are likely to benefit from home-based mechanical cervical traction. European Spine Journal, 2011 (20), 912-922. (Level 4 evidence - Independent study)

Center for Medicare and Medicaid Services. LCD for Cervical traction devices (L33823). Retrieved August 29, 2016 from

Colorado Division of Workers’ Compensation. (February, 2014). Cervical spine injury medical treatment guidelines. Retrieved August 30, 2016 from

Graham, N., Gross, A. R., Goldsmith, C., & the Cervical Overview Group. (2006). Mechanical traction for mechanical neck disorders: A systematic review. Journal of Rehabilitation Medicine, 38 (3), 145-152. (Level 1 evidence - Independent study)

Kang, J. H., & Park, T. S. (2015). Changes in cervical muscle activity according to the traction force of an air-inflatable neck traction device. Journal of Physical Therapy Science, 27 (9), 2723-2725. (Level 4 evidence – Independent study)

Misfud, M., Abela, M., & Wilson, N. I. (2016). The delayed presentation of atlantoaxial rotatory fixation in children: a review of the management. The Bone & Joint Journal, 98-B (5), 715-720. Retrieved abstract August 29, 2016 from PubMed database.

North American Spine Society. (2010). Diagnosis and treatment of cervical radiculopathy from degenerative disorders. Retrieved November 8, 2012 from

Polston, D. W. (2007). Cervical radiculopathy. Neurologic Clinics, 25 (2), 373-385.

Raney, N. H., Petersen, E. J., Smith, T. A., Cowan, J. E., Rendeiro, D. G., Deyle, G. D., et al. (2009). Development of a clinical prediction rule to identify patients with neck pain likely to benefit from cervical traction and exercise. European Spine Journal, 18 (3), 382-391.

U. S. Food and Drug Administration. (2010, April). Center for Devices and Radiological Health. Code of Federal Regulations. Title 21, Volume 8. Section 888.5850. Nonpowered orthopedic traction apparatus and accessories. Retrieved January 25, 2011 from

U. S. Food and Drug Administration. (2011). Center for Devices and Radiological Health. Establishment registration & device listing. 1721293. Retrieved December 30, 2010 from

Washington State of Labor and Industries. (2002, August). Technology Assessment. Pronex and HomeTrac cervical traction. Retrieved December 30, 2010 from

Young, I. A., Michener, L. A., Cleland, J. A., Aguilera, A. J., & A. R. Snyder. (2009). Manual therapy, exercise, and traction for patients with cervical radiculopathy: A randomized clinical trial. Physical Therapy, 89 (7), 632-642. (Level 2 evidence - Industry sponsored)




Policies included in the Medical Policy Manual are not intended to certify coverage availability. They are medical determinations about a particular technology, service, drug, etc. While a policy or technology may be medically necessary, it could be excluded in a member's benefit plan. Please check with the appropriate claims department to determine if the service in question is a covered service under a particular benefit plan. Use of the Medical Policy Manual is not intended to replace independent medical judgment for treatment of individuals. The content on this Web site is not intended to be a substitute for professional medical advice in any way. Always seek the advice of your physician or other qualified health care provider if you have questions regarding a medical condition or treatment.

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