In mechanical traction for low back pain, the patient is initially placed in which position to promote centralization of symptoms?

• A. Supine
• B. Prone
• C. Side-lying
• D. Seated

Answer: (B)

Centralization of symptoms with traction relies on positioning that helps unload the nerve roots and move the irritant material away from the nerve pathways. Placing the patient in a prone position puts the lumbar spine in extension, which, when traction is applied along the spine, tends to decompress the posterior aspect of the spinal canal and open the central canal space. This setup supports pulling apart the vertebrae and can help retract disc material away from the nerve roots, making pain locate more toward the spine rather than radiating down the leg. Starting in this prone, extended position thus offers the best chance for centralization to occur. Supine (more flexion), side-lying, or seated positions are used in other contexts or for patient comfort, but they’re not as effective first-line for promoting centralization with lumbar traction.