Traction for low‐back pain with or without sciatica

Inge Wegner; Indah S Widyahening; Maurits W van Tulder; Stefan EI Blomberg; Henrica CW de Vet; Gert Brønfort; Lex M Bouter; Geert J van der Heijden

doi:10.1002/14651858.CD003010.pub5

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Figure 1

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

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Analysis 1.1

Comparison 1 Low‐back pain with/without radiation, traction versus placebo, sham or no treatment, Outcome 1 Pain intensity.

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Analysis 1.2

Comparison 1 Low‐back pain with/without radiation, traction versus placebo, sham or no treatment, Outcome 2 Functional status.

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Analysis 1.3

Comparison 1 Low‐back pain with/without radiation, traction versus placebo, sham or no treatment, Outcome 3 Global improvement.

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Analysis 1.4

Comparison 1 Low‐back pain with/without radiation, traction versus placebo, sham or no treatment, Outcome 4 Return to work (days).

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Analysis 2.1

Comparison 2 Low‐back pain with/without radiation, physiotherapy with traction versus physiotherapy without traction, Outcome 1 Pain intensity.

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Analysis 2.2

Comparison 2 Low‐back pain with/without radiation, physiotherapy with traction versus physiotherapy without traction, Outcome 2 Functional status.

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Analysis 2.3

Comparison 2 Low‐back pain with/without radiation, physiotherapy with traction versus physiotherapy without traction, Outcome 3 Global improvement.

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Analysis 3.1

Comparison 3 Low‐back pain with/without radiation, two types of traction, Outcome 1 Global improvement.

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Analysis 4.1

Comparison 4 Low‐back pain with/without radiation, traction versus other treatment, Outcome 1 Pain intensity.

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Analysis 4.2

Comparison 4 Low‐back pain with/without radiation, traction versus other treatment, Outcome 2 Functional status.

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Analysis 4.3

Comparison 4 Low‐back pain with/without radiation, traction versus other treatment, Outcome 3 Global improvement.

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Analysis 5.1

Comparison 5 Low‐back pain with radiation, traction versus placebo, sham or no treatment, Outcome 1 Pain intensity.

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Analysis 5.2

Comparison 5 Low‐back pain with radiation, traction versus placebo, sham or no treatment, Outcome 2 Global improvement.

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Analysis 5.3

Comparison 5 Low‐back pain with radiation, traction versus placebo, sham or no treatment, Outcome 3 Return to work.

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Analysis 6.1

Comparison 6 Low‐back with radiation, physiotherapy with traction versus physiotherapy without traction, Outcome 1 Pain intensity.

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Analysis 6.2

Comparison 6 Low‐back with radiation, physiotherapy with traction versus physiotherapy without traction, Outcome 2 Functional status.

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Analysis 6.3

Comparison 6 Low‐back with radiation, physiotherapy with traction versus physiotherapy without traction, Outcome 3 Global improvement.

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Analysis 6.4

Comparison 6 Low‐back with radiation, physiotherapy with traction versus physiotherapy without traction, Outcome 4 Return to work.

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Analysis 7.1

Comparison 7 Low‐back pain with radiation, traction versus other treatment, Outcome 1 Pain intensity.

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Analysis 7.2

Comparison 7 Low‐back pain with radiation, traction versus other treatment, Outcome 2 Functional status.

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Analysis 7.3

Comparison 7 Low‐back pain with radiation, traction versus other treatment, Outcome 3 Global improvement.

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Analysis 8.1

Comparison 8 Low‐back pain with radiation, two types of traction, Outcome 1 Pain intensity.

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Analysis 8.2

Comparison 8 Low‐back pain with radiation, two types of traction, Outcome 2 Global improvement.

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Analysis 9.1

Comparison 9 Low‐back pain without radiation, traction versus sham, Outcome 1 Pain intensity.

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Summary of findings for the main comparison. Traction compared with placebo, sham or no treatment for people with low‐back pain with and without sciatica

Traction compared with placebo, sham or no treatment for people with low‐back pain with and without sciatica
Patient or population: people with low‐back pain with and without sciatica Settings: diverse Intervention: traction Comparison: placebo, sham or no treatment
Outcomes	Effects	No of Participants (studies)	Quality of the evidence (GRADE)
Pain intensity VAS (0‐100 mm). Follow‐up 12‐16 weeks.	1 trial showed that there was no difference in pain intensity between the 2 groups (MD ‐4, 95% CI ‐17.7 to 9.7).	60 (1)	⊕⊕⊕⊝ moderate Imprecision (< 400 participants)
Functional status Oswestry Disability Index or Roland Morris Disability Questionnaire. Follow‐up 12‐16 weeks.	Not measured.
Global improvement Follow‐up 12‐16 weeks.	1 trial showed that there was no difference in global improvement between the 2 groups (RD 0.06, 95% CI ‐0.16 to 0.28).	81 (1)	⊕⊕⊕⊝ moderate Imprecision (< 300 participants)
Return to work Follow‐up 12‐16 weeks.	Not measured.
Adverse effects	1 trial reported aggravation of neurological signs in 28% of the traction group, 20% of the light traction group and 20% of the placebo group.
CI: confidence interval; MD: mean difference; RD: risk difference; VAS: visual analogue scale.
GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate.
Note. Each 'Summary of findings' table presents evidence for a specific comparison and a set of prespecified outcomes. Therefore, the information presented in the tables is limited by the comparisons and outcomes reported in the included studies.

Summary of findings for the main comparison. Traction compared with placebo, sham or no treatment for people with low‐back pain with and without sciatica

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Summary of findings 2. Physiotherapy with traction compared with physiotherapy without traction for people with low‐back pain with and without sciatica

Physiotherapy with traction compared with physiotherapy without traction for people with low‐back pain with and without sciatica
Patient or population: people with low‐back pain with and without sciatica Settings: physical medicine and rehabilitation outpatient clinic of a larger hospital Intervention: physiotherapy with traction Comparison: physiotherapy without traction
Outcomes	Effects	No of Participants (studies)	Quality of the evidence (GRADE)
Pain intensity VAS (0‐100 mm). Follow‐up 12‐16 weeks.	1 trial showed that there was no difference in pain intensity between the 2 groups (MD 5, 95% CI ‐5.7 to 15.7) in favour of the control group.	39 (1)	⊕⊕⊝⊝ low Study design (high risk of bias) Imprecision (< 400 participants)
Functional status Oswestry Disability Index or Roland Morris Disability Questionnaire. Follow‐up 12‐16 weeks.	2 trials showed that there was no difference in functional status between the 2 groups (SMD from 0.36 (95% CI ‐0.27 to 1.00) to 0.43 (95% CI ‐0.30 to 1.16)).	69 (2)	⊕⊕⊝⊝ low Study design (high risk of bias) Imprecision (< 400 participants)
Global improvement Follow‐up 12‐16 weeks.	1 trial showed no difference in global improvement, another trial did show a clinically significant difference in global improvement (RD 0.53, 95% CI 0.28 to 0.79).	220 (2)	⊕⊕⊝⊝ low Study design (high risk of bias) Imprecision (< 300 participants)
Return to work Follow‐up 12‐16 weeks.	Not measured.
Adverse effects	1 study reported that 25% of the physiotherapy with traction group and 37% of the physiotherapy without traction group felt worse at 3 months' follow‐up.
CI: confidence interval; MD: mean difference; RD: risk difference.
GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate.

Summary of findings 2. Physiotherapy with traction compared with physiotherapy without traction for people with low‐back pain with and without sciatica

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Summary of findings 3. Traction compared with another type of traction for people with low‐back pain with and without sciatica

Traction compared with another type of traction for people with low‐back pain with and without sciatica
Patient or population: people with low‐back pain with and without sciatica Settings: diverse Intervention: traction Comparison: another type of traction
Outcomes	Effects	No of Participants (studies)	Quality of the evidence (GRADE)
Pain intensity VAS (0‐100 mm). Follow‐up 12‐16 weeks.	Not measured.
Functional status Oswestry Disability Index or Roland Morris Disability Questionnaire. Follow‐up 12‐16 weeks.	Not measured.
Global improvement Follow‐up 12‐16 weeks.	Not measured.
Return to work Follow‐up 12‐16 weeks.	Not measured.
Adverse effects	1 trial reported increased pain in 31% of the static traction group and 15% of the intermittent traction group.
VAS: visual analogue scale.
GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate.

Summary of findings 3. Traction compared with another type of traction for people with low‐back pain with and without sciatica

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Summary of findings 4. Traction compared with any other treatment for people with low‐back pain with and without sciatica

Traction compared with any other treatment for people with low‐back pain with and without sciatica
Patient or population: people with low‐back pain with and without sciatica Settings: diverse Intervention: traction Comparison: other treatment
Outcomes	Effects	No of participants (studies)	Quality of the evidence (GRADE)
Pain intensity VAS (0‐100 mm). Follow‐up 12‐16 weeks.	3 trials, of which 1 compared traction with 2 other types of treatment, showed no difference greater than 5 points on the VAS scale between the 2 groups (MD ‐2.90 (95% CI ‐8.53 to 2.93) to 4.50 (95% CI ‐0.45 to 9.45).	304 (3)	⊕⊕⊕⊝ moderate Imprecision (< 400 participants)
Functional status Oswestry Disability Index or Roland Morris Disability Questionnaire. Follow‐up 12‐16 weeks.	3 trials, of which 1 compared traction to 2 other types of treatment and used 2 types of questionnaires to assess functional status, showed no difference between the 2 groups (SMD ‐0.08 (95% CI ‐0.39 to 0.23) to 0.51 (95% CI ‐0.12 to 1.14)).	350 (3)	⊕⊕⊕⊝ moderate Imprecision (< 400 participants)
Global improvement Follow‐up 12‐16 weeks.	1 trial showed no difference in global improvement (RD 0.05, 95% CI ‐0.1 to 0.2).	42 (1)	⊕⊕⊝⊝ low Study design (high risk of bias) Imprecision (< 300 participants)
Return to work Follow‐up 12‐16 weeks.	Not measured.
Adverse effects	1 trial reported temporary deterioration of low‐back pain in 17% of the traction group and 15% of the exercise group.
MD: mean difference; RD: risk difference; SMD: standardized mean difference.
GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate.

Summary of findings 4. Traction compared with any other treatment for people with low‐back pain with and without sciatica

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Table 1. Clinical relevance

Author	Participants	Interventions	Outcomes	Effect size	Benefits/harms
Beurskens 1997	+	+	+	‐	‐
Bihaug 1978	+	+	+	‐	‐
Borman 2003	+	+	+	‐	‐
Coxhead 1981	+	‐	+	‐	‐
Fritz 2007	+	+	+	‐	‐
Gudavalli 2006	+	+	+	‐	‐
Güvenol 2000	+	+	+	?	‐
Harte 2007	+	+	+	‐	‐
Konrad 1992	+	?	+	‐	‐
Larsson 1980	+	+	+	‐	‐
Letchuman 1993	‐	+	+	‐	‐
Lidström 1970	+	+	+	?	‐
Lind 1974	+	+	+	+	+
Ljunggren 1984	+	+	+	‐	‐
Ljunggren 1992	+	+	+	‐	‐
Mathews 1975	+	+	+	‐	‐
Mathews 1988	+	+	+	‐	‐
Ozturk 2006	+	+	+	‐	‐
Pal 1986	+	+	+	‐	‐
Reust 1988	‐	+	+	‐	‐
Schimmel 2009	+	+	+	‐	‐
Sherry 2001	+	+	+	+	?
Simmerman 2011	+	+	+	‐	‐
Sweetman 1993	+	+	+	‐	‐
Tesio 1993	+	+	+	?	‐
Unlu 2008	+	+	+	‐	‐
Van der Heijden 1995	+	+	+	‐	‐
Walker 1982	+	+	+	‐	‐
Weber 1973	‐	+	+	‐	‐
Weber 1984 (1)	‐	+	+	‐	‐
Weber 1984 (2)	‐	+	+	‐	‐
Werners 1999	+	+	+	‐	‐
+: yes; ‐: no; ?: unknown.

Table 1. Clinical relevance

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Comparison 1. Low‐back pain with/without radiation, traction versus placebo, sham or no treatment

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain intensity Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

1.1 3‐5 weeks	2	247	Mean Difference (IV, Fixed, 95% CI)	‐18.49 [‐24.12, ‐12.87]
1.2 6‐12 weeks	1	150	Mean Difference (IV, Fixed, 95% CI)	0.30 [‐9.91, 10.51]
1.3 6 months	1	150	Mean Difference (IV, Fixed, 95% CI)	‐0.5 [‐11.55, 10.55]
1.4 1 year	1	97	Mean Difference (IV, Fixed, 95% CI)	‐9.10 [‐19.32, 1.12]
2 Functional status Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

2.1 3‐5 weeks	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.2 6‐12 weeks	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.3 6 months	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Global improvement Show forest plot	2		Risk Difference (M‐H, Fixed, 95% CI)	Subtotals only

3.1 3‐5 weeks	2	175	Risk Difference (M‐H, Fixed, 95% CI)	‐0.03 [‐0.17, 0.12]
3.2 6‐12 weeks	2	175	Risk Difference (M‐H, Fixed, 95% CI)	0.03 [‐0.12, 0.18]
3.3 6 months	1	150	Risk Difference (M‐H, Fixed, 95% CI)	0.02 [‐0.14, 0.18]
4 Return to work (days) Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

4.1 3‐5 weeks	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.2 6‐12 weeks	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
4.3 6 months	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 1. Low‐back pain with/without radiation, traction versus placebo, sham or no treatment

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Comparison 2. Low‐back pain with/without radiation, physiotherapy with traction versus physiotherapy without traction

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain intensity Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

1.1 1‐2 weeks	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.2 12‐16 weeks	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Functional status Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

2.1 1‐2 weeks	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.2 12‐16 weeks	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Global improvement Show forest plot	1		Risk Difference (M‐H, Fixed, 95% CI)	Totals not selected

3.1 1‐2 weeks	1		Risk Difference (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.2 12‐16 weeks	1		Risk Difference (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 2. Low‐back pain with/without radiation, physiotherapy with traction versus physiotherapy without traction

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Comparison 3. Low‐back pain with/without radiation, two types of traction

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Global improvement Show forest plot	2		Risk Difference (M‐H, Fixed, 95% CI)	Subtotals only

1.1 1‐2 weeks	2	93	Risk Difference (M‐H, Fixed, 95% CI)	0.35 [0.17, 0.54]

Comparison 3. Low‐back pain with/without radiation, two types of traction

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Comparison 4. Low‐back pain with/without radiation, traction versus other treatment

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain intensity Show forest plot	4		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

1.1 1‐2 weeks	2		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.2 3‐5 weeks	2		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.3 12‐16 weeks	2		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.4 6 months	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.5 1 year	2		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Functional status Show forest plot	2		Std. Mean Difference (IV, Fixed, 95% CI)	Subtotals only

2.1 1‐2 weeks	1	138	Std. Mean Difference (IV, Fixed, 95% CI)	‐0.06 [‐0.40, 0.27]
2.2 3‐5 weeks	1	235	Std. Mean Difference (IV, Fixed, 95% CI)	0.20 [‐0.05, 0.46]
2.3 12‐16 weeks	2	290	Std. Mean Difference (IV, Fixed, 95% CI)	‐0.03 [‐0.26, 0.21]
2.4 6 months	1	168	Std. Mean Difference (IV, Fixed, 95% CI)	0.15 [‐0.16, 0.45]
2.5 1 year	1	173	Std. Mean Difference (IV, Fixed, 95% CI)	0.04 [‐0.25, 0.34]
3 Global improvement Show forest plot	3		Risk Difference (M‐H, Fixed, 95% CI)	Totals not selected

3.1 1‐2 weeks	2		Risk Difference (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.2 3‐5 weeks	2		Risk Difference (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.3 12‐16 weeks	1		Risk Difference (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 4. Low‐back pain with/without radiation, traction versus other treatment

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Comparison 5. Low‐back pain with radiation, traction versus placebo, sham or no treatment

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain intensity Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

1.1 1‐2 weeks	2	79	Mean Difference (IV, Fixed, 95% CI)	2.93 [‐14.73, 20.59]
1.2 3‐5 weeks	1	39	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Global improvement Show forest plot	5		Risk Difference (M‐H, Fixed, 95% CI)	Subtotals only

2.1 1‐2 weeks	4	398	Risk Difference (M‐H, Fixed, 95% CI)	0.13 [0.04, 0.22]
2.2 3‐5 weeks	2	123	Risk Difference (M‐H, Fixed, 95% CI)	0.27 [0.12, 0.43]
2.3 12‐16 weeks	1	81	Risk Difference (M‐H, Fixed, 95% CI)	0.06 [‐0.16, 0.28]
3 Return to work Show forest plot	1		Risk Difference (M‐H, Fixed, 95% CI)	Subtotals only

3.1 2 years	1	39	Risk Difference (M‐H, Fixed, 95% CI)	0.15 [‐0.15, 0.45]

Comparison 5. Low‐back pain with radiation, traction versus placebo, sham or no treatment

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Comparison 6. Low‐back with radiation, physiotherapy with traction versus physiotherapy without traction

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain intensity Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

1.1 1‐2 weeks	2	110	Mean Difference (IV, Fixed, 95% CI)	‐7.96 [‐16.53, 0.61]
1.2 6 weeks	1	64	Mean Difference (IV, Fixed, 95% CI)	2.0 [‐10.02, 14.02]
2 Functional status Show forest plot	2		Std. Mean Difference (IV, Fixed, 95% CI)	Subtotals only

2.1 1‐2 weeks	2	94	Std. Mean Difference (IV, Fixed, 95% CI)	‐0.08 [‐0.49, 0.32]
2.2 6‐12 weeks	1	64	Std. Mean Difference (IV, Fixed, 95% CI)	0.14 [‐0.35, 0.63]
2.3 12‐16 weeks	1	30	Std. Mean Difference (IV, Fixed, 95% CI)	0.43 [‐0.30, 1.16]
2.4 6 months	1	30	Std. Mean Difference (IV, Fixed, 95% CI)	0.18 [‐0.54, 0.90]
3 Global improvement Show forest plot	3		Risk Difference (M‐H, Fixed, 95% CI)	Totals not selected

3.1 1‐2 weeks	1		Risk Difference (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.2 3‐5 weeks	1		Risk Difference (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.3 6 weeks	1		Risk Difference (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.4 12‐16 weeks	1		Risk Difference (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4 Return to work Show forest plot	1		Odds Ratio (M‐H, Fixed, 95% CI)	Totals not selected

4.1 3‐5 weeks	1		Odds Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 6. Low‐back with radiation, physiotherapy with traction versus physiotherapy without traction

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Comparison 7. Low‐back pain with radiation, traction versus other treatment

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain intensity Show forest plot	2		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

1.1 1‐2 weeks	2		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.2 3‐5 weeks	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.3 12‐16 weeks	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Functional status Show forest plot	2		Std. Mean Difference (IV, Fixed, 95% CI)	Totals not selected

2.1 1‐2 weeks	2		Std. Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.2 3‐5 weeks	1		Std. Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
2.3 12‐16 weeks	1		Std. Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Global improvement Show forest plot	2		Risk Difference (M‐H, Fixed, 95% CI)	Totals not selected

3.1 1‐2 weeks	1		Risk Difference (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.2 3‐5 weeks	1		Risk Difference (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 7. Low‐back pain with radiation, traction versus other treatment

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Comparison 8. Low‐back pain with radiation, two types of traction

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain intensity Show forest plot	3		Mean Difference (IV, Fixed, 95% CI)	Subtotals only

1.1 1‐2 weeks	3	149	Mean Difference (IV, Fixed, 95% CI)	6.58 [‐2.77, 15.93]
2 Global improvement Show forest plot	1		Risk Difference (M‐H, Fixed, 95% CI)	Totals not selected

2.1 1‐2 weeks	1		Risk Difference (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 8. Low‐back pain with radiation, two types of traction

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Comparison 9. Low‐back pain without radiation, traction versus sham

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain intensity Show forest plot	1		Mean Difference (IV, Fixed, 95% CI)	Totals not selected

1.1 12‐16 weeks	1		Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 9. Low‐back pain without radiation, traction versus sham

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