Lumbar traction for a posterior disc herniation is performed in which position?

• A. Supine
• B. Seated
• C. Lateral decubitus
• D. Prone

Answer: (D)

When the herniation is directed toward the back, performing lumbar traction with the patient in a prone position to achieve extension is most effective. Extending the lumbar spine during traction opens the posterior aspect of the spinal canal and reduces the posterior bulge, helping move disc material away from the nerve roots. The traction force in this position better unloads the posterior protrusion and creates spaces for the neural elements, which is why prone traction is preferred for a posterior disc herniation. Other positions don’t promote this posterior unloading as effectively and may fail to reduce posteriorly directed protrusion.