A therapist uses lumbar traction for a patient with nerve root impingement at L4-L5. Which position best relieves pressure on the affected nerve root?

A therapist uses lumbar traction for a patient with nerve root impingement at L4-L5. Which position best relieves pressure on the affected nerve root?

• A. Supine, hips & knees flexed
• B. Supine, with hips and knees straight and laterally shifted to the right
• C. Prone, hips and knees straight
• D. Sidelying on the right with a bolster between the table and the patient

Answer: (A)

Nerve roots are relieved when the space they pass through—the intervertebral foramen—is opened. Flexing the lumbar spine increases foraminal height, especially at the L4–L5 level, which reduces compression on the exiting nerve root and lowers tension within the canal during traction. Lying on the back with hips and knees flexed puts the spine in a flexed position, maximizing this foraminal opening and allowing the traction force to separate the vertebrae more effectively. In contrast, extending the spine (prone with straight hips/knees) narrows the foramina and can worsen nerve compression, and side-lying or lateral positioning doesn’t optimally increase foraminal space for the targeted nerve root. So the supine position with hips and knees flexed best relieves pressure on the affected nerve root during lumbar traction.

Nerve roots are relieved when the space they pass through—the intervertebral foramen—is opened. Flexing the lumbar spine increases foraminal height, especially at the L4–L5 level, which reduces compression on the exiting nerve root and lowers tension within the canal during traction. Lying on the back with hips and knees flexed puts the spine in a flexed position, maximizing this foraminal opening and allowing the traction force to separate the vertebrae more effectively. In contrast, extending the spine (prone with straight hips/knees) narrows the foramina and can worsen nerve compression, and side-lying or lateral positioning doesn’t optimally increase foraminal space for the targeted nerve root. So the supine position with hips and knees flexed best relieves pressure on the affected nerve root during lumbar traction.