Effectiveness of Mechanical Traction in Managing Pain and Improving Joint Mobility in Knee Osteoarthritis: A Review

Abstract

Background: Knee osteoarthritis (OA) is a prevalent degenerative joint disease causing chronic pain and mobility limitations. Mechanical traction has emerged in the past decade as a non-invasive intervention aimed at pain relief and improved joint mobility by unloading the knee joint. Objectives: This review examines the effectiveness of mechanical knee traction in reducing pain and enhancing joint mobility in patients with knee OA, summarizing clinical evidence from the last ten years. Both clinical outcomes and biomechanical rationales are discussed, including comparisons with standard therapies. Methods: A literature search (2015–2025) was conducted focusing on clinical studies, systematic reviews, and relevant biomechanical research on knee traction. Key outcomes of interest were pain reduction and improvements in joint range of motion (ROM) or physical function. Results: Recent randomized controlled trials (RCTs) and observational studies indicate that adding mechanical traction to standard physiotherapy or exercise regimens yields significantly greater pain reduction and functional improvement than conventional treatments alone (Choi & Lee, 2019; Abdel-Aal et al., 2022; Riyad et al., 2024). Traction at certain knee flexion angles (20°–90°) and intermittent traction protocols appear most beneficial (Abdel-Aal et al., 2022). Improvements in knee ROM are observed in some studies (Kamble & Malawade, 2023), though not uniformly in all trials. Mechanistically, traction likely relieves compressive joint forces, increases joint space, and reduces neuromuscular guarding, thereby alleviating pain. Conclusions: Mechanical traction is a promising adjunct therapy for knee OA that can reduce pain and modestly improve joint mobility, especially when combined with exercise. While short-term outcomes are positive, further research is needed to establish long-term efficacy, optimal protocols, and its place in clinical guidelines.