For mechanical traction position of head and cervical spine is determined by evaluation as well as condition being treated.

To obtain separation of vertebrae, the head should be positioned in flexion up to 35 degree; the greater the angle of traction, the greater is the posterior elongation.

To obtain greater muscle relaxation, position the head closer to neutral.

To obtain the unilateral effects, position the head in side bend position or in position of side bending with slight rotation before the traction is applied.

For manual traction, vary patient head position in flexion, extension, side bending and side bending with rotation and apply traction force in each position; note the patient response. When administering the treatment use the position that most effectively reduces or relieves the symptoms.

For Positional traction, determine the segment to receive the majority of traction force and palpate the spinous process at that level. Flex the head until motion of spinous process just begin at that level. Support the head at that with folded towels at that level of flexion. Then side bend the head away from the side to be distracted until movement of head is felt at that desired level. Finally rotate the head a few degrees towards the side to be distracted. Adjust the towel support to maintain this position for a low intensity, sustained traction stretch to that Wikipedia reference-linkfacet joint and surrounding soft tissue.