*missing the strap but can be replaced The Saunders Cervical Traction Device is designed to provide traction (stretching) to the cervical region (neck). The device requires no assembly and is ready to use out of the case. A prescription is required. SKU 199594 Traction forces are directed to the back of the head to pevent compression of the TMJ Easy-to-read pressure gauge provides total control of the force at all times Blow-off valve limits the amount of force that can be applied Innovative design replicates clinical traction and promotes consistency of treatment Positioning alternatives allow varying treatment options for the clinician Patented pneumatic system ensures relable force accuracy and leak-free performance Easy to Use - a portable treatment solution that increases patient compliance and satisfaction Patented self-adjusting neck wedges ensure a perfect fit Patented pump design incorporates a simple "click in place" mechanisim Quick and simple patient set-up enables home traction without assistance https://www.chattanoogarehab.com/us/saunders-cervical-home-traction-device-199594 ^manual and directions