Spinal Decompression: Your Questions Answered

More than 80% of North Americans report back and neck pain.  That’s a pretty significant number of people in constant pain; stiffness, discomfort and disability may linger on long after the original injury is healed.

Most back and neck pain can be traced to the discs within the spine with herniations, bulges, and degeneration most commonly diagnosed.  Back and neck surgery is invasive, expensive, and ineffective.  Fusion is one example of a surgical intervention that isn’t worth the pain and rehabilitation; frequently, patients who have had fusions will end up with chronic pain, stiffness, and limited mobility referred to as “failed back syndrome.”  A 2004 research paper released in the New England Journal of Medicine reported that in America 151,000 back surgeries are performed annually.  Out of these surgeries, many will end in “failed back syndrome” and no real measurable benefits for the patient at all.  This means that for patients with chronic back or neck pain other, and less invasive, treatments should be the first choice.

One very effective treatment for neck and back pain is non-surgical spinal decompression.  An effective decompression treatment plan will usually involve around twenty sessions at a half hour apiece.  The therapy can be done weekly or daily, depending on the plan.  Patients enjoy the treatment because it is relaxing, gentle, non-invasive, and can be done in the office while the patient remains fully clothed.  The doctor will choose the appropriate angles, forces needed, and position on the table to target the affected areas of the spine and may use ice therapy after the treatment session.

Decompression treatment will relieve pressure caused by a number of spinal complications including degenerative disc disease, spinal stenosis, facet syndrome, sciatica, and herniated discs as well as pain from associated neurological symptoms.

Spinal Decompression vs Traction

Historically, traction has been defined as a force intermittently applied to the spine in an attempt to stretch the spine, joints and muscles.   Pain relief with traction techniques is short term and inconsistent in nature.

Spinal decompression is a little different.  With traction, the body pulls in the opposite direction of the force being applied.  When spinal decompression equipment is used, a carefully calibrated computer algorithm is used to reduce strain and give the maximum benefits.  Strain gauges are used to create an electronic signal from a physical motion, allowing the computer program to integrate with muscle reactions and readjust itself accordingly.  The computer uses hold and release programming to stop the body’s natural desire to pull away from forces.  Traction, osteopathy and chiropractic therapies can’t effectively deliver the necessary intradiscal pressure over extended periods of time, rendering them much less effective in treating pain and healing back, neck or spinal injuries.

The Science Behind Spinal Decompression

In a study conducted by the University of Texas’ Health Science Center and the Department of Neurosurgery and Radiology of the Rio Grande Hospital, the importance of using decompression therapy was proven using intradiscal pressure measurements of a patient undergoing the treatment.

In the study, the patient had a cannula placed into the disc space between L4 and L5, which was then connected to a pressure transducer.  The pressure changes in the space were measured during the spinal decompression therapy, both before the therapy was begun and while it was being performed.   The study confirmed that negative pressure of more than -100 mmHg was possible within the nucleus pulpous of the herniated discs during the therapy.  On the other hand, the lowest pressure possible in traction therapy was 40 mmHg.  This confirms that decompression therapies are far more effective in producing necessary negative intradiscal pressure than traction.

This study was just one of many that are proving that decompression therapy is an important and beneficial intervention for patients with neck and back pain from herniated discs.  Another study of 219 patients suffering from degenerative disc disease and disc herniations concluded that 86 percent of those who followed decompression protocols showed an immediate improvement and decrease of pain levels, with 92 percent showing an overall improvement.  Five percent of these patients had a relapse in three months following the first treatment.

Research proves that decompression therapy can be the primary choice of treatment for patients suffering pain from lumbar disc herniations, facet arthropathy, degenerative disc disease, and any decrease in spine mobility.  In fact, studies show that even patients who have had surgeries that resulted in “failed back syndrome” should try decompression therapy before considering additional surgeries.

One problem that arises with back surgery is that it isn’t always possible to pinpoint the exact cause of the disability and pain.  Surgery directed at what “seems” to be the problem won’t help a patient who has developed more complications from the original underlying issues.  Decompression therapy is an effective way to treat both the underling cause of the pain as well as any other issues that accompany it, like radiating pain to the leg or extremities.   Decompression therapy is widely recognized as being the first option for back pain and disc herniation before any surgical interventions are considered.

Feeding the Injured Disc Vital Nutrients: Imbibition

It turns out that creating the negative pressure necessary for healing the discs also provides a mechanism for encouraging the nourishment of them.  Discs receive nourishment, like oxygen and fluids, through a process known as imbibition.  Imbibition is encouraged when the discs are permitted to expand into the space created by the negative pressure, allowing them to get oxygen, water and nutrients.  In addition to these nutritional benefits, the disc is allowed to retract and gently be repositioned into its intended space during spinal decompression.

Indications and Contraindications of Decompression Therapy

A patient who is the ideal candidate for decompression therapy must be 18 or older, and will have one or more of the following:

• Pain from herniation and bulging of lumbar discs that has lasted a month or more 
• Pain from disc degeneration that is still present despite a month or more of therapy
• Unresolved pain for more than six months following a failed back surgery

It’s important that a decompression candidate is available and willing to complete the entire course of treatment.

There are some contraindications for decompression therapy including:

• Spinal fusion using rods
• Local spinal osteomyelitis
• Osteoporosis (severe)
• Recent compression fracture of the lumbar spine below L1
• Pregnancy
• Cauda equina syndrome
• Hemiplegia or Paraplegia
• Abdominal/pelvic malignancy
• Metastatic or malignant spinal neoplasm
• Meningitis
• Disc pathology with sequestration.
• Unstable spondylolisthesis
• Local bilateral pars defects
• Aortic aneurysm
• Cognitive dysfunction
• Severe peripheral neuropathy

Conclusion:  Decompression Therapy or Not?

Of course, there is no one size fits all when it comes to patients with back pain, and results will not be the same for everyone who tries decompression therapy.  Body morphology, previous surgery, steroid or narcotic use, smoking, caffeine intake, and age may all impede decompression therapy.  Nonetheless, studies indicate that many of the patients who have been suffering long term pain or “failed back syndrome” can heal and resume their daily activities.  If a patient isn’t showing improvement between the 15^th and 18^th decompression therapy session, alternative treatments should be considered.  Surgery should not be the first choice of treatment and should only be weighed as an option if decompression treatments do not seem to be working. Spinal decompression is gentle, safe, non-invasive, and comfortable for patients.  The public is beginning to realize the benefits of decompression therapy, and with the encouragement of knowledgeable physicians, they are more likely to consider it as a first line treatment option for their recurrent back and neck pain.