Spinal Decompression

Spinal decompression has been an important part of my practice for some years now, and while it is a remarkably effective treatment for the vast majority of patients suffering from the symptoms of herniated and/or degenerated spinal discs, it is not an appropriate treatment for every patient with back pain. Sadly, the financial investment involved in providing spinal decompression services appears to sometimes influence doctors to recommend it in cases where it may not be necessary or indicated. No treatment is 100% effective, but when doctors are not as discriminating as they should be in what patients they accept, the results can be far from ideal. Even more concerning is the possibility that some patients may even get worse with this form of treatment when doctors prescribe it inappropriately for financial reasons.

Spinal decompression is an advanced form of spinal traction used in the treatment of disc-related back pain and related conditions such as sciatica. The primary difference between true spinal decompression and traction (and inversion) machines is that spinal decompression machines are set up to "trick" the spinal muscles into staying relaxed during treatment, allowing for greater changes in disc pressure than with regular traction, which has to fight the resistance of the muscles. As someone who previously used regular traction with my patients, I can attest to the fact that true decompression systems provide dramatically better results overall. Spinal decompression treatment provides excellent results for many people, but some fail to get any improvement at all, and others may even feel worse. I will attempt to explain the most common reasons for these treatment failures, and give suggestions for how to know when spinal decompression is and is not likely to help you.

Judging from my experience, the best patients for this form of treatment are the ones who have one or more bulging or herniated spinal discs and/or mild to moderate degeneration of the discs. Those patients who have previously had disc surgery still make good candidates for spinal decompression, provided they do not have any specific issues that would exclude them, such as metal implants in the spine, spinal instability, and/or some form of healing impairment at the site of the surgery. The large majority of patients who qualify under these criteria will typically get excellent results and be able to resume their daily activities without any major pain after going through the recommended spinal decompression treatment protocol.

While there are case reports that indicate complete disc ruptures can be treated with spinal decompression, in my experience, people with actual disc ruptures tend to not do very well with this form of treatment. It should be noted that even doctors sometimes incorrectly call a disc bulge or herniation a rupture. True disc ruptures (also called extrusions and sequestered discs), in which the inner gel of the disc is actually leaking out, are relatively rare, so it is good to find out for sure what your actual condition is. The simplest way to do this is to read the radiologist's report of the patient's MRI or CT scan. If you see terms like "extrusion" or "sequestered fragment", particularly when used in association with the words "large" or "severe", the patient may not be ideal candidate for decompression. This is not to say that decompression can't help in such cases, but the success rate for full disc ruptures is much lower than the success rate for bulges and herniations (which may also be referred to as "protrusions".

In addition to the importance of applying spinal decompression only in the appropriate cases, it is extremely important for the doctor or technician operating the machine to set the patient up properly for the treatment. It is very easy for a technician to get sloppy with setting up patients on the equipment, and this leads to ineffective treatment. Overall, because of the design of the better spinal decompression systems, even very poor patient set-ups rarely lead to patient injury, but mistakes in the use of the machine can definitely prevent the patient from getting the desired results and might cause a temporary flare-up in symptoms. To help avoid this problem, I recommend asking any potential spinal decompression provider you may be considering seeking treatment with about his or her training for the operators of the equipment. All operators of such equipment should have gone through a formal training program and should receive periodic re-training to help insure proper patient care.

One other consideration is the fact that some patients are not good candidates for spinal decompression treatment because of their inability or unwillingness to follow the recommended treatment protocol. In my experience, the primary reasons why a patient can't or won't follow the treatment recommendations are usually related to money and/or time.

A full spinal decompression treatment program that includes spinal decompression and other adjunctive treatments may seem somewhat expensive. In actuality, it is a much lower-cost treatment option than surgery for most people and has a statistically much higher success rate, so it can be a very good value, but nonetheless, some people try to cut down their costs by trying to reduce the amount of treatment. This can be a big mistake. In my experience, most people who complete the recommended decompression treatment protocol will get lasting relief and can safely return to their normal activities. Those who discontinue care prematurely will often relapse, and may suffer worse pain and worse damage to the disc because they resume excessively physically demanding activities before the disc has fully healed and stabilized.

Of course, some people fail to follow treatment recommendations primarily because they have busy lives and are unwilling to spend the time on getting better. This type of patient tends to miss a lot of appointments and may go long periods of time between treatment sessions. Unfortunately, the success of spinal decompression usually depends on getting the recommended amount of treatment at the recommended frequency of treatments. The effectiveness and results are not as good when people don't make time for their appointments. What some busy people fail to realize is that if they don't set aside time to properly deal with their health problem, sooner or later that health problem will deteriorate to the point where it forces them to make time to get treatment, and this often occurs when they are at their busiest and treatment is least convenient. It is my recommendation to invest the necessary time in getting better, rather than do the treatment intermittently and not get the best results.

In conclusion, spinal decompression is usually an extremely effective treatment for people suffering with pain from bulging and degenerated discs, but it is important that doctors select patients for this treatment carefully and make sure that the technicians operating the equipment get refresher training regularly. Patients need to beware of trying to reduce their time and/or money investment through reductions in treatment and to take the responsibility to follow the treatment recommendations to allow for maximum correction and healing. In my experience, when patients are properly selected and the appropriate treatment protocols are followed, the vast majority of spinal decompression patients get excellent long-term results.