Spinal Decompression
Each of us is constantly in a battle—with gravity! A frequent casualty is the soft disc material that separates each spinal bone. Pressure from our weight, trauma from an accident and other causes can increase the pressure on a weakened disc. In extreme cases, the soft pulpy center of the disc can escape and cause pain. That can be quite painful. We use the latest technology to help relieve the effects of back pain due to herniated and degenerated discs. Since discs are constantly under weight-bearing pressure, they can be slow to heal. By gently “stretching” your spine, we help relieve pressure and enhance healing. This is called disc decompression.
First, we’ll have you lie down on our specially-equipped table. Then, ever so slowly, we’ll stretch your spine. And then relax it. Stretch. And relax. Our practice members tell us this tractioning process is quite pleasant, even relaxing. Because they don’t feel the need to “guard” their spine, each sequence helps the damaged disc receive nourishment, expel cellular waste, and enjoy reduced pressure. Then, healing can begin.
Decompression traction therapy may be used to relieve pain from any of the following conditions:
- Herniated Disc
- Bulging Disc
- Slipped Disc
- Prolapsed Disc
- Degenerative Disc Disease
- Degenerative Joint Disease
- Spinal Root Impingement
- Posterior Facet Syndrome
- Acute Facet Problems
- Hypomobility
- Back Pain
- Joint Pain
- Radicular Pain
- Discogenic Pain
While not a cure-all, our decompression table is highly effective when combined with chiropractic care. Our experience shows that decompression can be helpful in supporting cases prone to frequent relapses. Do you know someone we could help overcome the effects of gravity?
Who Will Spinal Decompression Therapy Help?
Clinical Prediction Rules (CPR) are tools designed to assist doctors in clinical decision making. CPR’s use historical and physical examination findings, and combinations, to direct patient management strategies. Two CPR’s have been recognized in medical research for spinal decompression therapy: one for neck pain (Raney, Petersen et al. 2009) and one for low back pain (Cai, Pua et al. 2009).
Decompression Therapy for Neck Pain
The first study included 68 (38 female) neck pain patients who were 18 years of age or older and had a primary complaint of neck pain with or without arm symptoms (Raney, Petersen et al. 2009). Patients were excluded from the study if they:
- Displayed any red flags suggestive of serious pathology of non-MSK origin
- Were pregnant
- Displayed evidence of vascular compromise
- Displayed multiple level neurological impairments or CNS involvement
The treatment in the study included a combination of spinal decompression neck traction and active exercise 2-3 times per week for a total of 6 treatments in a three week period. Patients were advised to maintain normal activity during the study treatment duration.
After 6 treatments, 44% of patients were categorized as having a successful treatment outcome (greater than or equal to a +6 on the Global Rate of Change (GROC) scale – “A great deal better’).
The successful outcome group experienced significantly greater (p - 0.001) reductions in neck pain (Numeric Pain Rating Scale change of 2.2 average) and disability (Neck Disability Index score reductions of 12.5 average) compared to the non-successful group.
Five variables predicted the patients who best responded to cervical spinal decompression therapy:
- Patient reported peripheralization with lower cervical mobility testing (C4-C7)
- Positive shoulder abduction test
- Age is 55 or older
- Positive upper limb tension test A (ULTT A)
- Positive neck distraction test
Having at least 3/5 of the above variables resulted in a positive likelihood ratio (LR) of 4.81 for successful outcome with spinal decompression traction therapy and exercise (raising the probability of success from 44 to 78%).
If at least 4 variables were present, the positive LR of successful spinal decompression traction therapy was 23.1 resulting in an increased probability of success of 94.8% (no patients fulfilling at least 4/5 criteria had a poor outcome).
Based on the 2 points above, the authors suggested that the optimal threshold for spinal decompression decision making are selecting patients who have 3/5 criteria (Raney, Petersen et al. 2009).
Decompression Therapy For Low Back Pain
The second study included 129 patients (21 female) with a chief complaint of pain and/or numbness in the lumbar spine, buttock and/or lower extremity (Cai, Pua et al. 2009). Patients were excluded from the study based on:
- Current pregnancy
- Signs of spinal cord injury
- History of spinal fracture, surgery or osteoporosis
- Pain was determined to be non-spinal pain
The treatment in the study was three motorized lumbar traction sessions over a 9 day period. Twenty five patients (19.4%) were found to have a 50% improvement score on the modified Oswestry Back Disability Questionnaire (OBDI) and were termed the responders.
After 6 treatments, 44% of patients were categorized as having a successful treatment outcome (greater than or equal to a +6 on the Global Rate of Change (GROC) scale – “A great deal better’).
Four variables predicted the patients who best responded to lumbar spinal decompression traction therapy:
- Being 30 years of age or older
- Having no neurological deficit (this contradicts previous findings from other low back pain CPR research)
- Having a low Fear Avoidance Beliefs Questionnaire (FABQ) score
- Non-involvement in manual labor
Having at least 3/4 variables present in the patient, the probability of successful traction was deemed to be 42.2%. If 4/4 variables were present in the patient, the probability of successful traction was deemed to be 69.2%.
The authors caution that this CPR should not be used in a multi-modality treatment regime and should not be used to formulate treatment strategies longer than 3 sessions over a 9 day period.
While this study demonstrates several limitations, it is useful in assisting clinicians to identify variables in low back pain patients most likely to respond to lumbar spinal decompression traction therapy alone and patients who most likely require multi-modal care (Cai, Pua et al. 2009).
References
Cai, C., Y. H. Pua, et al. (2009). “A clinical prediction rule for classifying patients with low back pain who demonstrate short-term improvement with mechanical lumbar traction.” Eur Spine J 18(4): 554-561.
Raney, N. H., E. J. Petersen, et al. (2009). “Development of a clinical prediction rule to identify patients with neck pain likely to benefit from cervical traction and exercise.” Eur Spine J 18(3): 382-391.