If you are one of the 65 million Americans who suffer from low back pain you might be interested to hear about a growing treatment trend known as spinal decompression.
Spinal decompression describes a group of treatments that aim to relieve pressure from the spine or the nerve roots that pass through the spinal column. Our spines give immense support to our bodies all day, every day so it is no surprise that they need a little TLC sometimes.
Our spines are made up of vertebrae (bones), ligaments, and spinal discs. Injuries to our spine can happen through things like trauma or age-related wear and tear, causing our spines to put pressure on the nerves and spinal cord which, in turn, leads to low back pain. Spinal decompression is any type of treatment that looks to relieve this pressure on our spinal cord.
Common Conditions That Spinal Decompression Treats:
Pinched nerves
Bulging discs
Spinal stenosis
Is it good to decompress your spine?
Spinal decompression has been found to be particularly beneficial for conditions like degenerative disc disease and herniated discs. It is used to improve the circulation of blood and nutrients to the spine and helps to put the dislocated vertebrae back into their original position.
Types Of Spinal Decompression Therapy
Spinal decompression therapy can be categorized into:
Non-surgical spinal decompression therapy (eg. traction)
Surgical spinal decompression (eg. corpectomy, discectomy)
Non-Surgical Spinal Decompression
For many individuals who suffer from low back pain, the condition can be very hard to treat. While you might feel awesome after a chiropractor or physiotherapist visit, without ongoing treatment and a commitment to a home exercise program, the relief can be somewhat short-lived.
This is where some people have turned to spinal decompression and traction tables. These tables can be very expensive and are often not covered by health insurance, but the good news is that you don’t have to have a fancy table to get spinal decompression relief at home - there are some relatively simple exercises that you can do to get similar results for free.
What Is Spinal Decompression All About?
When we look at the theory and principles behind non-surgical spinal decompression therapy we can see that a general premise is to stretch and relax the spine in a controlled and safe manner. The theory behind this stretching process is that it creates a “negative intradiscal pressure” which basically means that it reduces the pressure within the disc itself.
The benefits of this are that, firstly it pulls the herniated disc material back into the disc, and secondly, it helps to improve the flow of nutrients back into the disc, creating a more healing environment. By creating a “pull” in the opposite direction of gravity we increase space within the disc, reducing the pressure and decreasing pain.
What Exactly Is Traction Therapy?
Traction therapy for the spine is a type of decompression therapy that takes pressure off the spine and spinal column. It can be done either manually (by hand, like at the chiropractor) or mechanically, using something like a traction table. This type of treatment is often used for conditions like degenerative disc disease, sciatica and herniated discs.
Traction therapy has been around for many years, starting off as simple static traction and progressing to more complex and motorized traction.
Does Traction Therapy Work?
When we looked at the clinical evidence behind this type of therapy there was limited information available to review the treatment. One systematic review was only able to find 7 randomized control studies that looked at intermittent motorized traction. 6 out of the 7 trials reported “no difference in outcomes between the traction groups and the control groups”.
Intermittent motorized traction (often known as spinal decompression therapy) is considered by some to be a unique form of traction. The manufacturers of this technology claim to have an “86% success rate”. It does appear, however, that a lot of the research that has been done with decompression therapy is marketing-oriented. The studies published have been listed under “emerging technologies” and have been described by the journal editor as “either very small scale, uncontrolled, under-powered, and/or open label”.
Unfortunately the evidence to support the effectiveness of non-surgical spinal decompression therapy is very limited. The treatment has never been directly compared to more conventional treatments such as spinal manipulation or exercise which have a wealth of data to support their effectiveness in managing lower back pain. When we consider how expensive spinal decompression therapy might be it is important to consider the cost-benefit analysis and see if the treatment is ultimately worth the expense.
Who Is Using Traction Therapy?
Chiropractors are among some of the biggest proponents of this technology with a recent limited online poll stating that “38% of chiropractors are using the technology in their offices”. According to the Job Analysis of Chiropractic, the presence of traction technology in chiropractor’s offices has increased from 73% in 1991 to more than 80% in 2003. With costs of the equipment ranging from $10,000 to more than $100,000 it is out of the reach of many individuals and it is a major investment for a chiropractor to consider.
Surgical Spinal Decompression Therapy
Spinal decompression surgery is aimed at relieving lower back pain that is being caused by the compression of the spinal cord/ nerves. Decompression surgery is a common operation for treating lumbar spinal stenosis and it has had generally good results.
A 2007 study of 77 patients found that while there was significant improvement in back and leg pain that was “sustained for at least 1 year” and an improvement in physical function, improvement in social function was not observed at the 5 year follow up. The authors of the study concluded that “physical function back and leg pain are significantly improved after 5 years, but initial significant improvements in social function diminish over time”.
When we consider the immense physical risks that this treatment carries, such as death, blood clots, nerve injury, and paralysis, it also makes one wonder if this type of treatment is preferable compared to more non-invasive and significantly cheaper treatments that have shown effectiveness in reducing low back pain, like exercise and spinal manipulation.
Risks Of Spinal Decompression Therapy
While we have mentioned the risks of spinal decompression surgery, the risks associated with nonsurgical spinal decompression therapy are also something to be considered. These risks include:
Tissue damage
Clot formation
Nerve injury
Paralysis
Aches
Pain
Before you start any type of spinal decompression therapy (surgical or non-surgical) you should consult with your healthcare practitioner to make sure that the treatment is appropriate for your specific condition and history. Spinal decompression therapy is not appropriate for everyone.
Conclusions
The debilitating nature of low back pain means that it is not surprising that people are often willing to try anything to find relief from the pain. As new therapies emerge and new technologies are experimented with it is important to look at the data behind the technology, as well as the safety of the treatment.
Many spine experts, including Dr. Stuart McGill, believe that there are often many things that we can do for our spines before resorting to more experimental things like spine surgery or spinal traction. If you are considering this treatment you should definitely consult with your healthcare provider and make sure that the treatment would be suitable for your particular situation.