Two pilot studies show that a new
non-surgical spinal decompression treatment has a beneficial effect on lower
back pain, and that it seems to benefit the morphology of the spine by
increasing disc height. One study, authored by Dr. John Leslie of the Mayo
Clinic and others, found that clinical use of a spinal decompression system led
to an 88.9 percent reduction in pain scores over the course of six weeks, as
well as improvement in Oswestry disability scores and
a drop in consumption of pain medications.
In the other study, CT scans of the
lumbar spine were taken of patients before and after treatment on a spinal
decompression system. They showed possible beneficial anatomical changes
associated with the treatment.
Dr. Christian Apfel,
lead author and associate professor of anesthesiology and perioperative
care at the University of California at San Francisco, says, "A
significant reduction in chronic LBP [lower back pain] after non-invasive
spinal decompression correlated with an increase in disc height." Control
groups to determine the placebo effect and the extent of spontaneous
improvement were not included in the Leslie study.
Thus, to gather definitive data on
the effectiveness of a spinal decompression system, randomized,
placebo-controlled, double-blind studies must be undertaken - and for longer
periods of time. This study was partially funded by Axiom Worldwide. A similar
controlled, randomized trial is called for to prove that an increase in disc
height leads to pain amelioration
Question: What is Spinal
Decompression Therapy?
Spinal Decompression Therapy is a
non-surgical, non-chiropractic therapy to relieve back pain and other problems
associated with spinal disc injuries.
Answer: Bulging discs, herniated discs, degenerative disc
disease, pinched nerves, sciatica, and arm pain or leg pain can often be
attributed to your spine asserting pressure on your discs. Poor posture, bad body
mechanics, repetitive
stress
and acute injury can cause your vertebrae to compress your discs or to slip out
of alignment which then applies pressure to your discs.
Compressed discs lead to two major
problems: a bulge or herniation pressing on a nerve;
and brittleness of the disc. The problem is often perpetuated because the
compressed disc restricts the flow of nutrients to itself which is needed to
heal.
Traditional corrective treatments
include surgery or chiropractic adjustment. Spinal Decompression Therapy is an
alternative FDA approved treatment option that has shown very good results.
Spinal Decompression Treatment is
non-invasive and provides gentle decompression of the disc through the use of a
decompression table. You are strapped to the table so that as it moves it
applies a distraction force to the targeted area of the spine (the compressed
disc). A computer controls the distraction force which is applied in between
periods of relaxation. This gently pulls the spine apart elongating
it and creating a small vacuum between the vertebrae which pulls the disc back
into shape.
Much like a
repetitive stress injury the decompression works in very minute increments. But
over time that adds up and lets the disc reshape itself, heal and get the
proper flow of nutrients going to fight off brittleness and future injuries.
This FDA approved technology relieves pain by enlarging the space
between the discs. The negative pressure of decompression releases pressure
that builds on to the disc and nerves, allowing the herniated and bulging disc
to eventually go back into normal position. Decompression is the only treatment
that is truly most effective for severe cases of herniation,
degeneration, arthritis, stenosis and pressure on the
nerve root. According to a clinical study performed by the Orthopedic
Technological Review in 2004, said that 86% of all cases experienced spinal
pain relief with disc decompression.
What is the difference between
decompression and traction?
Many clinicians specializing in
lumbar spine pathology have criticized traditional traction. Traction fails in
many cases because it causes muscular stretch receptors to fire, which then
cause para-spinal muscles to contract. This muscular
response actually causes an increase in intradiscal
pressure. On the other hand, genuine decompression is achieved by gradual and
calculated increases of distraction forces to spinal structures, utilizing
various degrees of distraction forces.
A highly specialized computer must
modulate the application of distraction forces in order to achieve the ideal
effect. The system uses applies a gentle, curved angle pull which yields far
greater treatment results that a less comfortable, sharp angle pull.
Distraction must be offset by cycles of partial relaxation.
The system continuously monitors
spinal resistance and adjusts distraction forces accordingly. A specific lumbar
segment can be targeted for treatment by changing the angle of distraction.
This patented technique of decompression may prevent muscle spasm and patient
guarding. Constant activity monitoring takes place at a rate of 10,000 times
per second, making adjustments not perceived by the eye as many as 20 times per
second via its fractional metering and monitoring system.
Genuine decompression also involves
the use of a special pelvic harness that supports the lumbar spine during
therapy. Negative pressure within the disc is maintained throughout the
treatment session. With genuine decompression, the pressure within the disc
space can actually be lowered to about -150 mmHg. As a result, the damaged disc
will be rehydrated with nutrients and oxygen.
Isn’t decompression just a fancy
name for a traction machine?
No. There is a big different between
traction, distraction and decompression. Traction has been around for hundreds,
if not thousands of years. The problem with traction as it is known today is
that it is not always beneficial. In 1998, the Scientific American rated
traction to be of little or no value in the examination of efficacious
therapies for lower back pain. This finding is consistent with many studies
that report traction can often times signal a nociceptive
splinting response and put a patient’s back muscles in spasm, resisting any
attempts to effect a change on the disc proper.
Distraction, a term used to describe
a flexion distraction technique, attempts to reposition the spine from the
offending lesion. This technique has been shown to be very effective, even
though potentially damaging to the person performing the technique and largely dependent
on the skill of the technician. Like traction, distraction procedures are
limited in the ability to reduce the intradiscal
pressure, or produce a negative pressure within the disc imbibing fluid,
nutrients and creating an environment for repair.
Decompression therefore is an event -
a combination of restraint, angle position and equipment engineering. One can
experience traction without decompression, but not decompression without
traction. Traction is a machine - Decompression is an event.
What Result I Expect?
Many patients with lower back
syndromes may experience pain relief as early as the third treatment session.
Comparison of pre-treatment MRI’s with post-treatment
MRI’s has shown a 50% reduction in the size and
extent of herniation. In clinical studies, 86% of
patients reported relief of back pain with the our
system. Within the past five years, some private practice clinicians have
reported success rates as high as 90%.
What Time Commitments Are Required
By Patients?
Each treatment session averages 25 to
30 minutes in duration (research has established that optimum results are
achieved with sessions that incorporate 10 to 15 decompression/relaxation
cycles). On average, one daily session for 20-30 treatments is necessary for
patient self-healing to occur.
Herniated discs generally respond
within 20 sessions, while patients with degenerated discs may need ongoing
therapy at regulated intervals to remain pain free. Still other patients, due
to lifestyle or occupation, may also require maintenance therapy. Patients with
posterior facet syndromes may achieve complete remission with 10 or fewer
sessions. Research has demonstrated that most patients achieve full remission
from pain after the initial treatment regimen.
What is the typical diagnosis?
Since non-specific low back pain and
cervical pain generally encompass a myriad of mechanical failures, including
muscles, tendons, ligaments, and other soft tissue that encroach or produce
pressure on the nerves, the term intervertebral disc syndrome can be used. This
diagnosis does not necessarily require (although recommended) an MRI to confirm
the presence of a disc involvement
Who can benefit from using Disc
Decompression Therapy?
The following would be inclusion
criteria for the Decompression Therapy (1) Pain due to herniated and bulging
lumbar discs that is more than four weeks old; (2) Recurrent pain from a failed
back surgery that is more than six months old; (3) Persistent pain from
degenerated discs not responding to four weeks of therapy; (4) Patients
available for four weeks of treatment protocol; and (5) Patient at least 18
years of age.
These indications are ideal
candidates for enrollment into our program and have the potential of achieving
quality outcomes in the treatment of their back pain: (1) Nerve Compression;
(2) Lumbar Disorders; (3) Lumbar Strains; (4) Sciatic Neuralgia; (5) Herniated
Discs; (6) Injury of the Lumbar Nerve Root; (7) Degenerative Discs; (8) Spinal
Arthritis; (9) Low Back Pain w/ or w/o Sciatica; (10) Degenerative Joint
Disease; (11) Myofasctois Syndrome; (12) Disuse
Atrophy; (13) Lumbar Instability; (14) Acute Low Back Pain; and (15)
Post-Surgical Low Back Pain.
Lastly, the system should be utilized
with patients with low back pain, with or without radiculopathy
who have failed conventional therapy (physiotherapy and chiropractic) and who
are considering surgery. Surgery should only be considered following a
reasonable trial of Decompression therapy protocols.
What conditions are contraindicated?
Patients with the following problems
or symptoms are usually excluded from using the Spinal Decompresion
therapy: Pregnancy, Prior lumbar surgical fusion, Metastatic
cancer, Severe osteoporosis, Spondylolisthesis,
Compression fracture of lumbar spine below L-1, Pars defect, Aortic aneurysm,
Pelvic or abdominal cancer, Disc space infections, Severe peripheral
neuropathy, Hemiplegia, paraplegia, or cognitive
dysfunction, Cauda Equina
syndrome, Tumors, osteod osteoma,
multiple myeloma, osteosarcoma,
Infection, osteomyelitis, meningitis, virus, and HNP
(sequestered/free floating fragment).
How long is each session and what is
the treatment protocol?
Each session on the Decompression
equipment is approximately 25-40 minutes long (45 minute sessions include
set-up and take-off), accompanied by 15 minutes of stimulation, heat packs and
manipulation. The patient comes for 20-30 visits over a 4-6 week period. The
doctor will provide a complete copy of the Spinal decompression treatment
protocol upon request.
How long before a patient
experiences change?
Often times a patient experiences
some relief within the first few (3-7) treatments. Usually by the 12th to 15th
treatment all patients have reported some remission of symptoms. Patients not
showing significant improvement by the 15th to 18th session may be referred for
further diagnostic evaluation.
Does Decompression Therapy work for
everyone?
Eighty-to-ninety percent of patients
who have been properly selected and comply with the Spinal Disc Decompression
protocol will have good-to-excellent outcomes. Patient’s conditions that do not
respond quickly to the therapy are often unable to be helped by anything
quickly. Patients vary in age, sex and body morphology and may require
counseling in weight loss, nutrition and other lifestyle changes.
Spinal decompression is a procedure which
is designed to take pressure off the spine, encouraging the spine to heal from
conditions which are related to pressure. There are two major types of spinal
decompression: surgical, and non-surgical, sometimes also called mechanical.
Procedures to relive pressure vary greatly in effectiveness, depending on the
individual patient, the condition, and the skill of the health care provider, and spinal decompression is not for
everyone
In the case
of surgical spinal
decompression, a surgeon goes into the spine directly to remove pressure from
things like herniated discs. The relief of pressure is designed
to help the herniated material slip back into place, and to reduce strain on
the back while it heals. For people with extreme pain caused by spinal pressure, spinal decompression surgery can be
beneficial, reducing or eliminating pain, depending on the condition.
Non-surgical
spinal decompression involves gently
stretching and repositioning the spine to promote the relief of pressure. In
the case of herniation, non-surgical decompression is
supposed to create a vacuum which sucks herniated material back into place, and
in other conditions, non-surgical spinal decompression releases strain on the
spine, which can in turn release pinched nerves and treat conditions like facet
joint syndrome, degenerative disc disease, and other conditions which
cause back pain, numbness, and tingling.
As a
general rule, spinal
decompression is only really effective for lumbar back pain and neck pain. For
the center of the spinal
cord, other treatments will be needed. Lumbar pain in particular can be
extremely debilitating, and it is also quite common, as many professions put
strain and stress on the lower back. For people who suffer from chronic pain,
the appeal of a procedure which might reduce the pain is certainly understandable.
Before undergoing spinal decompression of either type,
you should talk to your physician. Back pain can be extremely challenging to
treat, and it is important to opt for the best treatment. In the best case
scenario, spinal
decompression will alleviate back pain, but it could also be ineffective, or it
could exacerbate existing pain. Make sure that the provider of the procedure is
fully licensed and experienced, and be sure to ask for an honest assessment of
the potential outcome. You may also want to consider asking for patient
recommendations, to give you a chance to talk with people who have experienced
the procedure.
SIMPLE PELVIC TRACTION GIVES INCONSISTENT RELIEF TO HERNIATED LUMBAR DISC SUFFERERS.
EDWARD L. EYERMAN, MD
Journal of Neuroimaging June 1998
A new decompression table system applying fifteen 60 second tractions of just over one half body weight in twenty one-half hour sessions was reported to give good or excellent relief of sciatic and back pain in 86% of 14 patients with herniated discs and 75% of patients with facet joint arthrosis. (Shealy, C.N.,Borgmeyer, V., AMJ. Pain Management 1997,7:63-65).