Monday, August 15, 2016

All About Spinal Decompression Therapy

Spinal Decompression Therapy involves stretching the spine, using a traction table or similar motorized device, with the goal of relieving back pain and/or leg pain.
This procedure is called nonsurgical decompression therapy (as opposed to surgical spinal decompression, such as laminectomy and microdiscectomy).
This article provides an overview of nonsurgical spinal decompression therapy and its role in treatment of lower back pain and neck pain.

Theory of Spinal Decompression

Spinal decompression devices use the same basic principle of spinal traction that has been offered by chiropractors, osteopaths, and other appropriately trained health professionals for many years.
Both traction and decompression therapy are applied with the goals of relieving pain and promoting an optimal healing environment for bulging, degenerating, or herniated discs.
Spinal decompression is a type of traction therapy applied to the spine in an attempt to bring about several theoretical benefits including:
  • Create a negative intradiscal pressure to promote retraction or repositioning of the herniated or bulging disc material.
  • Create a lower pressure in the disc that will cause an influx of healing nutrients and other substances into the disc.1

Clinical Evidence

While the fundamental theory of spinal decompression is widely accepted as valid, there is a lack of evidence supporting decompression therapy as being efficacious. Additionally there are some potential risks.
Although some studies that do not include control groups conclude that decompression therapy is efficacious, the few that do generally conclude that mechanized spinal decompression is no better than sham decompression. [Schimmel JJ, et al. European Spine Journal 18(12):1843-50, 2009] Thus, there is insufficient evidence that spinal decompression therapy is as effective, or more effective, than less expensive manual methods in treating back pain or injured herniated discs.2
A review of medical literature to date indicates that most clinical trials examining the efficacy of spinal decompression therapy or traction were lacking in one or more areas, such as inadequate numbers of subjects to make a statistically valid conclusion, lack of blinding (the patient or provider is unaware of the treatment given), no comparison to a placebo group (called a sham controlled study), or lack of comparison to a treatment alternative.3 At the time of this article, few clinical studies of spinal decompression therapy have been published in peer reviewed medical journals.

How Spinal Decompression Therapy is Thought to Work

In nonsurgical spinal decompression therapy, the spine is stretched and relaxed intermittently in a controlled manner. The theory is that this process creates a negative intradiscal pressure (pressure within the disc itself), which is thought to have two potential benefits:
  • Pulls the herniated or bulging disc material back into the disc
  • Promotes the passage of healing nutrients, into the disc and fosters a better healing environment.

Spinal Decompression Session

During spinal decompression therapy for the low back (lumbar spine), patients remain clothed and lie on a motorized table, the lower half of which can move.
  • A harness is placed around the hips and is attached to the lower table near the feet.
  • The upper part of the table remains in a fixed position while the lower part, to which the patient is harnessed, slides back and forth to provide the traction and relaxation.
One difference between various decompression therapies is the patient's position on the table:
  • Some devices place the patient in the prone position on the table, lying face down (e.g. VAX-D)
  • Some devices have the patient lying supine, face up (e.g. DRX9000)
The patient should not feel pain during or after the decompression therapy although they should feel stretch in the spine.

Treatment Series and Costs

While spinal decompression therapy may be recommended as a potential treatment for a variety of lower back pain conditions, as with all lower back pain treatments, it is the patient's decision whether or not to have the treatment. Although the risk is low, the benefit of these treatments is not established.
Decompression therapy typically consists of a series of 15 to 30 treatments, lasting 30 to 45 minutes each, over a four to six-week period. Sessions are conducted in the practitioner's office.
The cost of each session typically ranges from $30 to $200, which means that a recommended series of treatments will typically cost from $450 to $6,000. Although insurance companies might pay for traditional traction, decompression therapy is not usually allowed although they are nearly the same.
Sessions may include additional treatment modalities, such as electric stimulation, ultrasound, and cold and/or heat therapy applied during or after the procedure.

    Recommendations may also include drinking up to a half-gallon of water per day, rest, utilizing nutritional supplements, and/or performing exercises at home to improve strength and mobility.

    Potential Candidates for Spinal Decompression Therapy

    Spinal decompression is an alternative therapy designed with the goal of alleviating pain and promoting healing of the intervertebral disc.

    Indications for Spinal Decompression Therapy

    The indications for spinal decompression therapy (given by its proponents) are relatively broad.
    It is often recommended as a treatment alternative for many types of lower back pain, sciatica (leg pain), or neck pain caused by a herniated disc, bulging disc, or degenerated disc.

    Contraindications for Spinal Decompression Therapy

    Stretching the spine to relieve back pain is not appropriate for some patients. The following groups of people are not good candidates for non-surgical spinal decompression:
    • Pregnant women
    • Patients with broken vertebrae
    • Patients who have had spinal fusion
    • Patients who have an artificial disc, or other implants, in their spine
    • Patients with failed back surgery
    • Anyone who has had multiple surgeries without recovery (pain improvement)
    • Patients with any of the following conditions are also not good candidates:
      • Osteoporosis, or osteopenia
      • Spondylolisthesis
      • Spinal stenosis
      • Spinal infection
      • Spinal tumor
      • Ankylosing spondylitis
      • Any condition that may compromise the integrity of the spine
      • Any condition requiring the patient to take blood thinner medication
    • Additionally, patients with neck and arm pain may experience worsening of their symptoms, in which case decompression therapy should be discontinued. In general, any patient who experiences pain during the spinal decompression procedure or after the procedure is likely not a good candidate for this type of therapy.
    Call ABChiropractic Family & Wellness at 636-916-0660 and speak to Karen or Rachel to schedule your new patient appointment.  Find out if you are a candidate for spinal decompression.  We are conveniently located in St Charles Missouri 63303.  


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