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. 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.
Spinal decompression in my San Antonio office has been quite successful for most patients, but it is not appropriate or effective for every patient. It has been my observation that some providers of spinal decompression services will recommend it as a “cure-all” for all patients in an attempt to keep their machines full and maximize their return on investment on the equipment. Even the best doctors don’t have a 100% success rate, because no treatment works for everyone. The problem is when doctors accept patients who are not really good candidates for treatment, the results are lacking, and some poorly-selected patients may even temporarily get worse when they receive this form of treatment.
From my experiences in my San Antonio practice, the patients who get the best results with spinal decompression are those with one or more bulging/herniated discs and patients with mild to moderate disc degeneration. Patients who have previously undergone disc surgery are somewhat more complicated, but most still get good results when they meet the selection criteria (no metal implantation in the spine, no spinal instability, and no impaired healing at the site of surgery). The vast majority of people who meet these criteria get very good results and are usually able to return to their normal activities without any significant pain.
While there are case reports that indicate complete disc ruptures can be treated with spinal decompression, in my experience, people with actual 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.
Besides the obvious importance of only using spinal decompression in cases where it is really appropriate, it is very important for the machine operator to be well-trained to ensure proper set-up of the machine for the patient. There are several different decompression machines on the market, each with their own specific set-up procedures. Whatever machine is being used, it is critical to have ongoing refresher training for the operating technicians to be sure that all patients are being set up on the machine exactly right. While the better machines are unlikely to produce any major injury if they are not set up exactly right, results can suffer tremendously if the patient is not positioned and secured on the machine correctly on every visit. I highly suggest asking any spinal decompression provider how frequently the technicians undergo training and only work with those providers who do re-training at a minimum of every 3 months.
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 complete spinal decompression program of care that inclues decompression as well as additional treatments may seem expensive to some people. Since spinal decompression is an alternative to disc surgery though, a cost comparison with surgery will show spinal decompression to be much less expensive with statistically much better resuts, making it a good value in most cases. Even so, some people try to lower the cost by attempting to reduce the amount of treatment they get. In my experiences from my San Antonio office, this approach is often a very big mistake. The people who discontinue care prematurely will often feel better and return to activities before their disc condition is stable. This can lead to re-injury and even worse problems. In my opinion, it is far better to invest in the recommended treatment in order to get maximum benefits.
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 summary, spinal decompression is a very effective means of treating the pain and disability associated with herniated and degenerated spinal discs, but there are some important factors in getting maximum results. Doctors and patients alike are responsible for making sure the treament is done properly to get maximum results.
Dr. George Best specializes in the treatment of disc-related pain. For more information about spinal decompression in San Antonio, visit his website at www.spinesanantonio.com.