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The last few years, spinal decompression has been widely publicized as a breakthrough in spinal disc herniation treatment. But the treatment has received some negative reviews by skeptics and some promoters of the technique have been the subject of disciplinary actions by various regulatory agencies for certain advertising claims. So does spinal decompression offer new hope for disc pain sufferers, or is it just a hoax? Let’s begin by first discussing what spinal decompression is… Spinal decompression is a ”high-tech” form of spinal traction. Despite the great lengths that decompression system manufacturers go to in order to distinguish decompression from traction, decompression IS a type of traction. Traction has been used for many years in the treatment of herniated discs, but with minimal effects in many cases, and it even aggravated symptoms in some patients. The problem with regular traction is that it activates the body’s muscle guarding response and can trigger muscle spasm, which produces pain and may even result in increased pressure on herniated discs.
Spinal decompression systems have supposedly solved this problem of provoking muscle guarding. True spinal decompression systems pull very slowly and gradually in order to keep the muscles relaxed and avoid triggering spasm. In addition, the more advanced of the spinal decompression systems also have computer-controlled motors and have sensors to measure the body’s resistance to treatment. Any hint of muscle contraction sensed by the system causes it to reduce its pull and allow the body to relax again. The most advanced of these systems can respond to what the body is doing in an amazing 1/17th of a second. Since the body’s reactions take place in approximately 1/5th of a second, these advanced spinal decompression systems can supposedly modify treatment before the muscles can spasm, allowing for comfortable herniated disc relief. In my experience, advanced spinal decompression systems do in fact provide very comfortable treatment and avoid the muscle spasm responses in most patients.Â
This ability to avoid the body’s muscle spasm response allows spinal decompression systems to dramatically lower the pressure within a herniated disc. This has been shown in research studies that measured intradiscal pressure during decompression treatment. Prior studies on regular traction did show some reduction in disc pressure, but not nearly as much as has been demonstrated with spinal decompression. In fact, during spinal decompression, disc pressure is actually dropped into the negative pressure range, creating a suction that pulls the bulging disc material back towards the center of the disc and away from sensitive nerves. In addition, fluid and nutrients are pulled into the disc from the surrounding tissues, and this assists in disc healing. Over time and repeated treatments, the herniated disc material is pulled back in, and the healing of the disc provides stabilization of the outer wall of the disc to prevent further bulging.
The frequency and duration of spinal decompression treatment will vary depending on the age and condition of the patient, the severity of the herniated disc, and the number of herniated discs. Spinal decompression can be used in both the lumbar and cervical spine very effectively.
Statistically, spinal decompression with the more advanced machines, and with appropriate patient selection has a success rate in clinical studies of 80-90%, and of those who are successfully treated, the results hold up well long-term in most cases. In the real world, with real patients who have real lives and not everything is as controlled as it is in a research study, the actual success rate is somewhat lower. In my experience, the real-world success rate runs about 70 to 80% (with effects lasting one year or more), depending on the severity and complexity of the case. This is still very respectable in the realm of disc treatment, where the success rate of things like injections and disc surgery run about 50% overall. Given the success rate and the fact that the most common side-effect is some temporary post-treatment muscle soreness, spinal decompression is often the best option in herniated disc treatment.
Unfortunately, the aggressive advertising and hype, and inapproriate use of spinal decompression by some health care practitioners in recent years has led to unrealistic patient expectations and crackdowns by regulatory agencies on advertising claims that have sullied the reputation of spinal decompression. While spinal decompression does represent a major advance in the treatment of herniated discs, it is not a cure-all, it is not 100% effective, and it is not appropriate for every patient.
Spinal decompression, when used appropriately, does produce enough improvement and disc healing in the vast majority of cases to allow patients to resume normal lives and return to most activities (even playing golf or tennis and working in the yard), but it does not restore a herniated disc to 100% normal. No treatment can. Even the still-experimental disc replacement surgery does not restore the spine to a normal condition and future back problems following disc replacement are to be expected. Overwork, poor posture, or failure to use good bending and lifting techniques can set the stage for a recurrence of disc problems no matter how good the results of treatment are initially.
With appropriate patient selection and by giving patients realistic expectations, spinal decompression providers can supply a very safe and effective treatment option for those with a herniated disc.