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.

In addition to the importance of applying spinal decompression only in the appropriate cases, it is extremely important for the doctor or technician operating the machine to set the patient up properly for the treatment. Several factors are involved, and every spinal decompression system has its own unique set-up procedure. Ongoing training of any personnel who operate this type of equipment is essential. It is very easy to get sloppy with setting up patients on the equipment, and this leads to ineffective treatment. Overall, because of the design of the better spinal decompression systems, even very poor patient set-ups rarely lead to patient injury, but mistakes in the use of the machine can definitely prevent the patient from getting the desired results and might cause a temporary flare-up in symptoms. To help avoid this problem, I recommend asking any potential spinal decompression provider you may be considering seeking treatment with about his or her training for the operators of the equipment. A one-time training done when the equipment was first received is simply not sufficient. I strongly recommend working with providers who perform re-training on the equipment on at least a quarterly basis.

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.

To summarize, spinal decompression can be an extremely effective treatment for people suffering with pain from bulging and degenerated discs, but it is important that doctors select patients for this treatment carefully and make sure that the technicians operating the equipment get refresher training regularly to be sure patients are being set up on the machine properly. Patients need to take the responsibility to follow the treatment recommendations to allow for maximum correction and healing.

Dr. George Best has been providing spinal decompression in San Antonio, Texas since 2006 with the DRX9000 system. For additional infomation, visit his website at www.spinesanantonio.com.

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