Spinal Decompression Proven To Be Ineffective?
One of the questions I receive on an almost daily basis has to do with the difference between spinal traction and spinal decompression. Although the mechanisms seem very similar there really is a very important difference. You see, when the spine is pulled in a traction type fashion the muscles of the spine actually react. They react by engaging and contracting to protect the delicate spinal cord and nerves. This protective mechanism is important, however not therapeutic to the disc because the pressures inside the disc don’t change and in some case they actually increase. True spinal decompression offers a very unique application in that as the spine is pulled there is feedback through a computer system that monitors the muscles guarding response. As the muscles engage the computer system backs off the pull and through a very sophisticated process the contraction is gently overcome. This leads to reproducible and consistent negative pressures inside the disc allowing an influx of nutrition and a decrease in bulging or herniated material. A very significant difference when compared to simple traction.
The above explanation is exactly why a recent study presented at the 2009 annual meeting of the International Society for the Study of the Lumbar Spine is very misleading. According to researchers from the Netherlands spinal decompression doesn’t work, and here is how they came to that conclusion. They took 60 patients that met the following criteria 1) they had low back pain of more than 3 months 2) they had radiographic evidence of a degenerative disc 3)or MRI evidence of a bulging disc. Every study subject was prescribed a course of physical exercise and then randomized into one of two groups: 1) 20 sessions on a machine marketed as a spinal decompression device and 2) sham spinal decompression which essentially was just static traction. The study subjects were blinded as to what treatment they received.
The researchers did find that the patients treated with the “spinal decompression” device in fact did have tremendous success. Their pain levels went from a 61 at baseline on a visual analog scale to 32 at the 14 week follow-up, there was also improvement in leg pain, Oswestry Disability Index Scores improved and there was a significant reduction in the use of pain medication. However, there was similar improvement in the sham group so the researchers came to the conclusion that spinal decompression doesn’t work. An interesting conclusion to say the least, now here’s my take on the study…
First, to be clear there was significant improvement in both groups. We all know the placebo effect is very powerful and if you recall from one of my previous blog posts there were similar results with vertebroplasty. A much more invasive and potentially dangerous treatment, but doctors wouldn’t accept the results. Why? Because they saw with their own eyes the clinical benefits in their offices on a daily basis. Another problem with this study is the machine used as the spinal decompression machine in my opinion isn’t spinal decompression, it was intermittent traction. And the only difference between both groups was that one was static (the sham group) and was was intermittent (meaning the table would pull on the spine with a relaxation in between). So essentially they were comparing traction to traction. My advice…have a third group utilizing either the VAX-D or the DRX9000 the only real spinal decompression devices on the market in my opinion.
So the bottom line, spinal decompression works and it works very well, especially on patients that have not responded to other treatments and are moving into a chronic situation. It’s safe and in my experience it is the best treatment for disc related low back and neck pain available today.
