Chiro Corner – Spinal Decompression
Non-Surgical Spinal Decompression is a treatment that gradually lengthens and decompresses the spine. The traction generated by the spinal decompression creates a negative pressure within the discs and helps restore normal spinal movement and function. Although the idea of spinal decompression has been around since Greek antiquity, Former Deputy Minister of Health in Ontario, Canada, Allan Dyer, MD, PhD is credited with the development of the heart defibrillator as well as non-surgical spinal decompression. Inspired by his own back pain, he pioneered the modern computerized spinal decompression. In 1991, Dr. Dyer introduced the VAX-D; this equipment was effective, but expensive, only treated the low back, and forced the patient to lay face down. In the late 1990’s other manufacturers began producing their own versions of non-surgical spinal decompression machines, and each of these manufacturers claim their equipment is better than that of the competition. You can think of these different types of decompression tables as automobiles. Yes, there are differences in how they look, but they all work the same way. Some have more stainless steel, some have DVD players, but to date there aren’t any published findings showing one is better than the other.
How does it work?
The discs of the spine are under constant pressure, which greatly slows the rate of healing. This pressure is measured in mmHG, just like a weather barometer. While you are standing, the gravitational load from your upper body plus the muscular tension within your spine creates 100mmHg of pressure within your lumbar spine. There is enough muscular tension keeping your spine together that, when you are lying down, the pressure still measures 75mmHg. Inversion tables use gravity to help reduce this pressure and stretch the tight ligaments and muscles of the lumbar spine only. Inversion therapy has been shown to reduce this pressure in the lumbar disc by over half (40mmHg) when compared to lying down, but has some significant drawbacks with treatment as discussed in the July issue of Pain Monthly magazine.
The decompression machine has a specific cycle that is determined by the doctor. The machine can be set up to focus the tension in the lumbar region or the cervical spine (neck). It begins with a slow logarithmic increase in tension, which allows a negative pressure to occur within the disc. Then, after a holding period, the machine will slowly release the tension. This is critical to avoid muscle guarding and spasm and achieve a therapeutic effect. A negative pressure of approximately -160mmHg is created by this sequence of motions. This negative pressure creates a vacuum-like effect within the discs. Repositioning and drawing in of the jelly-like fluid within the discs called the nucleus pulposus occurs due to the vacuum. The discs in your body are living tissues, but lack a direct blood supply. Like the other cartilage of your body, the discs of your spine get oxygen and nutrients through movement by a process called imbibition. The intradiscal vacuum created by the decompression treatment is thought to draw moisture, nutrients, and oxygen back into the discs from the vertebral bones above and below.
Although pain might start to subside within a few NSSD treatments, it is crucial to continue a treatment regimen. Spinal decompression treatment consists of about 12-25 sessions spanning a four to six week period and can be utilized in conjunction with other interventional procedures when trying to avoid surgery. The number and the length of time the treatment sessions span are dependent on the patient’s condition. The lack of pain does not indicate a full recovery, as any trauma to the disc wall takes time to heal properly. Given the chance, non-surgical spinal decompression can help ameliorate chronic neck and low back pain.
Who is a candidate for spinal decompression?
There are numerous structures in the spine that can cause spinal pain. The first and most important step in treating pain is to find out what is causing your pain and get an accurate diagnosis. It is important to note that patients may have similar symptoms, but different diagnoses and therefore should be treated differently. People suffering from bulging or herniated discs, degenerative disc disease, stenosis, facet syndrome, or those that have had a failed back surgery without hardware are all eligible candidates for non-surgical spinal decompression therapy. Patients are not candidates for spinal decompression if they have surgical hardware, metatastic cancer, severe osteoporosis, recent vertebral fracture, are pregnant, or suffer from unstable spondylolisthesis.
-Dr. Chance Moore, Chiropractor
