Every Sunday morning, I see really big advertisements in the newspaper for a revolutionary new product to help treat low back pain. Non-surgical spinal decompression promises to help eliminate low back pain or sciatica and improve your function and quality of life. The trade name for many of these decompression units are the VAX-D, the DRX 9000, or the SpinalAid system. (Fancy, space age sounding names, right?) But does spinal decompression really work?
While researching the answer to the question, I came across many different websites for spinal decompression units. Some of the websites were run by doctors, physical therapists, or chiropractors. My favorite website was for the VAX-D system. I liked it because the site listed many different published studies that prove how effective the VAX-D is. It made my search for scholarly studies a lot easier.
One of the studies listed on the VAX-D site was "published" in the Journal of Orthopedic and Sports Physical Therapy (JOSPT). Great! I have access to that journal, and I can easily find the study to evaluate the power of the study and decide if the VAX-D system is really as great as the VAX-D folks say it is.
One problem: I couldn't find the study in the JOSPT. The study was not listed in the table of contents in the JOSPT edition that was cited in the study. As a member in good standing with the American Physical Therapy Association (APTA) and a member of the Orthopedic Section, I should be able to find this study.
I contacted the JOSPT via email about my inability to locate the study that the VAX-D website listed. I got a response quite quickly from Edith Holmes, Executive Director/Publisher of the JOSPT. She noted that the citation in question was listed as a poster presentation at the 2005 Combined Sections Meeting (CSM) of the APTA. These lists are usually tucked in the back of the JOSPT during the month of the CSM. She went on to write, "The abstracts are presented here as prepared by the authors. (her bolding) The accuracy and content of each abstract remain the responsibility of the authors."
I responded to her with gratitude, and asked if those abstracts presented at the CSM were peer reviewed. She responded, "JOSPT does not peer-review these abstracts." (Peer review is important. It pretty much says, "Hey, this is a well-designed study and the results should be considered highly when making clinical decisions.")
Oh. So the study listed on the VAX-D is not peer reviewed. But the abstract is published. In the very back of the journal. Gotcha.
So back to the original question: Does spinal decompression really work as it says it does? The data available is from poorly designed studies that are very weak. Some of the studies, although "published," are not even peer reviewed.
Spinal decompression is a form of lumbar traction, and lumbar traction received a grade of "C" (no benefit demonstrated) in a (peer reviewed) study published in the October 2001 issue of Physical Therapy Journal. Spinal decompression may work, but we really can't prove it works. Plus, many insurance companies don't provide coverage for spinal decompression, so the out of pocket expense may be great.
Proven treatments for low back pain include advice to remain active, exercise, and maintain good posture. Your physical therapist can help you decide which exercises to perform to help you recover quickly from your episode of low back pain.
Have you used spinal decompression to help treat your low back pain? If so, please share your story and let us know how things turned out.