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 So the study listed on the VAX-D is not peer reviewed.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.
While I appreciate your article, it seemed quite slanted in trying to bring doubt as to the research papers. I’m sure you understand that it is quite challenging to arrange all studies to fit into certain peer reviewed journal’s requirements. But that in no way invalidates the usefulness of the study. So, in citing one example of one research paper does not invalidate this non surgical technique. By the same logic, if I were to show all the peer reviewed negative outcomes on spine surgery, then one could deduce that all spine surgery is not required.
Unfortunately, when it comes to the spine and difficult spine conditions, treatment can be quite difficult and many times it warrants an integrative approach among different specialists. One thing is certain, and that is non surgical spinal decompression is safe and it is often very successful for many people. It is logical to try the safer, less invasive treatments before jumping into riskier procedures.
The following group of doctors specialize in non surgical spinal decompression therapy. It’s effective more times than it’s not.
Thank you for your insightful comment. I appreciate you taking the time to help shed light on this subject.
I agree with you…if you show me peer reviewed studies (randomized controlled trials (RCT)) on the negative effects of spine surgery, I would deduce that all spine surgery is negative. BUT, there are RCTs that demonstrate positive effects of spine surgery, and I would not ignore those when deciding if spine surgery works.
I would be happy to review a peer reviewed RCT for spinal decompression if I could locate one. Many of the studies published are not randomized trials. If everyone in a study receives spinal decompression for eight weeks, did the spinal decompression make the patient better, did time make the patient better, or did the placebo effect play a role in the positive recovery of the patient? Randomization is important, and control groups are pretty essential too.
In this blog post, I do state that “spinal decompression may work” and it may be a helpful component of any spine care, but I have not seen the research to PROVE it.
I feel that the folks at VAX-D are making claims about the usefulness of their product by citing “published” studies. At least one study listed on their site isn’t really “published.”
I also contacted the author of the study in question to see if he had some more information about it (the outcomes; was he compensated by VAX-D) and to date have not received a response.
Again, thank you for your insightful comment. I must agree with you that treatment of spinal conditions should be an integrated approach of many specialists.
~Brett
For my readers, comment number one was posted by the American Spinal Decompression Association (ASDA). Their website is http://www.americanspinal.com/
~BAS
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