If you have low back pain, you probably understand how debilitating the condition may be. The symptoms that you feel coming from your low back can prevent you from sitting, walking, working, and enjoying recreational activities.
There are many different treatments and modalities available for your low back pain or sciatica. One such treatment that has become quite popular is spinal decompression. Online, television, and print advertising are bombarding consumers with promises of improved function and decreased pain. But are the claims true?
Spinal decompression is a form of mechanical spinal traction. Spinal traction refers to the separation of the bones, joints, and discs of the back. It is theorized that separating the bones, joints, and discs in the spine relieves pressure on the nerves in the back and helps decrease pain, and thus, improve function.
Advertising for spinal decompression targets people with degenerative disc disease, bulging discs, herniated discs, or spinal stenosis. Common trade names of spinal decompression devices are the VAX-D System, the SpinalAid System, and the DRX-9000 System, among others.
Many spinal decompression systems are operated by the use of a computer, allowing the health care provider to adjust the amount of traction force, the angle of traction provided, or the amount of time the traction force is applied. Some spinal decompression units require that you lie on your stomach while treatment is rendered; others have you lie on your back.
Are There Risks Associated with Spinal Decompression?
A review of the published data for the use of spinal decompression reveals very little risk associated with treatment. One study reported on a patient who developed severe pain while on the unit. A follow-up MRI of the spine revealed that this patient’s lumbar herniated disc had increased in size. The patient subsequently had a lumbar surgery and it was reported that the patient recovered fully. Other studies report some increase in pain for a few participants.
Many insurance companies (including Medicare and Medicaid in the US) do not provide medical coverage for spinal decompression. Most cite the paucity in well-conducted research as a reason. Spinal decompression therapy is often considered experimental in nature. Therefore, another “risk” associated with spinal decompression is the risk of losing money. Many protocols for the use of spinal decompression involve you attending sessions multiple times per week for several weeks. The out-of-pocket expense that you may incur as a result may be excessive.
Does Spinal Decompression Help Low Back Pain?
The main theory behind spinal decompression is that providing traction to the compressed structures in the spine helps relieve pressure and pain. So traction must help low back pain, right? A study published in the 2001 issue of Physical Therapy Journal (PTJ) evaluated various forms of treatment for acute (symptoms for less than 4 weeks), sub-acute (4-12 weeks) and chronic (more than 12 weeks) low back pain. The published evidence available for the use of traction for low back pain received a grade of “C” (no benefit demonstrated).
Claims have also been made that spinal decompression creates negative pressure in the discs of the spine, which helps to pull bulging discs back into place. A published study reporting on three patients concludes that spinal decompression did lower the pressure in the discs while using decompression. This is a small study, however, and no cause and effect conclusion about spinal decompression and low back pain can be made.
Available studies examining the use of spinal decompression systems in the treatment of low back pain are of poor quality. This makes evaluating the claims made by proponents of spinal decompression difficult.
"There is very limited evidence in the scientific literature to support the effectiveness of non-surgical spinal decompression therapy. This intervention has never been compared to exercise, spinal manipulation, standard medical care or other less expensive conservative treatment options which have an ample body of research demonstrating efficacy. Considering the cost-benefit relationship, many better researched and less expensive treatment options are available to the clinician."
Simply put, there is limited scientific evidence that spinal decompression can help your low back pain. Does that mean that it does not work? Not entirely. It just means that the current level of research is not sufficient to draw positive cause/effect conclusions for the use of spinal decompression. There may be other more affordable options for you to consider when faced with treating your low back pain.
What Does Help Low Back Pain?
While many treatments are available for your low back pain, the scientific data indicates that maintaining normal activity is a good treatment (grade of “A” -- benefit demonstrated -- in the 2001 PTJ review) for acute low back pain. Exercises for your low back also received a grade of “A” for sub-acute and chronic low back pain.
The great thing about exercise is that it is a low-cost, easily implemented treatment. Your physical therapist can teach you how to improve your posture and implement the right exercise program for your specific condition to treat your low back pain.
Daniel, DM. Non-surgical spinal decompression therapy: does the scientific literature support efficacy claims made in the advertising media? Chiropr Osteopat. 2007 May; (15)7. (Published Online).
Martin, CW. Vertebral axial decompression for low back pain. 2005 Feb.
Ramos, G. Martin, W. Effects of vertebral axial decompression on intradiscal pressure. J Neurosurg. 1994 Sep;81(3):350-3.
Jurecki-Tiller, M. et al. Decompression therapy for the treatment of lumbosacral pain. 2007, Apr.