Spinal Decompression: Comprehensive Care for Back PainDr. Connie D’Astolfo December 1, 2010
Back pain does not originate from a single cause – there are hundreds of causes, from simple sprain/strains to more complex biomechanical faults, spinal disc herniations, arthritis, fractures, or even cancer.
In some cases, back pain is considered benign and self-limiting, meaning that it will resolve over the course of a few days or weeks, without therapy. This is typically seen in cases of minor spinal sprain/strains. Your back or neck may feel stiff and achy from sitting too long at your desk or improper sleeping postures. In these cases, stretching, hot baths, and spinal stabilization exercises will assist with recovery.
Back pain, however, may also result from more severe injury to joint tissue or bone, or may be a cumulative effect of multiple injuries, dysfunctions, and disease. Back pain may also be a consequence of referred pain from an internal organ such as the digestive tract, pancreas, or gall bladder, or may be a co-morbidity associated with another illness (most commonly depression, anxiety, diabetes, heart disease, and obesity). In fact, back pain is now considered by the World Health Organization as a “chronic disease” because of its complex nature and the huge impact it has on our health, productivity, economy, and quality of life.
A common treatment known as spinal manipulation is an effective treatment modality for many common biomechanical causes of back pain, including sprains/strains, degenerative disc disease (arthritis), spinal disc injuries, and chronic postural compromises. Spinal manipulation is practised almost exclusively by chiropractors, with the exception of a small segment of physiotherapists with advanced training in manual medicine.
A new treatment approach known as “non-surgical spinal decompression” has gained publicity and popularity over the past few years. Despite the growing body of evidence to support spinal decompression for back pain, there are certainly some misconceptions surrounding the therapy. Spinal decompression is essentially “revolutionized” traction. Traction has been used by chiropractors and physiotherapists for over 50 years to stretch the spinal tissues and relieve joint stiffness and pain. Spinal decompression is an advanced traction modality that has the capability to safely stretch spinal tissues within a controlled time period (known as intermittent traction), preventing spinal muscles from spasm. More exciting, the intermittent decompressive action of the spinal decompression table also recreates a process known as “imbibition,” the natural method for disc diffusion. Your spinal discs have the potential to rehydrate under the mechanical forces of the spinal decompression unit. Over time and over the course of many successive treatments, there is clinical evidence that spinal decompression reduces pain from irritated nerve tissue and/or damaged disc material for cases of herniated disc injuries.
In carefully selected patients, spinal decompression has the capability to safely decompress spinal segments, stretching ligaments, muscles, and joint tissues, and effectively treating disc injuries. Spinal decompression therapy, however, may not be appropriate for all causes of back pain, including some cases of advanced degeneration and advanced osteoporosis, and in post-surgical patients. Still, for the majority of cases (i.e. discogenic injuries, spinal stenosis, and degenerative disc disease), spinal decompression therapy is typically more effective when used in conjunction with other modalities and when a comprehensive management plan is used to address dietary compromises, stress, depression, poor ergonomics, and inadequate lifestyle choices.
Mr. Smith, a 45-year-old man, presented to our clinic with severe right-sided leg pain, some weakness, and numbness/tingling. He rated his pain a 9 out of 10 on the pain scale. The patient was unable to work due to the pain and had been off work for over 3 months. He had attempted months of chiropractic and physiotherapy with no success. After a thorough history, orthopedic evaluation, and review of his xrays and MRI, we diagnosed the patient with an L5-S1 disc herniation. The disc herniation had been irritating his right nerve root, causing severe, sharp, radiating pain down his right leg. As a consequence of his pain and disability, the patient had also become depressed and anxious. His history and exam also revealed high blood pressure, borderline elevated glucose levels (pre-diabetic), and significant weight gain since the onset of his disability. Along with his pain condition and depression, the patient was at high risk for heart disease and diabetes.
Over the course of six weeks at our clinic, Mr. Smith underwent eight sessions of spinal decompression, six sessions of spinal manipulation and sensory-motor rehab, four sessions of psychological counselling (cognitive behavioural therapy), and four sessions of dietary counselling with our registered dietician. After the course of his six- week treatment plan, Mr. Smith’s pain was reduced from 9/10 to a rate of 1/10. He lost 15 pounds, his blood pressure had normalized, and his glucose levels were reduced. With the help of psychological counselling, the patient also learned to reduce his anxiety levels. Mr. Smith was finally in control of his life and able to resume his normal daily activities. For an additional two weeks, we assisted Mr. Smith with a plan to return to work, and at the eight-week mark he had successfully returned to full work duties. The full cost of his treatment was less than half the cost of typical rehab care, with quick and positive outcomes.
The research is clear that some cases of back pain tend to reoccur and persist if any or all of these factors are not addressed. Due to its complex nature, a comprehensive approach is recommended to effectively manage back pain, including emphasis on pain management, education and reassurance, regeneration and repair, lifestyle modification, and functional rehabilitation. This approach ensures long-lasting restorative effects with fewer treatment visits and lower overall costs.