What is Spinal Decompression Therapy?
Spinal Decompression Therapy is the breakthrough treatment for herniated discs, bulging discs, degerative disc disease, neck and arm pain, low back and leg pain. To fully understand and appreciate what this therapy can do for you, let’s first talk about what an intervertebral disc is.
What is an intervertebral disc?
The intervertebral disc, or simply “disc”, is the material that exists between any two vertebrae in the spine, with the only exception being between ther first two bones in your neck in which there is no disc. The disc material is made up of fibro-cartilage and fibrous tissue at it’s circumference which are formed in concentric bands much like the bands or rings seen in a tree trunk. The center of the disc consists of a soft, yellowish colored, elastic pulpy matter known as the nucleus pulposus. The disc is shown in the figure below and is labeled #1.
The purpose of the disc is to separate the vertebrae far enough away from each other and provide space for the exiting spinal nerves from the spinal cord. The discs also help shape the curves in your spine and they act like shock absorbers throughout your whole back when you are involved in physical activity, such as walking and running. In a health disc, the rings that form the circumference of the disc keep the contents of the nucleus pulposus directly in the center.
What is a herniated disc and bulging disc?
Sometimes however, the rings that contain the nucleus pulposus can be broken down one by one over time, or all at once as in a sudden traumatic accident that the contents of the nucleus pulposus can no longer be maintained in their center/normal position. When this happens, the nucleus pulposus will migrate either off to the side (as shown in the figure below and marked item #17) and put pressure on your spinal nerves, or towards the back and put pressure on your spinal cord. The resultant migration of the nucleus pulposus is the basis of the condition of herniated disc or bulging disc.
If the disc is said to be herniated, then the nucleus pulposus has broken completely through all of the concentric bands of tissues (or retaining walls) and exits the disc. This is the worst possible scenario for the disc. If the disc is said to be bulging, then only some of the retaining walls have been broken and the contents of the nucleus pulposus are still be retained within the disc, however a lump of tissue or swelling develops along the outer wall of the disc.
Whether your disc has been herniated or is simply bulging, they are considered to be space occupying lesions. They are given this name because where there once was space, as in next to the spinal nerves or spinal cord, there is no more. The bulge or herniation is now taking up space where it doesn’t belong, crowding the spinal nerves or cord and this is the basis for the kinds of symptoms you will experience.
Symptoms of a herniated disc
When the nucleus pulposus ruptures through its retaining walls and puts pressure on your spinal nerves or spinal cord, the following symptoms will most likely develop:
Leg Pain: Most commonly experienced over the outside of the thigh, lower leg and foot. Shooting pain may be experienced coming all the way down the leg. Patients often describe an electric shock type of symptom.
Parathesias: This is the medical word for abnormal sensations such as tingling, numbness, or pins and needles. These symptoms may be experienced in the same region as the painful sensations.
Muscle Weakness: Because of the nerve irritation, signals from the brain may be interrupted causing muscle weakness, usually of the ankle. Nerve irritation can also be tested by examining the reflexes of the knee and ankle.
Bowel or Bladder Problems: These symptoms are important because it may be a sign of cauda equina syndrome, a possible condition resulting from a herniated disc. This is a medical emergency and you should see your doctor immediately if you have problems urinating, having bowel movements, or if you have numbness around your genitals.
Neck Pain and Arm Pain: If the herniation occurs in the cervical/neck region, accompanying pain and numbness exists in the nec and arms including the hands.
All of these symptoms are due to irritation of the spinal nerve or spinal cord from a herniated disc. By interfering with the pathway by which signals are sent from your brain out to our extremities and back to the brain, all of these symptoms can be caused by a herniated disc pressing against the spinal nerves or spinal cord.
Prior treatment and affects of herniated discs.
Up until now, the only way to try and treat herniated discs, disc bulges or degenerative disc disease has been with prescription medications, which has undesirable side effects, steroid injections, which only provide temporary relief, or orhtopedic surgery, which has proven to fail more than 50% of the time.
How Spinal Decompression Therapy Works.
Now that you have a good ideas of what a herniated disc is, let’s talk about how spinal decompression therapy helps to fix them. Spinal decompression therapy starts off by placing you on a comfortable table laying down on your back side. Your upper body and rib cage area is secured to the upper part of the table using a velcro support brace. A second support brace is wrapped around your abdomen just above your pelvis. A small cable is attached to the backside of this second support brace. This will serve as the decompression device. The table is then either raised or lowered. This alters the angle of pull form the computerized motor where the cable originates from which is situated at the foot of the table. The angle of pull determines the specific level where decompression takes place.
Now what makes a herniated disc so painful is two things: 1) the nucleus pulposus has migrated either off to the side or back putting pressure on the spinal nerve or spinal cord and 2) since the nucleus pulposus has been displaced, the overall height of the disc has decreased. This decrease in disc height will limit the amount of space between two adjacent vertebrae causing even more pressure to be exerted on the spinal cord and spinal nerves.
Therefore, the overall goal of spinal decompression therapy is to restore the proper spacing between two adjacent vertebrae and also to pull or suck the contents of the damaged nucleus pulposus back towards their normal middle position.
The way this is accomplished lies in the engineering of the table and the positioning of the patient. Since the patient is laying down on their back, with their upper body and rib cage fixed to the table, there is very little muscle guarding around the injured part of the spine. A feeling of weightlessness, with respect to the spine, is present. This is important because any type of muscle guarding will prevent the spine form separtaing back to its normal position and prevent true decompression from taking place. As the computer begins to draw the cable towards itself, a mild separation between two vertebrae begins to take place. Again, the exact level of separation, for example L4/L5, depends upon the height of the table, position of the patient and angle of pull from the computer.
Since the disc material is made up mostly of water, when two adjacent vertebrae begin to separate, a negative hydrostatic pressure inside the injured disc begins to take place. This negative pressure in turn draws anything immediately surrounding it back towards the middle, in this case, the contents of the nucleus pulposus gets drawn back into the middle of the disc where it belongs. This in turn removes the pressure off of the spinal nerve and spinal cord and an immediate sense of relief is felt.
It is important to note here that your normal everyday traction that you might receive at a hospital or physical therapy office using weights and pulleys can never create true decompression. There is no way possible for this type of system to create a negative pressure inside the disc to suck the contents of the nucleus pulposus back towards the middle. This is due to the muscle guarding reflex that still remains around the spine. What you get in effect is a basic tug-of-war between the entire upper body and entire lower body. Muscle strains are common with this antiquated type of traction.
How many treatments will it take to correct a herniated disc?
On the average, anywhere from 18-28 treatments are required to pull the contents of the nucleus pulposus back where they belong. Patients are typically seen three times a week, however, each case is unique and is evaluated as such. Each treatment takes about 25-30 minutes to complete. There is no pain associated with the treatment. Many people usually fall asleep while the therapy is being performed.
How long before I notice a difference in my symptoms?
Most people will feel a little better after the first treatment and usually begin to notice a reduction in their symptoms by the 7th or 8th treatment.
My doctor said I need surgery on my disc, what should I do?
At a minimum, get a second opinion. Remember, surgery, whether it is successful or not, is permanent. Plus, there are a lot of things that can go wrong during an operation. If the doctor accidentaly nicks a nerve, you can get paralysis of the lower legs, you can lose feeling in your legs and a lot of times, there is so much scar tissue that develops from the surgery that your symptoms can actually get worse. Sof if you are about to have surgery, you owe it to yourself to get a second opinion immediately.
With spinal decompression therapy, there are no side affects. Either it works for you or it doesn’t. And with an 86% success rate, there is a very good chance that you will benefit from treatment.
Are the results of spinal decompression therapy long lasting?
Yes, there is a very high index of satisfaction that patients relate even long after treatment has ended. Most people remain asymptomatic indefinitely. If your case is very serious in the beginning, you may need an occasional session or two every month or so to keep the contents of the disc in their proper place to prevent your symptoms from returning.
Will people still be able to work while having this treatment done or will they have to take a couple of months off?
Most all cases of people who have spinal decompression therapy done still work. But there may be some isolated situations where the kind of work you do may interfere with treatment.
If this is such a great treatment, why are most medical doctor’s recommending surgery or medications to correct herniated discs or bulging discs?
Because this technology is so new, many doctor’s do not even know it exists. It takes a lot of time and effort to learn about new things and many doctors are either not interested or do not have the time.
Also, medical doctors are conditioned to either write you a prescription for your back problem and if that does not work, they recommend physical therapy or surgery. And if you are taking prescription medication for a back problem consider this; you are trying to correct a mechanical/structural problem, that being the herniated disc and the compression of the spine, using a chemical solution, that being the medication. There is no way medication was was ever intended to correct this type of problem. It was designed to mainly mask your symptoms.
Let’s also mention that unfortunately there are financial incentives to perform surgery and this is not good either.
For people reading this article that are told they have a herniated disc and their doctor says they need surgery, why should they come in and see us?
All of the literature says that as much as possible, try to avoid surgery. Statistically less than 50% have success. Also there are a lot of variables and a lot of risk on top of that, you are going down a slippery slope of being predisposed to having back surgery even more frequently in the future and compared to spinal decompression therapy, you have an 86% chance or greater of success. Some doctors reporting even higher so that we can get the nucleus pulposus back to the middle through safe, non-surgical, spinal decompression.