Low back pain or lumbago is a common musculoskeletal disorder affecting 80% of people at some point in their life. The can be either acute, sub-acute or chronic in duration. Chiropractic care involving spinal manipulations is considered a safe, efficient treatment for low back pain. Chiropractic is a health care system devoted to the non-surgical treatment of disorders of the nervous system and/or musculoskeletal system, generally done by special chiropractic doctors, quite efficient in carrying out spinal manipulation and treatment of surrounding structures.
While treating lower back pain, differential diagnosis using a triage concept of classifying low back injuries into categories helps to steer the doctor of chiropractic. These categories of chiropractic diagnosis include:

1. Potentially serious: tumor, infection, fracture, major neurological problem, local open wound or burn, prolonged bleeding (hemophilia), artificial joint implant problems, pacemaker problems, joint infection. In such case the chiropractic practitioner typically refers the patient to a relevant medical specialist or a surgeon, and chiropractic doctor may co-manage the patient’s care with other back pain specialists

2. Sciatica: it happens when the nerve root in the low back is pinched or compressed. The chiropractic method for such cases involves describing the symptoms experienced by patients.
3. Non-specific: when there is mechanical back pain in the lumbar spine (most common type of presentation). The chiropractic remedy for this category also involves detailing the symptoms.

With chiropractic analysis of potentially severe injuries, chiropractic manipulation is generally avoided over the relevant anatomy, although it may not be lined out on other areas. Doctors of Chiropractic, more commonly called as chiropractors, typically care for conditions involving lower back pain and/or neck pain through hands-on chiropractic care, including:

1. Spinal manipulation or adjustment: This chiropractic method involves a high-velocity, short lever arm thrust that is applied to irregular vertebra with the aim of improving functionality, reducing nerve irritability and restoring range of motion in the back, this manipulation is also known as chiropractic adjustment.

2. Mobilization: Chiropractic Mobilization aims to increase the range of motion in muscles and joints by applying low velocity manipulation, movement and stretching of those muscles and joints.

The chiropractic treatment plan is determined by the patient’s pain, disability issues and activity intolerance. Patient education with the supervision of the chiropractic doctor is significant to reduce anxiety levels that often accompany intense low back pain. The plan recommends chiropractic care 3-5 visits/week over 1-2 weeks. If no significant improvement is noted, the patient should be referred to another chiropractic expert or other appropriate chiropractic methods must be undertaken.
Furthermore, most chiropractic health centers offer a range of health services, such as:

Physical therapy: In various chiropractic methods, various types of equipment (ultrasound, traction, electrical stimulation, etc.) may be used with the aim of reducing back pain and inflammation.
Exercises: A range of cardiovascular, stretching and strengthening exercises may be prescribed by chiropractic doctors to decrease lower back pain, increase strength and restore range of motion.
Pelvic stabilization:. When flat feet and/or subtalar instability are present, the chiropractic doctor places a small heel lift in the shoe on the short leg side or prescribes corrective arch supports to help stabilize the pelvis.

Ergonomic: During the tenure of chiropractic care, the chiropractic practiotioner may advocate some procedure that should be employed at home and/or at work.

Patient education: Chiropractic care also involves advising a variety of lifestyle modifications including diet and nutritional programs to the patients suffering from lower back pain.
The doctors of chiropractic do not use any drugs or surgery in their practice. However, sometimes a chiropractic doctor may recommend that the patient to consult another practitioner.

When nearly 80% of the adult population in the United States say, “Oh, my back hurts,” at some point of time in their life, it becomes necessary for us to delve into the various aspects of back pain diagnosis. We usually relate this pain to the neck, upper back, lower back, and tailbone but actually, pain in the back can occur suddenly in any particular place or radiate to other areas; it can be chronic, constant or intermittent. So how do we know which type of back pain we have? Here are some ways to find out –

1. Physical Examination: Usually the discomfort of backache eases off on its own after a while. But if you do not get relief even after three days, it is better to consult your health care provider. Back pain diagnosis is usually done using a patient’s history and detailed physical examination. The examination reveals reasons for the ache, its location, and duration under various physical conditions. During the examination, spine movement is tested and lower limb muscles are stretched. Previous records of kidney and pancreatic disorders also help in diagnosing conditions related to health background and age.

2.X-rays: These are done to check the alignment of the spine. Electromagnetic radiations take images of bones and internal organs and are generally painless. An X-ray of the spine, namely discography, causes discomfort and requires injections. This is recommended to identify the location of an injured disc, a main back pain cause. Small amounts of radiation pose minimal risk of damaging cells irrespective of age. The procedure could be over in a few minutes or take a while in case of a serious complication.

3. Magnetic Resonance Imaging (MRI): This is another method of back pain diagnosis. It provides well-defined images of bone and soft tissue and serial slices through the lumber spine; helps detect annular tears, disc fragments and can even reveal infection and cancer. You have to however, remember that MRIs are costlier than X-rays and sometimes lead to unnecessary surgeries even when someone with a protruding vertebral disc does not complain of back pain.

4. Nerve Conduction Studies: Here surface electrodes are attached to the skin to monitor electrical functioning of muscles and nerve. The time taken for the impulse to travel from one electrode to another in noted down. This is used in back pain diagnosis to help confirm compression of nerves caused herniated discs or abnormal narrowing in blood vessels. It is also used to diagnose carpal tunnel syndrome, a peripheral nerve disorder.

5. Electromography (EMG): Here wire electrodes are inserted into a muscle briefly and electrical activity noted visually on a screen. This procedure is quite painful and is recommended by a physician when a patient complains of weakness and numbness in the affected area. Muscle disorders like muscle dystrophy and nerve disorders such as peripheral neuropathy, nerve root compression, and amyotrophic lateral sclerosis are detected through this test.

Triton DTS

The Triton DTS represents the finest Decompression Therapy System available today. Lumbar, Cervical and Wrist Decompression Therapy can be delivered utilizing the Triton DTS in a controlled and proven method, all at a fraction of the cost of competitive devices.

The Triton DTS represents 25 years of experience in design combined with a revolutionary belting system designed for quick setup, comfort and effectiveness.

Realizing the time constraints of today’s clinician, the Triton DTS utilizes a quick setup belting system for both spinal and wrist Decompression Therapy, with memory recall, allowing you to belt-up and start treatment in as little as one minute.

Triton DTS delivers exact force, continuously monitors progress and makes adjustments to poundage due to muscle guarding or patient relaxation. With each decompression pull the friction free table overcomes gravitational forces, and returns to a neutral position through a recoil device. Flexibility is a priority, so the Triton DTS includes Cervical and Wrist Decompression attachments. A High Volt Stimulator is included to improve local circulation to the target tissue and relax muscles. DTS includes a Stabilizer Biofeedback device for the rehabilitative phase assuring that your patient regains control of the core stabilizing muscles in the low back. Traditional techniques have not proven to be very effective on chronic disc related low-back and neck conditions. Considerable research has produced a relatively new therapy that is upwards of 80% effective in treating chronic disc problems. This treatment, known as Decompression Therapy, has opened the floodgates of new patients to the Chiropractors offering this therapy.

One of the most common questions about Decompression Therapy is “what’s the difference between Decompression Therapy and traditional traction or flexion/distraction”? Obviously we are using a “Y-Axis” traction force but we are using it differently. The provable outcome of traditional traction or flexion-distraction is distraction and mobilization. Various live human studies have proven that traction and flexion distraction can cause spinal musculature to guard producing a significant increase in systolic disc pressure. Proponents of the Cox Technique point to cadaver studies showing a resultant negative pressure, however living people tend to still be able to muscle guard (reflexive and anticipatory) which has been proven in study after study to actually increase disc pressure.

Decompression Therapy uses a tractive force that is carefully applied in such a manner as to overcome the patient’s ability to anticipate or reflexively guard against the force thereby creating total relaxation in the spinal musculature. This relaxation has proven to create the conditions necessary to unload the vertebral segments causing significant negative systolic pressure in the disc. Enough that most herniations can be non-surgically retracted and collagenous binding can begin where tearing of the annular fibers has occurred. Think of it like this, the only way to achieve decompression in the spine is to separate bones. If all of the barriers to decompression are not overcome the best you can hope for is soft tissue separation and a potential increase in disc pressure.
So what are the barriers that must be overcome in order to accomplish disc decompression (true unloading) and not just soft tissue distraction?

1. First the patient must be in a correct and comfortable posture and the table must accommodate all types of morphology. Postures: Prone Holding (very slender patients, patients with breathing problems, patients with thoracic herniations [rare]), Prone Restrained (patients with upper extremity compromise, patients who can’t lay supine) Supine Angular, (patients who can’t lay prone, large breasted women, budweiser challenged men, angled pulls at specific vertebral levels), Side Lying Pulls, (patients who are unable to lay prone or supine, antalgia), Positional Pulls, (patients who are severely antalgic; it is important to mirror the angle of antalgia and not straighten patients who have a protective scoliosis). The table must be stable and be able to lift large weights. Table surfaces must be able to place the body into flexion or extension or into a recumbent supine posture.

2. A belting/restraint system is necessary and must focus distraction directly to the iliac crests with correct center-line pull axis. There must be no venous or breathing compromise. The belting process must be quick, efficient and comfortable. Otherwise the patient becomes frustrated and tense, anticipating an uncomfortable and lengthy treatment.

3. A Split Table is necessary and must go from frictional Z-force resistance to free floating in a controlled release fostered by a retraction mechanism. There must be no spike in poundage as Y-Axis force is applied. The body will react to any spike in poundage with muscle guarding.

4. A controlled progressive onset of Y-Axis pull to peak force over at least 120 seconds. This pull features at least 3 incremental steps to peak poundage with a rest at each incremental step. We are sneaking up on the body with the force. This prevents guarding.

5. A cycled release from peak poundage during treatment to a REST poundage that does not release tension. Cycles must be quantified and reproducible. Release from peak to rest poundage must be aided by a retraction mechanism which improves the intermittent aspect and thus imbibition.

6. A controlled regressive release from peak force over at least 120 seconds. This prevents spasm and allows for a comfortable return to a positive systolic pressure in the disc. We don’t want to undo any collagenous binding of the annular fibers with sudden repressurization of the disc.

The key to gaining negative disc pressure is to reduce the MIS-APPLICATION of force. Decompression Therapy is highly specific and codified and reproducible. It’s sole outcome is directed towards improved disc healing based on known mechanisms of the preeminence and predominance of the disc’s role in back pain. Overcoming the barriers to decompression creates a complete state of comfort and relaxation; bones separate and decompression occurs.

What is Spinal Decompression Therapy?

Spinal decompression therapy is a non-surgical, comfortable traction therapy for the relief of back and leg pain or neck and arm pain. During this procedure, by cycling through distraction and relaxation phases and by proper positioning, a spinal disc can be isolated and placed under negative pressure, causing a vacuum effect within it.

What can this vacuum effect do?

The vacuum effect accomplishes two things. From a mechanical standpoint, disc material that has protruded or herniated outside the normal confines of the disc can be pulled back within the disc by the vacuum created within the disc. Also, the vacuum within the disc stimulates in growth of blood supply, secondarily stimulating a healing response. This results in pain reduction and proper healing at the injured site.

What machine is used for this purpose?

There are a number of spinal decompression machines presently used in the United States. After significant research, Hopkins Clinic for Physical Medicine has chosen to use the Triton DTS machine manufactured by Chattanooga, Inc., the premier manufacturer of physical therapy machines.

Who can benefit from Spinal Decompression Therapy?

Spinal decompression therapy is designed to unload the spinal disc. Any back pain or neck pain caused in whole or in part by a damaged disc may be helped by spinal decompression therapy. These conditions include herniated, protruding or bulging discs, spinal stenosis, sciatica or radiculopathy (pinched nerves).

Are there conditions where Spinal Decompression is not indicated?

Spinal decompression therapy is usually not recommended for pregnant women, or patients who have severe osteoporosis, severe obesity or severe nerve damage. It is not recommended for patients over 70. However, every patient is evaluated on an individual basis. Spinal surgery with instrumentation (screws and metal plates or “cages”) is also contraindicated. Surgery to the discs without fusion or fusion using bony replacement is not contraindicated.

How often do I take treatment sessions? How long does each session last?

Each session includes decompression therapy and spinal stabilization exercises and takes about 1 hour. Spinal decompression is usually performed 3-5 times a week for 15-20 sessions.

What are the results of Spinal Decompression Therapy?

Over 70% of patients have good pain relief. This success rate is similar to surgical results.

I have had spinal surgery, but continue to have pain. Can I try Spinal Decompression Therapy?

Spinal decompression therapy can help people with back pain after failed spinal surgery. It can be performed in most patients who have not been left with an unstable spine after surgery.

Do you suffer with low back pain, neck and carpal tunnel?  Have you been told you need back surgery?

Decompression Therapy is an effective treatment for these conditions. It is very affordable, less expensive than surgery.

You may refer to our -FAQs for more information and helpful answers about this non-surgical treatment.

The Decompression-Reduction-Stabilization therapy is an effective treatment for:

• Herniated Disc
• Degenerative Disc
• Facet Syndrome
• Sciatica
• Post-surgical Patients
• Spinal Stenosis

Do you have a herniated disc, multiple herniated discs, degenerative disc disease, facet syndrome, or any other type of spinal problem? Is you doctor suggesting surgery, pain management or physical therapy? Have you tried Chiropractic and just could not get enough relief?

Research indicates the disc is responsible for a significant number of lumbar/leg pain and neck/arm pain syndromes. Compression increase intradiscal pressure leading to annular compromise and possible extrusion of nuclear material.

Since the disc is an avascular structure, it doesn’t receive fresh blood and oxygen with every beat of the heart. It requires “diffusion” created by motion and ‘decompression’ to restore nutrients and enhance healing.

Decompression is defined as reduction in pressure (intradiscal). Recumbent positions (both prone and supine) decrease intradiscal pressures in comparison to standing and sitting. However focused, axial mechanical+Y translation traction, (creating ‘decompression’ i.e. unloading due to distraction and positioning) has been shown to reduce disc pressure and enhance the healing response even further.

There is some suggestion in the literature that extruded nuclear material may be “drawn in” by the reduction of intradiscal pressures. This concept however is not uniformly accepted since the length of time the material stays ‘drawn in’ has not been established in controlled studies. However, a temporary reduction in intradiscal pressure can still have a profound effect on the healing process via increased contact with the blood supply and fibroblast migration (so called phasic effects). This is in addition to the pain relief created neurologically by stretching soft tissue (e.g. stretch receptors, mechanoreceptors etc.) make decompression therapy a logical and viable addition to a “passive” pain care regiment.

Clinically it is important to establish criteria both in the utilization of Decompression therapy and in defining its utility. (As with many therapies, hyperbole and overstatement are common.) Axial Decompression (both lumbar and cervical) is first and foremost a “passive” therapy and as such has definite limitations in “curing” a chronic musculoskeletal condition. Its value is most specific in helping referral pain not solely low back or acute low back pain (symptoms for which manipulation has proven beneficial).

Loss of local muscle control, abnormal posture and alterations in spinal curves are the probable underlying source of most spinal ‘compression’ and degeneration. Therefore a “passive” therapy has little effect in truly fixing the underlying problem.

However, that being said, Decompression therapy (done safely within established protocols and a clear understanding of it’s limitations) can often effectively enhance the healing process and render quick, effective and often amazing pain relief in a properly selected patient population (many who have previously failed other treatments). Additionally it may also be very useful in determining the overall prognosis of passive care and expediting the phase-in of rehab protocols.

Indications and Use

Any non-acute (>1 week) low back or neck pain syndrome not related to a disease process, canal stenosis or acute strain/sprain injury is theoretically treatable by decompression. Disc and facet pain can often be relieved by early intervention with decompression. The acute inflammation of injuries however should be reduced by other means, in most cases, prior to beginning Decompression. Contraindications are similar to manipulative therapy, however since mechanical stretch creates no impact, mild to moderate Osteoporosis may not be contraindicated. (This holds true overall for frail and elderly patients who could potentially be injured by manipulative thrusts. Disc fragmentation, calcification, severe arthritis and any surgical spinal appliances are all relative contraindications.

Our clinical findings suggest Decompression will create a relatively quick initial response. Patients who will do well tend to feel a sense of relief (which can be direct pain cessation or a centralization of pain and/or reduction to an ache or stiffness) within six sessions. Full relief, if attainable through this passive treatment will usually be in 8-12 sessions. (Occasionally a ‘stubborn’ pain syndrome may continue to improve slowly over 15+ sessions though this is not the norm). Often patients will be treated 4-6 sessions and notice enough relief to allow active rehab to begin. Their Decompression may continue (pre or post rehab depending on the methods chosen) for 4-6 further sessions before discontinuing or reducing the frequency.

Typical frequency is 3-5 times per week. The extent and seriousness of the symptoms will determine if more than three sessions per week should be utilized. Our experience suggests Decompression is also an excellent supportive or maintenance treatment for those cases where pain relief is marked but prone to exacerbations.

The Triton DTS represents the finest Decompression Traction System available today. Cervical, lumbar, and wrist Decompression Traction can be delivered utilizing the Triton DTS in a controlled and proven method.

Decompression therapy is very affordable and cheaper than surgery. Spinal Traction is highly recommended by Neurological Research. It was found that out of 778 cases of patients receiving spinal decompression 92% said that they showed improvement (Neurological Research; Volume 20, Number 3, April 1998).

Spinal Disc Decompression, utilizing Decompression-Reduction-Stabilization, is a unique, non-surgical therapy developed for the treatment of chronic lower back pain, herniated discs and degenerative disc diseases.

The Spinal Decompression table in conjunction with additional modalities effectively relieves the pain and disability resulting from disc injury and degeneration, by repairing damaged discs and reversing dystrophic changes in nerves. Spinal Disc Decompression addresses the functional and mechanical aspects of discogenic pain and disease through non-surgical decompression of lumbar intervertebral discs. Studies verify the significant reduction of intradiscal pressures into the negative range, to approximately minus 150 mm/HG, which result in the non-surgical decompression of the disc and nerve root. Conventional traction has never demonstrated a reduction of intradiscal pressure to negative ranges; on the contrary – many traction devices actually increased intradiscal pressure, most likely due to reflex muscle spasm. The Decompression table is designed to apply distraction tension to the patient’s lumbar spine without eliciting reflex paravertebral muscle contractions.

By significantly reducing intradiscal pressure, Spinal Disc Decompression promotes retraction of the herniation into the disc and facilitates influx of oxygen, proline and other substrates. The promotion of fibro elastic activity stimulates repair and inhibits leakage of irritant sulphates and carboxylates from the nucleus. The most recent trial sought to correlate clinical success with MRI evidence of disc repair in the annulus, nucleus, facetjoint and foramina as a result of treatment and found that reduction of disc herniation ranged between 10% and 90% depending on the number of sessions performed, while annulus patching and healing was evident in all cases.

The most recent clinical study of 778 patients has showed that Disc Decompression Therapy was more than 70% successful in the treatment of herniated discs, degenerative disc disease, facet syndrome, and sciatica. In this same study, 92% of patients had a reduction in their pain of at least one point on the 0 to 5 scale.

I learned that my back’s vertebrae were compressed together and pinching nerves…

“Before I came to Dr. Adorable, I had pain in my lower back and neck everyday. I then learned that my back’s vertebrae were compressed together and pinching nerves. After 3 weeks of treatment, my pains began to go away and are now obsolete. Every morning I wake up, I am very grateful for everything that everyone in Advanced Wellness and Rehab Center has done for me.” – Brian Pelleg

“I’ve definitely noticed a big improvement in my neck and back, especially when I compare the current “busy season” at work with last year’s “busy season.” My job requires long hours and last year I would be in so much pain in an hour after getting to work. This year I can go the whole day without pain and still be able to get things done in the evening without worrying about pain. Last year I took my heating pad with me to work and this year it hasn’t come out of my closet.” – Rachan Vij

“Decompression table has helped me in that I used to have lower back pain after doing certain jobs at home, especially weed-eating the lawn. I no longer have that pain. I also used to have just some minor pain some days from sleeping wrong. This has practically gone away.” – Jim McInnes

“I have suffered from neck, shoulder and back pain resulting from an automobile accident in January 1973. During all those years, I have tried numerous treatment plans, stopping short only of surgery. The odds the surgeons gave me were not attractive. After just a short treatment period using the decompression table and chiropractic manipulation, I am finally pain free most of the time. On those rare occasions when the pain recurs, just a short period of maintenance on the decompression table fixes it right up. I recommend this treatment highly to anyone with neck and or back pain. The treatment is great and so are the staff and doctors!” – Lynne True

“I have had a fusion at L4 & L5 and an electronic pain stimulator implanted, but still I have had extreme back and leg pain, unable to sit, stand or walk for any length of time, unable to do house work or have a social life or my favorite- shopping. I had just about given up, crying with the pain when I came to Advanced Wellness. I was so impressed with Dr. Adorable and his knowledge and profound interest to help. I started the decompression therapy. I am truly thankful to have found an answer to my pain without another surgery. After the first session my limp was almost gone. I’m so excited to continue my treatments! To smile and laugh again! Everyone here are so kind and considerate.” - Devona Fish