Tag Archives: decompression

Inversion Tables

One question I have been asked often lately is what I think of inversion tables/therapy. To be honest I hadn’t really thought much about this particular method of spinal decompression.

Table from Relax the Back

On further investigation it appears to be just what I expected, generalized spinal decompression.  Research is sparse and biased, but the theory seems sound.  When you stand all day gravity pulls you down which causes compression of your body and the specific anatomy that is designed to handle compression is your spine, specifically  the intervertebral discs.  One related fun fact is that you are taller in the morning than at night.  Your discs take on fluid all night long while there is no pressure on them from gravity and are full when you wake up.  All day long that fluid is compressed out, thus you shrink.  Inversion tables allow you to reverse that trend for a few minutes.  So if you are experiencing back pain due to compression these tables may provide some relief, or even allow the body to heal.

I would say that it is safe, but would not recommend this therapy to people with cardiovascular problems, glaucoma, are pregnant, or other conditions where increased pressure going the opposite direction could cause problems.  I would also recommend having another person present when using this therapy in case something does go wrong.  There are decompression tables that can be used without the risks of inversion.

One thing I should mention; in any form of decompression if you have a sprain or strain it will increase, not decrease your pain.  In this case you would just be pulling on already injured soft tissue.  Decompression is more for chronic pain, not acute sprains or strains.  I have seen success with patients in using the more specific decompression, but they are always in my office and monitored.  I have not had first hand experience with inversion.  If it works for you then by all means use it.  Inversion products range from $100’s to $1000’s.  You could also just hang upside down at your local jungle gym.

Spinal Decompression

Decompression is the newest form of traction.  Traction has been around for decades.   The modality of traction has developed over time as have most treatments.  The theory behind it is that over time or with serious injury the discs in your spine can become compressed or herniate.  This can cause irritation and pain.  PIC-0121Essentially you get pain in your neck or back or even radiating to your arms or legs.  Decompression takes this pressure off for a time, allowing your body to recover and heal.

Patients will usually feel relief almost instantly while on the decompression table.  With the Chattanooga table that we use you put a belt around your waist and one around your chest for low back issues.  For neck issues you put your head on a little pad that sits just below the base of your skull.  You lie comfortably on a table as a gentle pressure pulls the weight off of specific regions of the spine.  Treatments vary from person to person.  Anywhere from 5 to 20 treatments is normal.  I do not normally recommend more treatments than that unless we are seeing constant and steady improvement.

PIC-0122Decompression can be used as a lone treatment or in conjunction with other modalities.  It is often used for disc herniations, sciatica, radicular symptoms (pain down the arms or legs), or low back pain that does not respond to other treatments.  If the injury is acute this therapy can cause some discomfort, and should be discontinued if it is painful.  The number one side effect that I have noticed is that during treatment the patient feels great and they get used to feeling good, but when getting off the table the pressure returns and the pain seems increased for a short time this can usually be minimized with proper reloading.

The research on decompression is limited and the studies done have been of limited quality.  Because of this lack of best evidence most insurance does not cover decompression.  Despite this, there are many positive case studies and the experience that I have had with my patients indicate that it is effective in many cases.

I purposely avoided the controversial marketing topic in this post, if you’d like to hear more about that let me know.

Lumbar Disc Herniation

Blown disc, slipped disc, herniated disc, bulging disc, etc.  There are many names for a vertibral disc herniation.  This is a hard subject to keep short.  I will attempt to just give basic, simplified information to limit the length of this post.

A disc herniation has various levels as with most injuries.  The worse the herniation the more complicated the symptoms and the treatment.  Most herniations can be resolved and respond well to conservative care such as chiropractic.  In fact most herniations will resolve on their own in 6 months, but no one wants to wait 6 months for their back pain to go away.  With chiropractic treatment the symptoms are often reduced to less than 50% in 6 weeks or less, and can at times be resolved completely in as little as 3 months.

Disc herniations can happen to anyone and they don’t have to just be in the low back.  They can happen due to constant pressure of poor posture, sudden pressure due to trauma, weakened muscles and ligaments or weaknesses you’ve had since birth.

Some of the signs that you may have a herniation are: a sudden onset of low back and possibly leg pain that can go all the way down the leg.  The pain is usually described as a sharp or shooting pain and increases with bending forward, (although this direction of bending is typical it is not universal) or pressure increases such as coughing, sneezing or having a bowel movement.

Image from Spine Universe

Image from Spine Universe

Treatment for disc herniations are many,  the ultimate goal is to get the disc to reabsorb back in.  To understand any treatment you must understand the nature of an intervertebral disc.  (video) It’s kind of like a Jelly donut.  If you squeeze a jelly donut the jelly comes out.  If you only do it a little bit and then take the pressure off the jelly will kind of suck back in.  If you relieve the pressure and the damage isn’t too severe the disc will suck it’s nucleus back in and repair with time.  This is called decompression.  It can be accomplished many ways, and there is still debate as to which method is best.

The big problem with disc herniations is that often the pain is too severe to receive treatment.  So, the initial goal is to reduce pain enough to be able to be treatment.  The sooner you can get up and moving around the better the prognosis is going to be, even though there is severe pain. Some pain control techniques are cold packs, electric stim, mechanical spinal decompression, and if required pain medication.

The next goal is to centralize the pain.  Many patients worry when their back starts to hurt worse, but if the pain is coming out of the legs and centering around the pain generator it is a good thing.  Centralizing the pain means that we are relieving the pressure on the nerve.  After the pain is centralized, treatment becomes more normal and regular.

Once you’ve had a disc herniation you may be predisposed to injury in the future, therefore it is essential that you begin some form of core strengthening routine to build up your muscles so that they can protect from future injury.

Disc herniations can be very painful and can interrupt your life for quite some time.  The good news is that with chiropractic care you can often avoid surgery and be back to normal again relatively quickly.

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