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Will spinal decompression help with herniated disc injury or sciatica pain

traction lower back pain

You are desperate for "that thing" that save you from the endless torture and nag of lower back pain. And there it is on the infomercial, shorting promises that this new "godsend" spinal decompression technology (that is so "not-the-same from the traditional "traction machine") will bring you relief from your lower back pain like nothing else. 

WOW! 

You have never believed anything said during an infomercial. Yet, this time, you are ready to throw in your retirement saving for the slimmest chance that this "spinal decompression" (the name sounds so medical and professional) might take away your lower back pain and sciatica away for good, forever, and ever.

Today, in this post, let's look at the non-surgical spinal decompression therapy, mechanical traction unit (that has been around for much longer), and the inversion tables.

Mechanical Traction Units

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The use of traction in medicine trace back to the late 19th century to reduce a fracture. Traction used for spinal treatment as we know it started in the 70s, with the Gravity Lumbar Reduction Program by the Sister Kenny Institute.

Use and functions

Mechanical traction can be performed in many different ways, targeting either your lumbar or cervical spine. Mechanical traction can be used to stretch the lower back muscles at low force to reduce muscle spasm. It can also be used to reduce spinal compression and creates opening/gapping between spinal segments with more traction force.

It is believed that gapping between spinal segments results in negative pressure within the lumbar disc tissue so that the herniated or bulged disc will be sucked back into its rightful place. In addition, gapping also opens up disappearing spaces for the nerves to travel through, thus reducing nerve irritation and nerve pain symptoms (temporarily). 

During the traction treatment, you will be set up on the unit with the intended pulling force. You will stay in this set up for about 10-20 minutes with a timer and a bell. If you are doing this at home, you should make sure that you can release the traction force efficiently in case any pain or discomfort occurs. 

According to scientific researches

Here are some research studies looking into mechanical traction treatment for lower back pain and sciatica:

Most of these studies suggest that mechanical traction treatment does not outperform other physical therapy modalities for people experiencing acute and chronic discogenic lower back pain with or without sciatica in long term.

Most patient will experience significant improvement in discogenic lower back and leg pain after 6 weeks of combined treatment (resting, modalities, stretching, strengthening, hands-on manual therapy).

One study suggests success in resolving lower back pain with mechanical traction. However, this study has a limited research model (case study) and does not represent a larger population.

Types and set ups

  • Some home units can be set up hanging from a door, using body weight as the pulling force.
  • Some units create separation with air compression pumps, allowing you to lay down and apply heating pad while undergoing traction.

The good:

  • This is a long-established treatment. It has helped a significant population to feel better from disc-related pain and nerve impingement.
  • It is relatively easy to set up. You can purchase a home unit online with many options.

The bad:

  • The simple set up almost always creates sudden and dramatic increase in muscle stretching around the lower back. Some people's body react to this change very negatively. Massive defensive muscle spasm can cause more pain and worsening of sciatica symptoms.
  • Can be hard to tolerate for people with claustrophobia

Recommendation...

I recommend mechanical traction home unit if you:

  • ​Had experience with similar mechanical traction device during a physical therapy or chiropractic treatment
  • Your experience was positive with temporary relief in symptom
  • You have someone at home to help you learn to set up and use the device properly

Make sure you call and consult with your doctor first. Once you have the unit, learn to set it up correctly. Use it to control your symptoms as needed. And be sure to stop the treatment immediately if experiencing an increase in pain or leg numbness.

Spinal Decompression Therapy

Spinal Decompression Therapy is computerized, programmed and glorified traction treatments. 

Use and functions

​All the principles behind the reasons and goals for this treatment are exactly the same with the traditional traction units above. 

drx9000 spinal decompression for lower back pain

However, the Spinal decompression therapy units such as the DRX9000 or VAX-D are ginormous computerized machines. The computer contains programming that monitors your muscles constantly during the treatment. This way, the machine will automatically adjust the speed and force of traction to make sure your muscles are relaxed throughout the process.

With the muscles completely relaxed during traction, the spine and painful discs may finally experience the unloading and relief this treatment claim to provide.

Most large, sophisticated machine like these will also tilt and spin, making the traction force for targeted based on patient's needs.​

According to scientific researches

According to several studies such as:

All these studies indicate improvement in lower back pain and nerve pain, as well as the quality of life in the majority of the testing subjects. 

These studies might sounds very promising. However, as we examine them closely, each of these studies is done with a weak research model and small subject group.

Studies with less strict design are easily biased and mislead.​

Health practitioner Daniel DM expressed same concern in this abstract. The evidences in these researches produce weak evidence towards the manufacture's claim. 

The Good

  • Patients are much much less likely to experience a negative reaction to these programmed and monitored traction than the simple mechanical version.
  • You are likely to experience some level of pain relief if your source of pain is truly discogenic

The Bad

  • It is likely to be very expainsive treatment. Most clinic invest large sum of money to purchase these large units, they tend to make money from it. Many insurance companies will refuse to pay for this treatment, especially when stretching and exercising has stronger evidence for long term improvements.
  • No one will know for sure that you will respond to this treatment (like all things in medicine). It all sepends on what's truly causing your pain.

Recommendation...

If you doctor, chiropractor, or physical therapist recommend non-surgical spinal decompression therapy:

  • Find out about your financial obligation, cost and length of treatment first (call your insurance to verify the coverage, cuz it is going to be a huge bill if there is any error in communication)
  • Make mental notes about whether if the treatment is effective at all. Continue with the treatment if it is helping. However, talk to your practitioner if there is no change in symptoms. Do not continue treatment without justification.
  • As soon as you start to feel better and stronger, perform gentle core exercises to promote long term recovery and spine health.

Inversion Tables

Inversion table has been made popular in the 1980s by the Teeter Hang Ups. (Before up, inversion tables were probably torsion equipment for spies.) 

The inversion table allows users to hang up-side-down from the ankles, using gravity and body weight to perform passive stretching to the joints, muscles and ideally: the spine.

Use and functions

These non-conventional fitness equipment claim to relieve lower back pain and improves muscle flexibility. Some people swear by it. Some people had no luck with it, other than increased BP and dizziness. 

In fact, conversion tables are considered risky for people with high BP, heart disease, glaucoma and pregnant. 

Even if you don't have above conditions, you should ​cautiously start your inversion table to very gentle declination, and progress slowly to reach full inversion, and never stay in the inverted position for more than a few minutes.

inversion table for lower back pain

If you would hop on an inversion table, what would you be stretching?

The answer is: it depends. If you were born flexible, lean with smaller muscle mass, you are more likely to be stretching your joint capsules. If you are stiff and firmly muscled, you might be stretching large core muscles.

If you are deconditioned with poor core strength and experiencing lots of pain, you might even hurt yourself trying to use an inversion table.

Despite the claim by advertisers, I personally do not think the inversion table will help to gap the lumbar spine. Being upside-down is an awkward position, and very few people can relax their core muscles while inside an inversion table. Too much muscle activation prevents the spine from being truly tractioned.

According to scientific researches

Okey, this is awkward. I had a hard time finding real research studies to quote here that either support or reject the claims that the advertiser made to improve lower back pain. 

A few pieces of weak evidence I found was from the 1980s. I am not going to consider using them here.​

If you know of a good one, please let me know. ​

The Good

  • THe inversion table is highly popular among fitness enthusiasts. It is a very efficient at improving flexibility by using passive prolonged elongation to reset the muscle bundle's nerve signals. You will likely to experience less tightness in your hamstrings, hip flexors, quadratus lumborum and paraspinal muscles.
  • The inversion table is also a good equipment for core strengthening. You can use the inversion force to strengthen the upper abdominal muscles obliques by performing gentle exercises while inverted.

The Bad

  • ​The equipment might be risky for those people with less core muscle controls. Injuries may happen.
  • Less likely to traction and gapping the lumbar spine. You might experience more gapping in your knee than in your lower back.

Recommendation...

I recommend invention table for home use if you:

  • ​Have tried an inversion table in a gym, retail store, or at a physical therapy or chiropractic treatment
  • Had a positive experience with improved flexiblity, relaxtion, or lower back or leg pain
  • Has strong muscles for good body control and experienced with fitness equipement

Make sure you call and consult with your doctor first if you have condition such as lower back pain or sciatica. Not recommended for people struggling with heart disease, high BP, claucoma or is currently pregnant.

Thank you for reading, and I hope you find this post helpful.

Recommended readings:

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