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Spinal Decompression or Traction Therapy

A few words about Spinal Traction Therapy, or as it is also called, Spinal Decompression Therapy.

There is nothing new at all about the concept of traction therapy for treating back pain. There is evidence of its use in the times of ancient Egypt and writings from Hippocrates several centuries BC. In Chiropractic College, we were even presented with etchings dating from medieval times of a person being hung upside down on a rack with a board being placed and pressed across the low back. *** This was not a torture device .. it was state of the art therapy!

Way back in our not too ancient history, traction/decompression therapy gained attention when many people took to running and jogging, and subsequently irritation mechanical problems in the low backs. The trend was to use "gravity boots," or boots that the user would strap on, pull themselves up to lock their feet onto a chinning bar, and hang free ... about as complex as hanging from the monkey bars. Despite the simplicity of the therapy, it was reasonably effective and no doubt helped many people avoid surgery.

(A side note: At that time, surgery was a typical medical treatment for many low back pain complaints that did not seem to respond to medication and bed rest. In comparing patients that did undergo surgery with those who avoided it, after five years, there was very little difference in outcomes. Chymopapain injections had much the same results. Since that time, surgery is generally reserved for cases where there is severe (loss of function) compression of the nerves, and cases where conservative measures have failed and the patient is dealing with disabling pain.)

I digress...

Various methods have emerged over the years to apply decompression to the lower back. Most of these involve some form of inversion (hanging upside down) using various rigs as a variety of the monkey bar experience.

One common rig is a stretcher like device on an A-frame. The patient locks their ankles into the bottom of the device, and then rests back, and slowly raises his/her arms. By the way the device is positioned, as the arms are raised, the centre of gravity changes, and like a teeter-totter, the stretcher tips back and upside down. When the user has reached their tolerance, s/he slowly brings the arms to the side, and the device rights itself.

The device is reasonably effective. The only downside is the sensation of being inverted and the pressure in the head. For any otherwise healthy person, this is not a danger at all... yet for some with fragile health, it is best avoided. I am not aware of any injuries being made worse from this type of device, nor of any complications from judicious use, but we like to be cautious in our recommendations. The costs for this sort of kit range from a few to several hundreds of dollars. The more expensive ones are more stable and likely a bit easier to use.

Another device that I have used and recommended to several satisfied patients is the Invertrac http://www.invertrac.com/. While there is little evidence to support this device is any more effective than going upside down backward in extension (as above), intuitively I like the patient spine being flexed by going forward. This would seem to open the joints better. The device currently would cost you $325. It is well made, stable, easy to use, stores neatly under the bed, and is better for drying laundry than the stretcher type device. Again, there is no evidence that I am aware of any injuries. A fit and otherwise healthy person would feel a pressure in the head. The more one uses the device, the more they get used to the sensation. The same caution exists for a person with more frail health issues... we just don't know the risk.

Decompression on a table again is nothing new. There have been various rigs available at least since I have been in practice. Most of these involve bracing the upper body and attaching waist belt to weights and a pulley.. and letting gravity do the job. This device is the basic design http://keitzer.com/Qstore/uploads/ttft_usage.jpg except that we now have a motor to do the pulling, instead of weights hanging on a rope and pulley.

I suppose what has raised the level of awareness of decompression therapy, is several higher tech devices attached to computers that can rapidly vary the degree of traction. But otherwise, despite the bells and whistles, does much the same job and simpler devices.

Is traction therapy for you? I suppose on a case by case basis, it can help. No one therapy works for all people. Certainly the type of traction done lying down is more comfortable than hanging upside down. There is no evidence that it is more effective. The patient must compare the cost of expensive repeated treatment in a clinic with a fancy bells and whistles device, with a one time purchase and using a simpler device at home.. or several visits to the play ground.

No matter what type of traction the patient explores, nothing short cuts the need to maintain better posture, back hygiene, and exercise.

History of traction or decompression therapy. http://www.medicinenet.com/spinal_cord_injury_treatments_and_rehabilitation/article.htm

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