Spinal Decompression

Contraindications to Spinal Decompression Therapy

Spinal Decompression Therapy is a revolutionary treatment involving intermittent traction which can help relieve, back pain, neck pain, arm and leg pain. Developed in the 1990's, it has grown tremendously in popularity as more and more patients realize the benefits of pain relief and surgery avoidance. It is highly effective (over 80%), low cost (less than 5% the cost of surgery), FDA cleared, and very safe with an extremely low risk profile.

There are some patients who are not candidates for spinal decompression however. Patients with chronic back pain or chronic neck pain who have sciatica or radiculopathy may benefit tremendously. Common problems that benefit include lumbar disc herniation, cervical disc herniation, facet syndrome, failed spine surgery, ruptured discs, degenerative disc disease, sciatica, and spinal stenosis.

Spinal decompression therapy has saved many people from spinal surgery. According to a recent study in the Journal of the American Medical Association, surgery is no more effective than non-invasive treatments, including chiropractic care, for patients with lumbar disc herniation causing sciatica.

However, if a patient has had a previous spinal fusion with instrumentation then spinal decompression is contraindicated. The key here is instrumentation. Spinal fusions without instrumentation are okay for the treatment. The concern is the unlikely event that the instrumentation may shift. For instance if a patient had a neck fusion with a plate the end result is typically no more radiculopathy and a solid fusion. However, at times the end result is no pain even though the fusion did not occur and the instrumentation is holding the bones together. The intermittent traction from the neck decompression, even though slight, could cause a screw to shift and the plate to move.

Another contraindication is pregnancy. Back pain and sciatica are very common during pregnancy. Chiropractic treatment and massage can be very helpful if done safely during pregnancy for back pain. Spinal decompression involves slight intermittent traction and there is a need to put a harness over the pelvis and abdomen region. In order to ensure the effectiveness of the treatment, the harness is secured snugly and therefore in pregnant women the treatment is not allowed because of the resultant pressure on the uterus.

Patients with significant spinal osteoporosis should not undergo lumbar decompression or cervical decompression. Since there is a baseline increased risk of vertebral compression fractures from the decreased bone density, spinal decompression may add to that risk. Patients who have severe osteoporosis may sustain fractures from simply getting up out of a chair or out of bed or sneezing. Patients with osteopenia, which is a slight decrease in bone density less severe than osteoporosis, are okay for neck decompression or back decompression in that regard.

These conditions are not indicated for spinal decompression. A comprehensive pain management center will have other options for pain relief in those patients which may include pain medications, interventional pain management, physical therapy, chiropractor treatment, acupuncture, or massage.