Chiropractor Chandler AZ

Disc Decompression Treatments

Spinal decompression treatment can reduce neck and back pain and improve spinal disc healing. Rehabilitation maintains those gains and reduces the shearing forces that produce pain and further degenerate the low back.

How Does Spinal Decompression Work?

Spinal discs have a limited blood supply requiring body movements to bring blood and nutrients to the tissue. As explained in the video below, body weight compresses joints along with the contracting lower back muscles. Nerve pain, muscle spasms, and limited movement prevent normal fluctuations in pressure that bring nutrients into the disc. Without unloading, fewer nutrients are available for disc repair and healing.

Discs require movement for blood flow and nutrients. Sitting in a static position comprises the disc and slows blood flow. Think of a wet sponge; discs receive blood by taking a foot of the sponge and having fluid rush inward. Stepping on the sponge pushes fluid out. Prolonged sitting or standing is like half compressing an edge of the sponge for hours.

With an injury, we are not moving, and therefore not creating the cycles of blood flow. It would be as if we kept a foot partially compressed on the sponge and allowed just a little bit of fluid movement.

Spinal decompression therapy pulls the foot off the sponge and lowers it down, creating a cycle that repeats over and over, enhancing nutrient flow to the disc. A specially-designed traction table pulls the joints apart, decreasing pressure on the disc. As the table returns to the starting position, the disc reloads and blood is pushed out of the disc.

A 30-minute treatment significantly increases cycling, and the amount of blood flowing through the discs. More blood and nutrients translates to faster healing and a shorter recovery time. By combining spinal decompression with chiropractic, physical therapy, exercises, stretching, Class IV laser, and massage therapy, we improve long-term outcomes.

Video: Can a Chiropractor Help with a Disc Bulging or Herniated Disc

Spinal decompression treatment alone would speed disc healing. However, without chiropractic and other therapies, muscles and joints could not protect the disc, increasing the risk of future injuries. Proper core strength and stabilization restores normal movement to the lower back and protects it during times of excess stress and strain.

Establishing normal muscle mechanics prevents future damage from occurring and reduces the likelihood of future injuries.

Which Injuries Respond to Disc Decompression?

Extruded, bulging, and degenerative discs respond well to the increased blood and nutrient flow from decompression treatments. Many people benefit during both acute episodes and to relieve chronic pain.

When Should I Get Spinal Disc Decompression?

If an MRI shows a significant disc extrusion or herniation, decompression treatments might be a good option. People with a history of degenerated discs, arthritic changes, or chronic low back pain often feel relief from the treatments when added to a rehabilitation program. F

Can Disc Extrusions Heal Without Treatment?

Whenever the body has an injury it attempts to repair and heal itself. For an extruded disc, the body will try to “patch up” the disc over time. It will also try to break down the jelly material (nucleus pulposus) that has escaped out the back of the disc. It can take months to repair a disc and even longer to break down the jelly.

People can have disc herniations and extrusions that do not cause significant pain or symptoms, and do not require much office treatment. The risk is further tearing the fibrous disc and making the extrusion bigger before it is fully repaired.

A person could follow many of the exercises and suggestions in our low back book and not require active office treatment. However, if the disc is causing significant pain, muscle loss, or sensory changes, formal treatment is the best option.

Waiting for the disc to stop hurting and not strengthening the core muscles predisposes a person to future low back injuries. I do not recommend this option. You developed the disc damage for a reason; work on fixing the weak link in your low back and avoid this pain in the future.

Video: Disc Injuries & Treatment Options - Patient Story

Why Is Treating Disc Herniations So Difficult?

As with any injured tissue, treatment goals for a herniated disc are to decrease pain and inflammation. The location of the injury makes it difficult to treat. Every day we apply pressure to the disc—every time we take a step, twist, or sit, we stress and strain the spinal discs.

In addition, blood supply to spinal discs is very limited. In our normal movements, disc pressure fluctuates, and as a result blood rushes into and out of the area. Think of the wet sponge again: if you step on the sponge, the pressure pushes the water out of the sponge, only to rush back into the sponge when the foot is removed.

Walking provides the pressure changes needed to compress and decompress. Exercise and normal walking movements nourish a vertebral disc. When disc herniations cause severe back pain that limits your ability to walk, less blood flows to the discs. Large muscle spasms cause further compression and also restrict blood flow.

Spinal disc decompression treatments stretch the spine and decompress joints. Decompression treatment involves multiple cycles of loading and unloading the joints, as well as bringing in blood and nutrients to accelerate healing. Unloading the joints decreases pressure on the pain nerves, decreasing your discomfort.

A 2018 study published in Spine Surgery and Related Research, reviewed the research on chronic disc pain following surgery. In the article “Sensory Nerve Ingrowth, Cytokines, and Instability of Discogenic Low Back Pain: A Review,” researchers concluded that, “Pathological mechanisms of discogenic low back pain include sensory nerve ingrowth into inner layers of the intervertebral disc, upregulation of neurotrophic factors and cytokines, and instability. Inhibition of these mechanisms is important in the treatment of discogenic low back pain.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6698542/pdf/2432-261X-2-0011.pdf

Spinal disc pain is different from many other tissue injuries. Small tears or fissures develop in the fibrous layers of the discs. The fluid nucleus pulposus can push backwards through the tears, creating a disc bulge. Tissue damage triggers inflammatory pathways that increase disc pain nerve activity, causing increased pain nerve growth and activation in the deeper layers of the spinal disc. The herniated nucleus pulposus also activates these pain nerves.

Until the disc fibers can heal, increased numbers of pain signals travel to the spinal cord and brain. Unfortunately discs can take months to heal, especially if they experience excessive shearing forces causing more fiber damage. Even a small disc bulge can cause increased pain nerve activity for months, complicating recovery and lumbar spine function.

This is why it’s essential to improve sitting, standing, and walking postures. Poor postures slow nutrient flow to the discs, delaying recovery. More importantly, slouching loads the front of the disc, causing excessive forces to push backwards on the damaged fibers. Healing can take two steps forward and then three steps back on a daily basis.

The same forces that damage spinal discs also damage the facet joints, joint capsules, spinal stabilizing spinal ligaments, muscles, and tendons near the disc. In addition, joints above and below the injury site experience increased stress as the body tries to protect the injured discs. Over time, stabilizing function in the lower back deteriorates and excessive motion damages many tissues in the lower back.

Spinal stabilization exercises target postural muscle function to minimize damaging shear forces. Extension exercises load the backs of the spinal discs, pushing the nucleus forward; away from the damaged tissues. The extension exercises help to decrease overall pain from overactive pain nerves.

A 2018 article published in the Journal of Physical Therapy Sciences, “Effects of Stabilization Exercise Using Flexi-bar on Functional Disability and Transverse Abdominis Thickness in Patients With Chronic Low Back Pain,” evaluated the benefits of adding a Flexbar to core stabilization exercises. People performed 30 minutes of exercise three times per week for six weeks. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5857446/

One group performed stability exercises by adding a Flexbar to further challenge proprioception and stabilization. While the control group performed the same exercises without the Flexbar. Adding the Flexbar increased stimulus to the deep spinal stabilizer muscles, producing greater improvement in functional stability and reduced pain levels.

Flexbar provides a similar stimulus to the upper extremity that standing on a vibration plate does for the lower extremity.

Many people think they need to lift heavy weights to exhaustion to gain strength and endurance, but that is not true. Functional workouts often provide greater benefit to people because they challenge the weakest muscle groups and neuromuscular control systems.

Video: Sciatica - Differences Between Facet Syndrome & Lumbar Disc Herniations

Why Did Past Decompression Treatments Fail?

Usually when people say decompression treatments did not work for them, it is one of two reasons:

1. They flared up their sciatic pain in the first few treatments when decompression pulling was increased too fast. The back muscles did not like the stretch and spasmed to protect the back, inadvertently causing increased pressure on the disc and nerve root.
2. They went through a series of treatments that only involved decompression and the physical therapy accompanying it was lacking quality core strengthening and stability exercises. For example, a patient might say that he would go in for decompression, followed by three sets of 10 on the back extension machine, followed by a massage. The treatment was expensive and the pain returned in a few years because the person failed to stabilize his core and low back.

Spinal decompression must include proper rehabilitation exercises.

Video: Spinal Disc is like a Jelly Donut

Anatomy:

Inversion Table:

Video: Inversion Tables - Patient Fail

Different products help different people. Too many times I have said it depends on the person, and this is one of those times.

Goals of home treatments are to:

1. Decrease pain and inflammation
2. Increase flexibility
3. Increase strength

Are Inversion Tables Good?

Inversion tables are an excellent treatment tool to utilize at home as long as they are used safely and smartly. A person can apply the axial stretch to his/her arthritic joints and relieve compression forces on the disc and joints at home.

Inversion tables should not be used if a person has a difficult time reclining or hanging upside down. People with risk of stroke or significant cardiovascular disease should not use them. Check with your cardiologist or primary care physician when in doubt.

How to Use an Inversion Table

The key is to start slowly and progress steadily. Too many people try to go all the way upside-down and hang for five minutes, which is a great way to aggravate the back.

I suggest starting with a slight decline, just a little below parallel to the floor. Hang for 20-30 seconds, and then return to the starting position for 30 seconds. Repeat this process several times. Slowly begin reclining further and further over time, and slowly increasing the time to one minute.

When a person is having a bad day and feeling extra tight, it is recommended that he or she reduce the time and degree of recline. Challenging the body with too much of a stretch can set off a protective muscle spasm and “jam the sore joints together.” This is how and why people flare up their backs with home inversion tables.

Is an Inversion Table Helpful for Arthritis Pain?

Some people do very well managing their daily spinal joint pain with a light inversion stretch, which takes pressure off the damaged joint surfaces. Every individual is different, and inversion is an effective home treatment for many.

Is It Good for Disc Injuries?

Most people with disc extrusions and herniations do very well with inversion tables. By stretching the joints apart, inversion relieves pressure from the compressed nerve roots. It can be a great home treatment, but be careful not to over stretch or challenge the back on a bad day.

Are Inversion Tables Good For SI & Ligament Pain?

No. Inversion tables stretch and shear the sacroiliac joint, which often makes it worse. If lumbosacral ligaments are sprained then the pulling action of inversion makes the condition worse.