Tri-County Spinal Care Centers

Decompression and Traction

Neck and Back Pain can be debilitating. Our goal is to help you avoid surgery if at all possible. The methods for pain reduction include:

• PT and Rehab and Physiotherapy
• Chiropractic treatment
• Medication Management
• Interventional Procedures like epidurals, facet blocks, medial branch blocks, and radiofrequency ablation.
• Spinal Decompression Therapy

Decompression and Traction in the Medical Literature – Does Decompression Work?

Traction has been used for many years for spinal pain and radiculopathy, as well as for relief of whiplash associated disorders and headache. It has also been used frequently for arthritis pain from facet arthritis/facet syndrome. As you can see below, contrary to lumbar traction cervical traction and cervical decompression actually works very well.

The following is a summary of the literature describing the effectiveness of traction and decompression:

Cervical Spine Disorders – A Comparison of Three Types of Neck Traction, by Zylbergold and Piper

This was a randomized clinical trial to compare the effect of intermittent, static and manual cervical decompression traction on cervical spine disorders. One hundred patients (mean age 53 years; standard deviation 12.6 years) were randomly assigned to one of the three types of traction or a fourth group, which received no traction. The cervical disorders of cervical disc disease (59 patients), osteoarthritis (21 subjects), spondylosis (7 patients) and strains (21 patients) were distributed so that the groups were statistically equivalent. Each group received instruction in back care, moist heat for 15 minutes, a program of range of motion and isometric exercises and assigned traction or no traction. Treatment was given twice weekly for 6 weeks. Pre and post treatment measures of cervical ROM, medication use and present pain intensity assessed by using the McGill Pain Questionnaire were compared. Although all of the patients improved significantly, patients receiving traction had better outcomes in terms of cervical spine mobility, decreased pain and less medication use. The authors concluded that cervical traction should be included in the treatment of cervical disorders.

Cervical Radiculitis: Treatment and Results in 82 Patients by Honet and Puri

Patients were classified as to the severity of cervical radicular symptoms. Depending upon severity, they were placed in one of three treatment groups. Patients with minimal symptoms received over-the- door home traction at 15-20 lbs. Patients noted to have moderate pain with more profound clinical neurological deficit were treated as outpatients and required relatively heavier force (15- 55 lbs cervical traction on a clinical device in the supine position). The few patients with severe, unrelenting pain were hospitalized. Fifty-eight of the 82 patients receiving cervical traction across all categories had "excellent" results, and eight patients had "good" results. Of the 16 patients with "poor" results, 13 were in the severe (hospitalized) group, and 9 of those patients went on to have surgery. The results of Honet and Puri's study indicate that patients with moderately severe cervical radicular pain can benefit from relatively high force cervical traction (cervical decompression).

Cervical Traction As A Therapeutic Tool by Valtonen and Kiuru

This study is based on 212 consecutive patients diagnosed with cervical syndrome and treated with cervical traction (cervical decompression). The mean age was 55 years with a range of 21-80 years. Thirty five percent had symptoms less than 4 months, 24% 4-12 months and 41% longer than 12 months. The patients were treated with some form of heat and massage to relax the muscles, followed by cervical traction. The traction method was usually supine using a head halter and weight system. The traction was given 3 times per week for 4 weeks in the department of physical medicine. Sixty-one percent had complete relief or marked improvement of symptoms. The authors concluded that cervical traction is a relatively good means of relieving symptoms of cervical syndrome.

Nonoperative Management of Herniated Cervical Intervertebral Disc With Radiculopathy Using Cervical Traction by Saal, et al

A study of 26 consecutive patients (mean age 43.1 years, range 22-58 years) with cervical herniated nucleus (herniated disc) and radiculopathy were followed for more than one year. Twenty-four of the 26 patients were successfully managed with aggressive nonsurgical treatment including cervical decompression treatment (cervical traction). The 24 patients returned to full time work duties. Part of the treatment was cervical traction provided in a clinic followed by home cervical traction for all patients. The authors concluded that a systematically applied nonsurgical treatment of neck traction for a clearly defined group of patients with symptomatic cervical disc herniation had outcomes equivalent to results of similar patients treated surgically. The nonsurgical treatment included cervical traction for all patients.

An Evaluation of Conservative Treatment Including Cervical Traction for Patients with Cervical Disk Syndrome, by Martin and Corbin

Sixty-one patients (72.2% age 40-70 years, 24.6% age 50-70 years) were diagnosed with cervical disc syndrome by a neurologist. Treatment consisted of various forms of heat and massage followed by neck traction (cervical traction) using a Sayre sling with the patient seated. A ½ inch felt pad was placed between the patient’s back teeth to reduce the discomfort of the chin strap force through the TMJ. The heat and massage were given to prepare the patient for traction. Following several cervical traction (neck decompression) treatments varied from 1 to 42 with an average of 8 treatments. Fifty-seven percent of the patients continued with home cervical traction, and many continued to use cervical traction for several months following dismissal from the clinic. Following the initial treatment period 67.2% had definite improvement. At follow-up (6 months to 5 years; average time of 23 months) 77.1% had definite improvement and were able to conduct their daily lives without difficulty. Only 2 patients had an adverse response to traction treatment and they were in the subgroup of 12 (19.7%) patients who required surgical treatment. The primary treatment was cervical traction. The authors concluded that the primary reason for patient improvement was due to the cervical traction.

Eyerman, Edward MD. Simple pelvic traction gives inconsistent relief to herniated lumbar disc sufferers. Journal of Neuroimaging. Paper presented to the American Society of Neuroimaging, Orlando, Florida 2-26-98.

MRI of 20 patients treated with the decompression table shows in our study up to 90% reduction of subligamentous nucleus herniation in 10 of 14. Some rehydration occurs detected by T2 and proton density signal increase. Torn annulus repair is seen in all.

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C. Norman Shealy, MD, PhD, and Vera Borgmeyer, RN, MA.
Decompression, Reduction, and Stabilization of the Lumbar Spine: A Cost-Effective Treatment for Lumbosacral Pain. American Journal of Pain Management Vol. 7 No. 2 April 1997

Eighty-six percent of ruptured intervertebral disc (RID) patients achieved 'good' (50-89% improvement) to 'excellent' (90-100% improvement) results with decompression. Sciatica and back pain were relieved." "Of the facet arthrosis patients, 75% obtained 'good' to 'excellent' results with decompression.

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Gionis, Thomas MD; Groteke, Eric DC. Surgical Alternatives: Spinal Decompression. Orthopedic Technology Review. 2003; 6 (5).

Results showed that 86% of the 219 patients who completed the therapy reported immediate resolution of symptoms, while 84% remained pain-free 90 days post-treatment. Physical examination findings showed improvement in 92% of the 219 patients, and remained intact in 89% of these patients 90 days after treatment.

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Bruce Gundersen, DC, FACO; Michael Henrie, MS II, Josh Christensen, DC. A Clinical Trial on Non-Surgical Spinal Decompression Using Vertebral Axial Distraction Delivered by a Computerized Traction Device. The Academy of Chiropractic Orthopedists, Quarterly Journal of ACO, June 2004

All but two of the patients in the study improved at least 30% or more in the first three weeks. Utilizing the outcome measures, this form of decompression reduces symptoms and improves activities of daily living.

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Guehring T, Omlor GW, Lorenz H, Engelleiter K, Richter W, Carstens C, Kroeber M. Department of Orthopaedic Surgery, University of Heidelberg, Germany. Disc distraction shows evidence of regenerative potential in degenerated intervertebral discs as evaluated by protein expression, magnetic resonance imaging, and messenger ribonucleic acid expression analysis. Spine. 2006 Jul 1;31(15):1658-65

Distraction results in disc rehydration, stimulated extracellular matrix gene expression, and increased numbers of protein-expressing cells.

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Treatment of an L5-S1 Extruded Disc Herniation Using a DRX-9000 Spinal Decompression Unit: A Case Report. Terry R. Yochum, DC, DACBR, Fellow, ACCR, and Chad J. Maola, D.C. Chiropractic Economics, Vol 53: Issue 2.

Spinal Decompression Therapy ...allowed imbibition (the absorption of fluid by a solid body or gel) and complete reduction of the visualized herniation."

Spinal decompression therapy provided an effective means of treatment for this patient's symptoms resulting from discal herniation (extrusion) with associated impingement of the adjacent nerve root.

MR imaging proved to be a useful and non-invasive technique in monitoring the efficacy of decompression therapy as it applies to this case.

Decompression of the spine proved to be superior to the other forms of conservative care when applied to our patient. The patients' results were both subjectively favorable and objectively quantified.