Robert A. Hayden, DC, PhD, FICC
Many studies have been published showing the efficacy of spinal decompression in bulging discs. This is neither new nor surprising, but the excitement of recent research is contagious. Indulge me for a moment while I share some enthusiasm with you!
There are 33 vertebrae in the human spine that are separated by 23 intervertebral discs (IVDs). These are made of very strong cartilage that is arranged in onion-skin-like layers around a liquid center, called the nucleus. Think of that gum that has the liquid center, and you have the hang of it.
Each disc is designed to act as a cushion to put space between vertebrae to protect bones. If bones touch bones, since they are made of metal (calcium), they will erode and destroy each other. The spacing of vertebrae is also important to create holes for the spinal nerves to exit the spine on their way to their respective body parts. IVDs are about 70% water when we are young, but they dry as we age (sadly, like some other parts), making discs more fragile and prone to injury by tearing.
The two motions that are very likely to cause disc injury with repetitive motion are the combination of flexion (bending forward) and rotation (turning to the side). A small tear in a disc allows the fluid from the nucleus to follow the tear, creating a bulge in the side of the disc. This may be described as a herniated, bulging, slipped, or ruptured disc. Unfortunately, there is much confusion when these terms are used interchangeably.
When a disc is injured, it may cause pain in the back or neck, with or without radiating pain, numbness, or tingling down the extremities. There may be muscle weakness in the affected extremity as well, which is a serious problem. All these mean you have a problem that needs addressing.
If this happens to you, you need to find a provider who is prepared by education, experience, and licensure to do musculoskeletal diagnosis. These conditions may be mimicked by other, more serious conditions, so a good history, exam, and possibly imaging in the hands of a qualified provider are in order.
So here is where we talk about spinal decompression. It is as the name implies: spinal decompression drops the pressure in the IVD non-invasively and comfortably. It does not use needles or drugs. There is no “recovery time” from the procedure, as most people feel better immediately after the procedure.
After a good history, physical exam, and imaging when that is indicated, a differential diagnosis is made. This will be specific as to which disc, which side, and the specific nerve involved. Your treatment options, conservative first, then pharmacological, then surgical, will be discussed with pros and cons of each. As a rule, conservative care should always be tried and exhausted before drugs or surgery.
The treatment itself involves lying on a specially designed decompression table with a strap placed on the trunk and pelvis for lumbar discs, and on the head for cervical discs. There is a computerized actuator that lengthens the table slowly to elongate the spine, creating a suction in the IVDs. This reduces pressure on the injured IVD’s nucleus. It literally sucks the bulge back to the center of the nucleus where it belongs. Each session takes about 25 minutes, and usually there is a series of treatments given until symptoms are completely gone.
There are many studies supporting non-surgical spinal decompression for disc injuries. The study mentioned above found that people with disc bulges with chronic lumbar pain had “reduction in pain and an increase in disc height.” This is very exciting because it suggests that spinal decompression pulls water into the IVD from surrounding tissues as a lasting result of the therapy. This essentially reverses the degenerative process.
There is also a manual version of spinal decompression called flexion distraction. It is well studied and produces excellent results. You may see more on this technique at www.coxtechnic.com.
If we do not get the results we want after a round of decompression, we will get an MRI if we have not already and discuss further options, including adding pain management or a surgical consultation. Again, pros and cons will be discussed.
It is always good to have options to fight the “Battle of the Bulge” without drugs, surgery, or needles. Not only that—-we can win.