Where Should I Go For Spinal Decompression?

Chiropractic is just an infant in contrast to allopathic medicine. It has been in existence barely more than a century. In that time it has grown and developed into the most popular form of alternative health care in the world today. It has evolved from a hands-on art where doctors of chiropractic pressed, twisted, and pulled people upon crude benches, to the complex and sophisticated world of software and microcircuitry. Chiropractic has implemented technology, radiology, research, and expanded its vision. As we have now crossed over into the new millennium, chiropractic faces many of the same obstacles that conventional healthcare has: the complexities of diminishing insurance reimbursement, and an alarming economic impact. Within the advancement of technology and chiropractic, spinal decompression has emerged as the “new miracle cure.” Not so fast here, we need to back up some, and place this into perspective. There are many points of interest to be considered and all things may not be as they seem. It is possible that spinal decompression may not be right for you for several reasons, and it is important that you carefully research this. All doctors are not equal, nor are their economics.

With the widespread use of marketing in healthcare, there is an increased awareness for the options available to the potential patient. This began with the FDA scoring a marketing victory that permitted the advertisement of drugs on television. You can find everything from cholesterol statins, erectile dysfunction, and sleep aids, not to mention, a host of side-effects. This awareness brings into the equation, a mindset where patients proceed to their physician and demand certain drugs. This can become a fundamental question of ethics for the challenged physician: Can I prescribe this medication? Is it safe to prescribe this medication? If I don’t prescribe this medication, will the patient go somewhere else and get it? This is the target of Big Pharma, to sell their drugs. It is very unfortunate that most often the economics of healthcare today will dictate the practice. Several years ago I read a study where specialty hospitals will perform various surgeries (many of which are unnecessary) far more often then those facilities that do not bear a distinction of specialty, because it is their “bread and butter.” This unfortunate revelation in healthcare is widely scattered throughout all the disciplines and facilities. Chiropractic is no different.

Which leads me to chiropractic and spinal decompression. We are observing a relatively new phenomenon in chiropractic. Though the spinal decompression modality began as a chiropractic entity in its use, it has limited spread to neurology and physical therapy. “If ya’ can’t lick ’em, join ’em” is an applicable after thought when other disciplines star using chiropractic methodology. Its inception is probably less than a decade old, and its proliferation into the chiropractic community is somewhere in the neighborhood of a half dozen years. Not to mention that spinal decompression is basically a computerized version traction, therefore its practical origins are physical therapy. I have read more than one article where a physical therapist was more than a little put-out by the chiropractic profession for claiming this procedure. Spinal decompression has undergone a similar exposure pattern as drugs and television, and conversely the chiropractor is faced with the same ethical question of treatment. When the spinal decompression equipment bursts onto the scene, it began with the large, bulky, but impressive DRX. These machines were in excess of $90,000 and many times the chiropractic physician was forced into an expensive marketing package for many thousands of dollars. This would involve a saturation campaign of cable infomercials and full page newspaper ads. This has expanded into radio and non-subscription television. People began flocking for the new treatment at the chiropractor’s office. This of course, brings to the table, many more ethical questions.

First, it has been well documented and published that chiropractors may forego proper assessment on their patients for spinal decompression. That is to say that economic precedent takes over: the chiropractor has such a high overhead from the historical cost of these machines and marketing packages, that they throw as many people as they can into the program, so that they can pay for all this equipment. Many chiropractors are charging $200 per session, or $4000 per plan. It is also apparent that there is a possibility of injuring patients without proper assessment.

Second, pain and fear are powerful motivations. When people enter a doctor’s office and are faced with the possibility of surgery, or are in tremendous pain, it is not uncommon for the treating physician to emphasize the downside of their condition as an alarmist. People who are in a great deal of pain are often not rational and pay the money before discussing other possible options. When we deal with a treatment plan that is (for the most part) not covered by insurance, the doctor has a responsibility to make the plan as reasonable as possible. How good is any treatment, if it is not accessible to those who need it most? The treating physician is ethically obligated to assess and present the treatment options to the patient, so that they may make an educated and informed decision.

Third, physicians need to market themselves accordingly. This means that they should not oversell their product and represent it accurately. Terms like “miracle cure,” or “modern miracle” should make you wary. Many modern chiropractors flock the “sheeple” right in for something that they claim will instantly eliminate their worst back dilemma. In the reporting of spinal decompression studies, it is much too early to determine its long term effectiveness. Many of these reports are twenty or more years in the making, and there is much disparity between early reports. Remember, no form of healthcare is 100% effective in its approach. I have seen various numbers over the years on the success of chiropractic care with diagnosed disc issues, with the most prevalent percentage being around 83%. I think this seems close to the success that I have seen in my practice, though this conflicts with the recent Consumer Report’s article of very satisfied patients at 59%. Spinal decompression may well take us into the 90% category with an increased success rate in the worst cases (of all those that do not require surgery).

Finally, there is no data on the longevity of spinal decompression. Once again, the methodology is simply too new. There may some speculation that in successful cases, and in the absence of new, significant trauma, there may be no more need for an additional exhaustive treatment plan in the course of a patient’s life. I find this highly unlikely. There are too many mitigating factors to consider, and though many people may enjoy years of success with spinal decompression, I find that “the more degenerated a spine” is, the least likely it is to have considerable longevity.

When you seek a chiropractor, find one with a good reputation, who uses established, recognized techniques. If the doctor uses spinal decompression, one should consider what other services they offer. I am hearing repeatedly of the disturbing trend that chiropractors are discontinuing their spinal adjusting and only performing decompression. Why would a trained and licensed health professional give up seven or more years of higher education to limit themselves to this procedure? I can think of only two reasons: they were either not very good at adjusting the spine, or the spinal decompression practice has become too lucrative for them to ignore. Also be weary of the doctor who changes everything that they do, for this new “miracle cure.” Spinal decompression is just a tool, and a good one at that, but it is not a replacement for what has made chiropractic great over the past 100 years!