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Spinal Decompression

Warragul Chiropractic prides itself on evidence-based chiropractic therapy.  Spinal manipulation has been extensively researched over many years and has demonstrated effectiveness and safety in the treatment of a range of spinal disorders 1.

Over the past two decades decompression therapy has also emerged as an important therapy for the management of spinal and related disorders.

What Conditions May Benefit From Decompression?

    • Sciatica (leg pain, weakness or numbness/tingling originating in the low back) 2
    • Brachialgia (arm pain, weakness or numbness/tingling originating in the neck) 6
    • Pain due to Herniated, Protruding or Prolapsed Discs 2,3,4,5
    • Pain due to Arthritis and disc degeneration 7,8,9
    • Spinal Stenosis 7,8,9
    • Failed back Surgery 10 

How Does Decompression Work?

Decompression therapy is applied using precise gentle computer programmed movements (using an automated table) or applied by the practitioner at specific vertebral levels (Cox Technic).  As the spine is gently stretched, pressure is reduced within the intervertebral discs, the nerve canals are widened, joints are opened and surrounding soft tissues and joints are stretched. 11,12

Decompression therapy is thought to have the following effects:

      • Disc conditions – as bulges or herniation's are drawn in during decompression, the transfer of essential nutrients and oxygen may facilitate the disc to heal.
      • Nerve Conditions – nerve pressure is reduced which may return blood flow and nutrients to swollen, inflamed or damaged nerve tissues.
      • Joint Conditions – Pressure is released from stiff and inflamed joints which may assist the return of   normal spinal movements.

Warragul Chiropractic has two specifically designed decompression instruments.

How Strong is the Evidence for Decompression Therapy?

In the most recent 'systematic review' of decompression therapy seven randomized controlled trials involving 403 patients were analysed.13 In contrast to previous research reviews involving decompression therapies this study included only clients who had been confirmed as having disc herniation on CT and MRI scans. Although, long term follow-up was lacking in the cohort, short term results demonstrated spinal decompression was effective for both pain relief and functional improvements. The author's concluded the following:

"For clinical practice, the short-term pain reduction and functional improvements provided by traction can be clinically worthy, considering the potential to improve"

Automated Non-surgical decompression therapy 

This decompression therapy slowly and gently lengthens the spine through precise computer programmed movements.

Treatments typically take between 10 and 30 minutes, depending on the spine region being targeted and the severity of the condition. The table has an advanced computer-controlled biofeedback response which controls decompression forces in real-time. This feature allows for very gentle stretching forces to be applied to the spine, all but eliminating unwanted muscle spasms, a  side-effect frequently associated with conventional traction tables.


Cox Technic - Spinal Decompression and Joint Mobilising Therapy


The Cox 8 tables unique design allows the practitioner to manually apply very precise decompression (distraction) therapy at selected spinal levels.  In addition, the instrument is used to ‘mobilise’ spinal joints facilitating the restoration of spinal movement.


Which Decompression  Method is Best for Me?

Your practitioner will take a thorough history and perform a careful examination to determine whether your condition is suitable for decompression therapy.  Most conditions suitable for decompression will respond well on both devices, however there are some specific cases in which one may be selected over the other.

How Long Until I Feel Better?

Your experience with pain is individual, so your relief time is unique to you as well.

With this in mind, published clinical outcomes can give you an idea of what to expect.

General Healing Time

  • Bones heal rather quickly if they have a steady blood supply: 5-6 weeks.
  • Ligament and tendons take a bit longer: 6-8 weeks.
  • Discs and cartilage take the longest: 3 months or more.

If you have a mixture of these factors, it may take some time.  Other health related issues may increase your healing time, for example, diabetes, obesity, smoking, drinking alcohol and a sedentary lifestyle.

Disc Healing Time

Whilst every case is different, it is generally recommended that 3 months be allowed for a disc to heal.  Like a broken arm that stops having pain after a few days in a cast, you still need to wear the cast for many weeks to allow healing. Your back may also stop hurting early in your treatment plan, but you will have to give space for your disc to heal before challenging it with more demanding activities like prolonged sitting, bending, lifting and twisting. 14

Like a broken arm that stops having pain after a few days in a cast, you still have to wear the cast for many weeks to allow healing. Your back may also stop hurting early on in the treatment care plan, but you will have to give space for your disc to heal for at least 3 months                        

Your Expected Healing Time

"Control, Not Cure" for spine pain relief:

Our practitioners embrace the principle "Control, Not Cure" when dealing with chronic spine pain conditions. Whilst a large percentage of patients have excellent relief with therapy,15 so often the underlying source of pain doesn't just go away. For instance, a severely damaged disc, scoliosis and spondylolisthesis are spinal conditions with you for life. Your chiropractor identifies such conditions and will advise on how to manage or prevent future painful episodes and improve your quality of life.

Clinical Data Outcomes

Cox Technic protocols are published standards as they guided the collection of data from 30 chiropractic clinics regarding 1,000 low back pain patient cases, the first and largest collection of its kind in chiropractic. Two-hundred and ninety-three (293) different variables were gathered from and/or about each patient regarding the patient and his/her condition, history, care, outcomes.16 This case study uncovered the number of days to maximum improvement and the number of visits to maximum improvement.

  • The mean number of days to maximum improvement was 29.
  • The number of visits to maximum improvement was 12.

However, some conditions do need more days and chiropractic visits. When conditions are taken into account, the results vary. Examples:

L5 Sprain/Strain

  • 45% of patients were maximally improved in less than 20 days, and 91% were maximally improved at 3 months


L5 disc herniation

  • 25% of cases were maximally improved in less than 20 days and 86% were maximally improved in less than 3 months


1. Evidence-Based Nonpharmacologic Strategies for Comprehensive Pain Care White Paper 12.15. 2017

2. Gudavalli MR et al: A randomized clinical trial and subgroup analysis to compare flexion-distraction with active exercise for chronic low back pain. European Spine J. 2006 Jul;15(7):1070-82

3. Sherry E, Kitchener P, Smart R: A prospective randomized controlled study of VAX-D and TENS for the treatment of chronic low back pain. J Neuro Res 2001 Oct;23(7):780-4.

4. Ozturk B1, Gunduz OH, Ozoran K, Bostanoglu S: Effect of continuous lumbar traction on the size of herniated disc material in lumbar disc herniation. Rheum International 2006 May;26(7):622-6

5. Filiz M et al: Mechanical Traction for Lumbar Radicular Pain: Supine or Prone? A Randomized Controlled Trial. Am J Phys Med Rehabilitation 2018 (ePub Ahead of Print)

6. Fritz et al. Exercise Only, Exercise with Mechanical Traction, or Exercise With Over-Door Traction for Patients With Cervical Radiculopathy, With or Without Consideration of Status on a Previously Described Subgrouping Rule: A Randomized Clinical Trial. J Orthop Sports Phys Ther 2014;44(2):45–57. Epub 9 January 2014. doi:10.2519/jospt.2014.5065

7. Ammendolia C et al: Comprehensive Nonsurgical Treatment Versus Self-directed Care to Improve Walking Ability in Lumbar Spinal Stenosis: A Randomized Trial. Arch Phys Med Rehabil. 2018 Dec;99(12):2408-2419.e2. doi: 10.1016/j.apmr.2018.05.014

8. Choi J, Lee S, Jeon C: Effects of Flexion-Distraction Manipulation Therapy on Pain And Disability In Patients With Lumbar Spinal Stenosis. J Phys Therapeutic Science 2015;27(6):1937-9

9.  Murphy, DR; Hurwitz, EL; Gregory, AA; Clary, R. A non-surgical approach to the management of lumbar spinal stenosis: A prospective observational cohort study. BMC MUSCULOSKELETAL DISORDERS 2006; 7:NIL_1-NIL_8

10. Kruse, Jerrilyn Cambron:  Chiropractic Management of Postsurgical Lumbar Spine Pain: A Retrospective Study of 32 Cases. JMPT 2011 Jul-Aug Vol. 34

11. Chow DH, Yuen EM, Xiao L, Leung MC: Mechanical Effects of Traction on Lumbar Intervertebral Discs: A Magnetic Resonance Imaging Study. Musculoskelet Sci Pract 2017; 29:78‐83

12. Gudavalli MR*, Cox JM* et al. Intervertebral Disc Pressure Changes During the Flexion-Distraction Procedure for Low Back Pain

13. Cheng et al. The effect of mechanical tractionon low back pain in patients with herniated intervertebral disks: a systemic review and meta-analysis Clinical Rehabilitation 2020, Vol. 34(1) 13–22

14. Hirschberg G: Treating Lumbar Disc Lesion by Prolonged Continuous Reduction of Intradiscal Pressure. Texas Medicine 1974; vol. 70: 58-68

15. Cox, JM, Feller JA, Cox JA: Distraction Chiropractic Adjusting: Clinical Application, Treatment Algorithms, and Clinical Outcomes of 1000 Cases Studied. Topics in Clinical Chiropractic 1996; (3)3:45-59, 79-81

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