Traction is NOT Decompression

An injured disc and a disc decompressed

An injured disc and a disc decompressed (Image: Google)

A Clinical Perspective by Dr. Timothy Burkhart D.C. (Burkhart & Chapp Chiropractic)

I have been in practice for 28 years and integrated spinal decompression treatment into my practice in 2008. Since then, I have treated hundreds of patients with spinal decompression. The results have been amazing, and more and more people are seeking this treatment as an alternative to surgery. As I explain spinal decompression to patients, one of the most frequent questions I am asked is, “What is the difference between traction and decompression?”

You could also make the argument that a CT scan is in fact an X-ray evaluation. Yes, the CT uses radiation, but it is much different than a plain view X-ray film that might be taken in a medical or chiropractic facility. So, what’s the difference? The difference is the technology of the equipment used.

Patient on traction table

Traction table using pulley system (Image: Google)

Pulling a patient in opposite directions in the cervical or lumbar spine with a set of cables IS NOT the same as a patient directly captured to a table that is monitoring decompressive force in millisecond intervals. Straight line or axial traction has been around as a back treatment for a long time. Unfortunately, the results of traction treatment have had a poor record of treating chronic low back pain or similar conditions. If one considers the study done by Anderson & Nachemson (FN study), intervertebral disc pressure actually was found to significantly increase under traction. This is an inconvenient truth for those who argue that decompression is traction and traction is decompression.

In 1994, Gustaro Ramos, MD, etal (FN study) was able to establish that decompression treatment could significantly reduce intradiscal pressures. Decreased pressure in the intervertebral disc leads to, by its very nature, a “phasic physiological” change that can bring about positive outcomes in patient care.

Chiropractic Dubai using the Hill DT decompression treatment table

Chiropractic Dubai using the Hill DT decompression treatment table (Image: Chiropractic Dubai)

As more and more research and case studies are published, the body of evidence seems to lead to the fact that coupled with a comprehensive approach, decompression IS different than traction. The primary difference between axial traction and spinal decompression is the progressive logarithmic computer application of force that overcomes the patients muscle contraction. In 1997, a study authored by C. Norman Shealy, MD, Phd, etal (FN Study) clearly demonstrated that better outcomes were noted when patients were treated with decompression vs. traction.

I have experienced similar results when using traction based strap or cable pull systems prior to using our current direct capture, patient contact logarithmic system. Patients’ number one complaint from traction based systems was muscle spasm, guarding or painful splinting of trunk musculature post treatment. No doctor or therapist wants to see a patient finish a treatment and be more acute. Once we began using the Hill DT system, we rarely, if ever, have our patients complain of an increase in spasms or pain after their treatment. In fact, many of our patients fall asleep during their 20-30 minute treatment!

More research can and should be done to determine the full scope of what is occurring during decompression treatment. There is a lot of positive research already speaking to the immediate and long term positive benefits of this therapeutic approach. However, most of us that treat patients each day with long term, chronic or acute neck and low back pain would agree that patient results speak for themselves.

Dr Tim with Dr Lau during the Hill DT training in Singapore back in 2014

Dr Tim with Dr Lau during the Hill DT training in Singapore back in 2014