Decompression and Traction for the Intervertebral Discs
Life tends to be really hard on the discs between the vertebrae in our spines. Discs are made of a flexible cartilage with a thick fluid and a hard nucleus in the middle. Discs are designed to improve motion and provide shock absorption which makes them the most abused structure in the spine. When we bend forward, the disc bulges backward. This can cause weakness due to wear and tear on the inner posterior aspect of the disc. Likewise, placing too much strain on the top can make the disc bulge all the way around. This is seen when someone is overweight, does a lot of high impact exercises, or loads the body with too much weight like with squats.
Each time a disc bulges farther beyond its normal borders, micro-tearing occurs. Tears heal with scar tissue which is, by its nature, not as pliable and can tear again. It is possible to train scar tissue into flexibility and help it act like regular disc tissue but it takes time and training. Too often the more rigid scar tissue will tear and recreate the original problem. This is where traction or decompression comes in.
I may offend some docs who are big into decompression therapy but to me, it and traction are the same thing. I think they started using the fancier word “decompression” because they developed more sophisticated and expensive equipment and needed a word to match. I must confess, though, as a linguist, decompression does portray a clearer and more concise picture of what we are hoping to accomplish. But, I digress. With decompression or traction (and from here I will use the words interchangeably) the goal is to take away pressure from the disc. When pressure on the disc is lessened, the disc can reshape and heal.
Traction can be accomplished in a number of ways. The method I am asked about most is about home-unit to hang upside down. In this case, one straps their ankles into a clamp and then leans backward to a specified angle. Some units will allow a person to hang completely upside down. I recommend 45 degrees to start. That is usually enough to open the disc space without getting a head rush that will shorten the traction time.
There is a host of other traction devices. Most of them can be found on late night infomercials. All of have some legitimacy but some are definitely better than others. The one I have seen a lot recently has the person lying down with their heels resting on a moveable piece that pulls and moves the legs side to side. I am not sure how much traction is occurring but movement is always good. One of the better ones I have seen in the past looks like a big cushy loop that hangs in a doorway. The person is situated so that their upper back is on the ground and their pelvis and legs are parallel with the doorway. Again, the end result is the same and usually positive.
Some providers have very nice decompression machines that are extremely effective in separating the vertebrae thus decompressing the disc. With severe disc bulges and herniations, these machines can be lifesavers. The only downside is the expense which can be significant. In our office, we have available a more hands-on form of traction called flexion-distraction. The table we use flexes at the lumbar level and is spring loaded. The doctor puts one hand on the spine holding a specific level in place and uses the opposite hand to push the table down. The spine separates then accommodates as the spring pushes the table back up. If the chiropractor knows what they are doing, this a very effective form of traction and can make a big difference in the disc.
All of the forms of traction that I mentioned above address the low back. There are, however, various units for the neck, as well. There are three main types of cervical traction. One way uses a harness around the chin and base of the skull attached to a rope and pulley. These units either have a counter-weight, usually a water bag, or a tension spring. The other devices look like a collar between the shoulders and the chin/skull that expand when pumped full of air. Both are effective and mostly utilized at home. The third combines traction with an attempt to restore curvature. This unit is a wedge whereupon a person lies with their head hanging over the tall side of the wedge. Often times there is an elastic strap or a weight that pulls down from the forehead.
Whatever method you choose or whichever method is the most effective for you, the key to success, as with most things, is to apply it consistently over a significant length of time. I have a cervical traction unit that I use when my neck is hurting and I routinely have Dr. Wagnon adjust me on the flexion-distraction table. Discs, just like people, sometimes just need a break from the pressures of everyday life, traction or decompression is a great way to accomplish this.