By Steven Hefferon, PTA, CMT
One of the most effective yet overlooked natural treatments for back pain and sciatica is spinal decompression. Bulging and herniated discs pressing on nerves in the spinal column have been corrected without surgery time and again. Lower back strains have been eased. Sciatica has been eliminated. Even painful arthritic joints have found relief in minutes using some forms of spinal decompression.
What is spinal compression and why does it hurt?
Inside the spine are 23 discs which serve as shock absorbers between the vertebrae in our backbone. These discs have two basic parts: an inner gel-like center called the nucleus pulposus which serves as a cushion to support your body weight and a tougher exterior ring called the annulus fibrosus whose main job is to keep the center intact.
These discs are more water than anything else. Throughout the day our bodies are pulled downward by gravity. This pressure squeezes fluid out of the disc and into surrounding soft tissue. As fluid leaves the disc the compression causes the disc to shrink in height by as much as 20%.
By the end of a typical day an adult has lost as much as a half inch or more in height from the combined fluid loss across all discs since getting out of bed. Most of this fluid is reabsorbed while we sleep. But since there is only a partial recovery each night, the average person will lose anywhere from a half to two inches in height over the course of their lifetime.
It’s not the compression of the spinal disc itself that causes pain. Instead, as discs shrink, less distance is maintained between the vertebrae. With less cushioning the vertebrae are more likely to pinch nerve roots as they exit the spinal canal. Worse yet, muscle imbalances in our body can create unequal pressure on one side leading to a bulging or herniated disc.
Think of a balloon. If you blow up a balloon then squeeze one side of it, the air pushes out the other side of the balloon. This is similar to a bulging disc. Squeeze hard enough and the air will rupture the balloon. There’s your herniated disc. When the disc loses its integrity, material from the disc itself can pressure nerves in the spine leading to severe back pain and sciatica.
The problem with decompression surgery
Ask many doctors about spinal decompression and one of two types of invasive surgery immediately comes to mind. One called microdisectomy removes spinal nerve pressure by cutting away the part of a herniated disc nucleus pressing against a nerve. The other surgical procedure, called laminectomy, actually cuts away part of the bone itself to relieve pressure from pinched nerves.
I don’t recommend either surgery except as an absolute last resort. The track record of permanent pain relief from back surgery is horrendous. In fact, back surgery has a failure rate so dismal it’s the only category of surgery with its own clinical name for failure: Failed Back Surgery Syndrome. But that’s not the half of it. The real problem with surgery is it rarely addresses the underlying cause of virtually all non-trauma related cases of back pain.
I often compare the surgical approach to back pain with a car that’s out of alignment. Since the tires receive uneven pressure they wear out faster on the side receiving more pressure. Left uncorrected you may eventually face a catastrophic blowout. Surgery is like replacing the worn tire (symptom) without fixing the alignment (cause). If you don’t correct the underlying cause the problem will return.
How to decompress — without surgery
Instead of cutting away parts of your body, non-surgical spinal decompression relieves pain and pressure by simply reversing the direction of compression along the spine to increase space between vertebrae. Even the slightest increase in space causes a mild suction effect which allows bulging and even herniated discs to return to their proper position. Here are three tools I can recommend for safe spinal decompression right at home.
Inversion therapy is possibly the oldest spinal decompression treatment in use today. It’s earliest recorded use was well over 2,000 years ago when Hippocrates strung up a patient upside down on a ladder, using ropes and pulleys to hoist him up. Today’s inversion tables use the same concept with a whole lot more comfort and control.
They are also one of the few methods available which decompress not only the whole length of the spine, but the whole length of the body. Decompression starts at the ankle joints where you are held securely to the table. As you invert, the pull of gravity provides a mild traction all the way from your ankles to the top of your spine.
Good inversion tables allow the user to easily adjust the amount steepness of incline. This is important for getting used to the treatment since most adults haven’t hung upside down since elementary school. I recommend lying on an inversion table at just a slight downward angle to start and gradually increase the angle over time as you become more comfortable.
Does inversion therapy really work? You bet it does! Numerous back pain and sciatica sufferers have told me that they experienced their first pain relief in years after just minutes on an inversion table.
Scientific studies back up the anecdotal evidence with hard facts. A study out of England shows patients who added inversion therapy to their physiotherapy routine for sciatica were over 70% less likely to require surgery. Another found 155 out of 175 patients unable to work due to back pain were able to return to work after just 8 sessions on an inversion table. And inversion therapy has been found to decrease electrical indicators of muscle pain by 35% within 10 seconds of inversion.
Other benefits of inversion therapy
Inversion therapy is one of my favorite methods of spinal decompression because it provides numerous side benefits. First of all, inversion provides a great feeling stretch to many muscles and ligaments increasing your flexibility. Joints like the hips, knees, and ankles are “unloaded” relieving their weight-bearing pressure. This often leads to decreased pain and easier movement of the joint.
Inversion also helps you maintain your height and posture. Since inversion helps your discs to reabsorb lost fluids more readily, height normally lost due to spinal disc fluid loss is minimized. Healthier discs also help prevent the hunched-back posture so common in older adults due to worn out spinal discs.
Other benefits from inversion therapy, that I won’t have space to share in detail within this article, include improved circulation, enhanced mental alertness, and faster workout recovery time.
Inversion therapy is considered very safe.
However, some people should consult with their doctor before inverting. Those with high blood pressure, glaucoma, severe circulatory issues or spinal cord trauma are a few examples of individuals who should exercise caution with inversion therapy.
The Nubax Spinal Decompression Device
For those unable to use an inversion table or who are simply uncomfortable with the idea of hanging upside down, the Nubax is a great alternative for lower and middle back spinal decompression.
When using the Nubax you never have to leave the floor. You simply kneel and lean forward into a set of adjustable shoulder pads. Meanwhile, a waist belt restrains your lower body as you lean forward providing an immediate spinal decompression as your upper body pulls away from your lower body.
Since you have the option of leaning forward more than gravity might normally pull, the leverage gained allows you to decompress more strongly than with an inversion table. Just be careful not to overdo it when starting out with this device.
There is a downside of using the Nubax compared to an inversion table. The Nubax by design really doesn’t do anything for your neck and upper back. So if you’re experiencing lower back pain, SI joint pain, or sciatica you might get great results from the Nubax. But your neck and upper back pain probably wouldn’t be helped.
The “Poor Man’s” spinal decompression
A very good inversion table or Nubax will only run you a few hundred dollars. That’s a great investment compared to the price of repeated doctor visits, medicines, or heaven forbid, spinal decompression surgery.
But some of you might be saying, “Steve, I would love to get an inversion table or Nubax, but just don’t have the money right now. Is there anything else I can use to decompress my spine for pain relief in the meanwhile?” Yes there is — a sturdy large exercise ball.
Remember how gravity provides a gentle traction whenever you’re upside down? Try lying across the ball (facing up). Roll your head and body backwards towards the floor, allowing your back to arch and conform to the surface of the ball. While not as effective as inversion or the Nubax, this exercise just may provide enough decompression to give the pain relief you need to get through the day.
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Nosse, L.: Inverted Spinal Traction. Archives of physical medicine and rehabilitation. 1978 Aug;59(8):367-70.
Manjunath Prasad KS, et al. Inversion Therapy in Patients with Pure Single Level Discogenic Disease: a pilot randomized trial. Regional Neurosciences Centre, Newcastle General Hospital, Newcastle Upon Tyne, UK.
Sheffield, FJ.: Adaptation of Tilt Table for Lumbar Traction. Archives of physical medicine and rehabilitation. 1964 Sep;45:469-72.