The notion of a "magic decompression machine" or mechanism, though unsupported by numerous research trials (Spine Jun. ’89, Nov. ’07 Spine Vol. 11 & Eur. Spine Jan. ’09 to mention a few using "typical" low cost traction equipment) has nonetheless managed to gain a real foothold in the market. That decompression has seen such growth and enthusiasm over the last decade is a testament to the dynamic effect decompression/traction can offer back pain patients, even with limited and/or biased education. In 1998, surveys by 2 major manufacturers suggested less than 10% of DC’s actively marketed decompression, a survey by The American Chiropractor, in ’09 reveals as many as 34% now do. Emphasizing doctor skill empowers both the doctor and the chiropractic profession as the producer of the result, relegating the machine to its proper role as simply a tool. This being the conclusion from both the FDA as well as the "significant results" gained from the research trials NOT using specialized, expensive equipment.
More and more, chiropractors are seeking the knowledge of how to do decompression before purchasing a decompression system; analogous with learning how to adjust before buying an adjusting table. We have seen a four-fold increase in attendance of chiropractors not having first purchased a Decompression/traction system at our seminars this past year.
Technique is defined as a method or procedure utilized to undertake an activity. One might conclude that where there are more opinions than facts, the more numerous the "techniques".
Decompression/traction therapy is fraught with numerous opinions as well. But, unlike adjusting techniques, decompression therapy has the added burden of relentless hyperbolic and unsupported marketing claims. This has created an environment of confusion, obfuscation and manufacturer biased training that has, at once, both grown and stymied the use of this highly valuable therapy to under 30% of the profession. Many thoughtful and well seasoned clinicians have fallen prey to the claims, jumping in with eyes wide shut. The vast majority who seek "decompression technique training" tend to do so in order to get the better results with whatever equipment they purchased. Many are also acutely aware of the risk potential of applying a therapy to patients without formal training in the procedure.
Decompression/traction applied to a disc with an intact, hydrostatic nucleus will "decompress;" i.e., create a centripetal effect and an osmotic gradient. This enhanced and expedited osmosis in addition to activation of pain gate mechanisms, can perhaps hyper-accelerate the slow matrix healing of the disc and avoid the negative effects associated with inversion and excessive bed rest.
What constitutes decompression as a technique is having an objective clinically driven treatment algorithm and patient classification system without necessary alignment with a particular machine.
Patient selection classification is the obvious and rational trend in physical medicine and so, too, with decompression therapy. The only requirement of a machine is to allow the greatest versatility and amendment to the patient condition...the system must work with us, not get in our way. We need to classify our patient based on reasonable scientific and clinical standards first. Fortunately, many pioneers have paved the road before us, such as McKenzie, McGill, Grieves, Sarhman, Lee, etc.
By focusing on current research, we can create a much clearer pattern of disc pain vs. non-disc pain, and somatic referral vs. radicular symptoms. This research is available in the works of Bogduk, Towmey, Grieves and Mulligan, to mention a few. Certain clinical tests, such as Form & Force-closure, can afford a viable differential prediction between a disc compression problem vs. a movement disorder not predominantly disc related. Straight Leg Raising ( SLR), Femoral stretch, Millgrams and other "nerve-tension" signs can offer an excellent sensitivity/specificity ratio in helping us adjudicate nerve tension from simple discogenic pain or annular tears. Each condition, though often manifesting similar subjective complaints, may require distinctly different treatment methods to be effective. First do no harm is as important in chiropractic & decompression therapy as it is in medicine. A good technique eliminates one-size-fits-all and creates a codified and pointed treatment plan. This affords the clinician a reasonable direction-of-travel from diagnosis to treatment parameters, whether supine, prone, directional-preference, side-lying, short, long or Continuous Passive Motion (CPM) protocols. Chiropractors can now learn and utilize a technique with decompression to better treat injured discs. We, as clinicians, can never know with utter certainty prior to the treatment if it will compel the body to heal; but, we can, based on reasonable and research proven classification parameters, give ourselves and the patient the best possible decompression/traction intervention available.
Dr. Jay Kennedy is a 1987 graduate of Palmer Chiropractic College and developer of the Kennedy Decompression Technique. Dr. Kennedy teaches his popular technique to practitioners who want to learn how to become experts in the application of this increasingly mainstream therapy. Kennedy Decompression Technique Seminars are approved for CE through various Chiropractic Colleges. For more information, visit www.KennedyTechnique.com