Non-surgical spinal decompression (NSSD) is a treatment frequently used for managing chronic back pain. This non-invasive therapeutic approach aims to alleviate pressure on the spinal discs and nerves. NSSD is often considered an alternative to more invasive procedures for certain painful spinal conditions. This article explores the mechanics of NSSD, how it provides pain relief, the conditions it treats, and when it should be avoided.
Understanding Non-Surgical Spinal Decompression
Non-surgical spinal decompression (NSSD) is a form of motorized traction utilizing a specialized, computer-controlled table. The patient is secured with harnesses around the trunk and pelvis, allowing the table to gently stretch the targeted spinal segment. Unlike conventional traction, which applies a steady, continuous pulling force, NSSD uses an intermittent approach. The computerized system cycles between periods of tension and relaxation. This cycling helps prevent the paraspinal muscles from going into spasm, allowing the therapy to be customized and optimizing the decompression effect.
The Mechanism of Pain Relief
The mechanism of pain relief involves creating negative pressure within the intervertebral disc space. As the table stretches the spine, it causes a slight separation between the vertebrae, reducing pressure inside the disc. This controlled pulling force can reduce intradiscal pressure to a sub-atmospheric level, sometimes reaching -100 mmHg. This pressure reduction creates a vacuum-like effect that may help draw bulging or herniated disc material away from sensitive spinal nerves, alleviating symptoms like radiating pain and numbness.
The alternating cycles of stretching and relaxing also promote imbibition, which is essential for disc health. Intervertebral discs lack a direct blood supply and rely on movement to pull in water, oxygen, and nutrients. The cycling of pressure enhances the diffusion of these healing fluids into the disc, accelerating the repair of damaged disc fibers.
Common Back Conditions Treated
NSSD is primarily recommended for painful conditions rooted in disc compression or degeneration. It is commonly used for treating herniated or bulging discs, aiming to reposition displaced disc material and relieve pressure on surrounding nerves. This mechanism is particularly helpful in managing sciatica, which often results from a disc compressing the sciatic nerve root.
The treatment is also used for chronic pain associated with degenerative disc disease (DDD). Decompression cycles improve disc hydration and nutrient exchange, which may slow the degenerative process and relieve stiffness. Additionally, NSSD may offer relief for spinal stenosis (narrowing of the spinal canal) and posterior facet syndrome.
Who Should Avoid Spinal Decompression
While NSSD is a non-invasive option, it is not appropriate for all patients with back pain, and certain conditions are considered contraindications. Individuals who have had a spinal fusion surgery with metal hardware should not undergo this therapy, as the stretching forces could destabilize the instrumentation. Patients with severe osteoporosis or those with active spinal infections or tumors are also advised to avoid decompression due to the risk of fracture or worsening the underlying condition. Other absolute exclusions include:
- Pregnant women.
- People with a known abdominal aortic aneurysm.
- Certain types of spinal instability.
- Recent spinal fractures.
Beyond these safety concerns, patients should maintain realistic expectations for the treatment’s efficacy. Full treatment protocols often require numerous sessions, typically 20 to 28 visits over several weeks. Maximizing long-term outcomes involves integrating the decompression therapy with a comprehensive rehabilitation plan, such as physical therapy and targeted exercises.