spinal decompressionAs a Nanaimo chiropractor, I get many questions regarding the concept of decompression. Some of them are:


  1. Are those inversion tables any help?
  2. How about gravity boots?
  3. Does hanging from monkey bars help?
  4. Is a hot tub good for my back?
  5. Why does traction not help my back but your treatment does?


Too much compression on the spine can be very damaging, especially when the forces are beyond what the discs can withstand. And logically, to decompress or anticompress the spine would seem to be a reasonable approach to the issue. This is a very good concept to elaborate on and in order to answer the above questions, one needs to understand how the spine works in a hydraulic fashion rather than simply thinking about bones being in and out of place.


The spine is made up of bones and soft tissue. The vertebrae contribute to 2/3 of the total height and are full of blood and pressure. The have arteries pushing blood into them and act like charges canisters of blood. But at each end of the vertebrae, there are strainers that do not allow parts of the blood to pass. Between each vertebrae are the soft tissues that keep them separated and these critical structures are called intervertetebral discs. ( inter…meaning between, and vertebrae…meaning a bony body that turns ). Interestingly, the discs contribute to a 1/3 of the height and do not have any blood vessels in them.


Now comes the good stuff. Hydraulics. And if there is no blood in the disc, how does it survive. All cells in the human body need oxygen and glucose to live. The key lies in the fluid flow in and out through a intricate network of pipes. And here in lies the answers to the questions above.


Each disc relies on the fluid flow from the vertebrae and this fluid flow relies on movement. The fluid that supports the structure of the disc is water and this water comes from the blood and is transferred across the strainer by way of movement. The centermost part of the disc, called the nucleus pulposus, has an affinity to water. It loves water and has negatively charged proteins in it (called proteoglycan) that bond magnetically to water. The more of this protein that is around, the better the disc acts like an absorbent sponge. And the ultimate goal of the sponge is to keep the vertebrae separated.


As too much compression is placed on these discs, water is squeezed out and you are left with a drier sponge that can’t resist compression. This results in the vertebrae approximating one another. And when bones get too close to one another, they produce pain as a result because they are surrounding by nerves. Furthermore, if too much anticompression occurs (like that seen with Dr. David Hadfield, Canadian astronaut ), discs swell up too much….very similar to what it feels like when you lie in bed too long.


Now, let’s talk hydraulics because this is where it gets important. All cells in the body need oxygen and nutrients to survive but importantly they all need to get rid of the byproducts. The arteries carry the food and water and the veins get rid of the effluent. A backup of effluent is often the main problem with inflammation, for example, and that is why we use ice to decrease inflammation (reduce the inflow by vasoconstricting the vessels so there is less effluent). So, discs have this tidal flow of nutrients coming in, but even more important are the veins taking the by products away. This is the difference between traction and what I perform called anticompression or unloading spinal decompression (USD).


After my publication in The Spine Journal, the data I collected supported my clinical hunch that discs respond better to dynamic USD. When I looked at the MRI images after subjects performed chair-care ( an exercise I tested), the discs plumped up in height. I suspected this was to be the case because of an important vein system call the Batson’s venous plexus that allows blood to move in a bidirectional fashion. As you may know, veins have one way valves and it is the break down of these one way valves that causes varicose veins. Interestingly, the only vein system NOT to have these one way valves are the veins of the spine. I think it is to allow blood to flow in all directions as needed containing important pressure to back up into the discs. This bidirectional flow is critical and useful for the discs of the spine.


So let’s come back to the questions and see if we can answer them now:


  1. Are those inversion tables any help?

Hanging upside down be may fine to stretch out the soft tissues but it does not provide the fluid flow effectively to ( and from ) the discs. After about 5 seconds of hanging upside down the fluid slow down considerably and the act of being upside down is only best if you reload the spine again.


  1. How about gravity boots?

This is basically the same answer as a bove but with the added unnatural forces to the ankles.


  1. Does hanging from monkey bars help?

It can if you have good shoulders but I would recommend getting off the monkey bars after about 3-5 seconds and then repeat.


  1. Is a hot tub good for my back?

This environment is good to unload discs and relax muscles but you have to careful that you are not heating up structures that are inflamed as this can exacerbate symptoms.


  1. Why does traction not help my back but your treatment does?

Often I will have patients wonder why USD works well with spinal conditions. I believe it is possibly the pulse of load to unload that provides the clues to generating the best outcome.


Caveat: be sure to consult with your Nanaimo chiropractor prior to performing any of the above strategies.