Non-surgical spinal decompression for back and neck pain

What is non-surgical spinal decompression?

Non-surgical spinal decompression gently stretches your spine using a specialised, computer-controlled table. The table applies a pulling force that builds up gradually, holds, then eases off, repeating in cycles throughout your treatment.

It's designed for pain linked to your spinal discs, such as a herniated (slipped) disc, a bulging disc or disc degeneration, and the nerve pain these can cause in your legs or arms.

It's not the same as spinal decompression surgery, which is an operation to remove bone or disc tissue. Non-surgical decompression involves no incisions.

How does it work?

Between each pair of bones (vertebrae) in your spine sits a disc, a cushion with a gel-like centre. When a disc bulges or herniates, it can press on nearby nerves and cause pain, numbness or tingling.

Decompression gently lengthens the spine to reduce the pressure inside the affected disc. This effect has been measured directly: in a study published in the Journal of Neurosurgery, researchers measured pressure inside patients' lumbar discs during treatment on a decompression table. They found that pressure inside the disc fell as the pulling force increased, and at higher force it dropped below normal resting levels into negative pressure.

What this means, and what it doesn't: the measurement shows that decompression can reduce pressure inside the disc during treatment. The idea that this helps draw disc material back and supports healing is a widely held theory, but it hasn't been proven directly. That's one reason we never use decompression on its own. In DTX, it's followed by structured rehabilitation to rebuild strength and stability.

What happens during a decompression session?

1. Positioning. You lie comfortably on the decompression table. A harness or neck support is fitted depending on whether your lower back or neck is being treated.
2. Settings. Your physiotherapist sets the force, angle and stabilisation for your condition and the affected level of your spine.
3. Treatment. The table gently increases the pulling force, holds it, then eases off, in repeated cycles. Most people find it comfortable, and many find it relaxing.
4. Rehabilitation. Decompression is one part of a 60 to 75-minute DTX session. The rest of your session focuses on mobility, stretching and strengthening.

You're fully clothed throughout, and you can go straight back to your day afterwards.

Does spinal decompression work? What the studies show

Research on non-surgical spinal decompression is growing, though most studies are still small. Here's what the key studies found, including their limits.

In a randomised study of 148 people with lower-back disc degeneration, three-plane traction-decompression gave faster and more lasting relief over 12 to 15 weeks than standard traction or no traction.
Zhirnov VA, et al. Traumatology and Orthopedics of Russia, 2013. doi.org/10.21823/2311-2905-2013--1-51-60

→ Read our full review of the decompression evidence

Non-surgical decompression or surgery?

For most people with disc-related back or neck pain, a structured non-surgical program is a reasonable first step, and many people improve without an operation.

For lumbar spinal stenosis (narrowing of the spinal canal in the lower back), a Cochrane review of five randomised trials compared surgery with non-surgical care such as exercise, bracing and injections. The reviewers couldn't conclude that either approach was clearly better. Disability scores were similar at six months and one year, with a small difference favouring surgery at two years. In the studies that reported them, complications occurred in 10% to 24% of people who had surgery, and the reviewers advised clinicians to be cautious when proposing surgery for this condition.
Zaina F, et al. Cochrane Database of Systematic Reviews, 2016. Read the review

Surgery still has an important place. It may be the right choice if you have severe or worsening nerve symptoms, such as increasing weakness in a leg or arm, or if non-surgical care hasn't helped enough. If your assessment or your progress suggests you should see a spine surgeon, your physiotherapist will tell you honestly. Starting with DTX doesn't rule out surgery later.

Who may benefit?

Your physiotherapist decides whether decompression suits you at your assessment. It's commonly used for:

• Herniated (slipped) disc and bulging disc
• Sciatica (pain spreading from the lower back down the leg)
• Nerve pain spreading from the neck into the arm
• Degenerative disc disease
• Lumbar and cervical spondylosis

→ See all conditions we treat

When decompression may not be suitable

Decompression isn't right for everyone. It's commonly avoided or adapted in situations such as:

• A recent spinal fracture, or a spinal tumour or infection
• Previous spinal fusion surgery or spinal implants
• Osteoporosis (decompression may be used only for low bone density, called osteopenia)
• Ankylosing spondylitis beyond the early stage
• Certain stages of spondylolisthesis
• Pregnancy, depending on the stage

If decompression isn't suitable, your DTX program uses other therapies instead, such as shockwave therapy (ESWT), pulsed signal therapy (PST), physiotherapist-led stretching and exercise therapy.

Seek urgent medical care, not physiotherapy, if you have loss of bladder or bowel control, numbness around the groin, or rapidly worsening leg weakness.
→ Know the red flags

Part of a complete program

Decompression is stage two of the six DTX stages: Assess, Decompress, Restore, Strengthen, Empower, Maintain. It's delivered with US FDA 510(k)-cleared technology, within a program of 15 to 25 sessions, and followed by rehabilitation and follow-up at 1, 3, 6 and 12 months. The 1- and 3-month follow-ups are included in your program fee; the 6- and 12-month reviews are charged separately.

→ Explore Maana Spine DTX™
→ Read our full review of the decompression evidence

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