Does spinal decompression work? An honest look at the evidence

What does the strongest research say?

The best summary, a Cochrane review of traction, found it was no more effective than sham treatment or other common treatments for low back pain.

The Cochrane review on traction for low back pain looked at 32 randomized trials with 2,762 people. It found traction, alone or combined with physiotherapy, was no more effective than sham traction, physiotherapy without traction, or treatments like exercise, laser, ultrasound and corsets. That held for people with and without sciatica, and for both manual and mechanical traction. The authors rated the evidence quality from very low to moderate and noted a shortage of high-quality studies.

Decompression tables are a form of motorized traction. Manufacturers say their computer-controlled cycles work differently, but there isn't strong independent research showing better results than other traction.

Do guidelines recommend decompression?

Major guidelines don't list decompression among recommended first-line treatments for low back pain.

The American College of Physicians guideline recommends starting with non-drug options: heat, massage, acupuncture or spinal manipulation for short-term pain, and exercise, rehabilitation, mindfulness, yoga, tai chi and similar approaches for chronic pain. Traction isn't among them. NIH's NCCIH summarizes the evidence for complementary approaches for back pain in plain language.

So why do people try it?

Because it's non-surgical and drug-free, side effects are usually mild with proper screening, and some people feel better.

• Some people have already tried physical therapy, medications or injections without enough relief.
• Some want to avoid or delay surgery or repeated injections.
• Some simply prefer a hands-off, drug-free option and are willing to commit the time.

Those are reasonable reasons to ask, as long as expectations are realistic. Back pain often improves on its own over time, which makes it hard to know what helped any one person.

How does decompression compare with other options on evidence?

Exercise has the most support; injections show small short-term benefit; decompression has the least research.

How should I decide whether to try it?

Get a proper diagnosis, rule out reasons it isn't safe, set measurable goals, and agree on what happens if it isn't helping.

• Make sure serious causes have been ruled out. See warning signs.
• Check you aren't in a group for whom it's not recommended. See who should not have it.
• Ask the clinic how they'll measure progress and when they'd stop. See questions to ask.
• Keep up exercise and daily activity alongside it.

What will this clinic tell me?

The same thing this page says: it may help some people, research is limited, and the exam decides.

Springville Disc Center doesn't publish outcome statistics or promise results. Dr. Gordon Stapel, DC will review your history, exam and imaging, tell you if he thinks decompression is worth trying, and tell you if he doesn't. Call (801) 491-8688 with questions.

This website is operated for Stapel Family Chiropractic (Springville Disc Center) in Springville, Utah. Care is provided by Dr. Gordon Stapel, DC, a licensed chiropractic physician. About this site.