Spinal decompression vs. physical therapy

What's the difference between them?

Physical therapy builds strength and movement you keep doing at home. Decompression is a passive treatment done on a table in the office.

What does the research say about physical therapy and exercise?

Exercise is one of the best-supported treatments for chronic low back pain, though the benefit is moderate.

A 2021 Cochrane review of 249 trials found that exercise probably reduces pain compared with no treatment or usual care in chronic low back pain, and may work better than some other common treatments. The American College of Physicians recommends exercise among first-line non-drug treatments for chronic low back pain. The AAOS lists physical therapy as a common treatment for a herniated disc in the lower back.

What does the research say about decompression?

There is little high-quality research, and reviews of traction have not shown a clear benefit.

Decompression tables are a type of motorized traction. A Cochrane review found traction, alone or added to physiotherapy, was no more effective than sham treatment or other treatments for low back pain, with or without sciatica, although the quality of the evidence was low to moderate. Some patients still feel better with decompression, and it has few serious side effects when people are screened properly. More: does spinal decompression work?

Can I do both?

Yes, and for many people that's the sensible route: decompression sessions plus a home exercise routine.

Decompression doesn't replace staying active. If you have exercises from a physical therapist, keep doing them unless a provider tells you otherwise. Let both offices know what you're doing. See what to do between decompression sessions.

I already tried physical therapy. Is decompression the next step?

It can be one option, if the exam shows disc-related pain and nothing rules it out. So can injections, a different PT approach, or a surgical opinion.

• Think about how long you did PT and whether you kept up the home program. Sometimes a different therapist or approach helps.
• Bring your PT notes, imaging reports and medication list to a consultation.
• Ask what's expected, how progress will be measured, and what happens if you aren't improving.

Compare other options too: decompression vs. injections and decompression vs. surgery.

Do I need a referral?

Not for physical therapy under Utah law, and not to request a consultation here.

Utah Code § 58-24b-307 lets a physical therapist evaluate and treat you without a referral from another provider; your insurance plan may still require one. You don't need a referral to call Springville Disc Center at Stapel Family Chiropractic for a free consultation with Dr. Gordon Stapel, DC. Call (801) 491-8688.

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.