3 Tips to Improve Decompression Clinical Outcomes Today
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Let’s face it; if you can achieve better outcomes from your decompression practice, more likely than not, you will increase your patient base. We’ve looked into common mistakes in decompression therapy practices and developed 3 steps tips you can implement now to improve your spinal decompression clinical outcomes. First, Don’t Pull Too Hard What is the most common thing that male doctors do when they want to improve their spinal decompression outcomes? Pull harder. The thought process is, “If I pull harder, I will get better results.” What we have found through 9 years of clinical experience and consultations with hundreds of spinal decompression doctors is that sometimes less is more when it comes to the force needed to “decompress” a herniated or bulging disc. While some patients may require more force more force, for example body builders or construction workers, the typical patients who are not responding to care as quickly as you would like often respond better and faster to LESS force and NOT more. The recognized gold standard dictates applying force at approximately 50% of the patient’s body weight, for approximately 25 minutes. However, we have found that applying force at 35% of the patient’s body weight achieves the same or better results, without causing patients to go into spasm or lock up. Second, Don’t Worry So Much About the Angle Of Pull The angle of pull is more marketing hype than actual truth. Very rarely have we found that the angle of pull makes a difference in therapeutic outcomes. Ten degrees, 20 degrees, 22.4 degrees, etc., all are probably going to produce the same therapeutic outcome. One of the world’s spinal decompression experts, Dr. Jay Kennedy put it best, "Angles are pure and exact math. The most differential thing you could ever hope to attach to a decompression table is a human being!” As improbable as it sounds, there are still clinicians who believe that a specific angle can reach a specific outcome for the spine in every instance. This is a biomechanical impossibility. For any angle to be accurate, EVERTHING must be consistent, including exact patient positioning, spinal height, disc height, ligamentous tension, curvature/lordosis angle, etc. In short, no two people are the same; the most we can know about angulation is that (supine) a steep angle will transmit more of the force higher in the spine. How much and high is speculative at best. The best information on this subject derives from a 1968 traction study (Colachis and Strom and Rene Cailliet, MD)1, “[The] authors suggest that acute pull angle creates less flexion than obtuse angulation. It is hardly $100,000 information, and thus exact degree angles are best suited for a sales pitch not a viable treatment." Reference 1. Kennedy J. Debunking the Myths of Decompression. In: KDT Newsflash Extra, April 2008. Third, Start Grouping Your Patients on Two Main Categories. Group your patients into the following groups: lexion based and extension based. The easiest way to figure out the appropriate grouping is to have patients perform movements in flexion to determine if the resultant leg pain travels farther down, into the leg or farther up, into the spine. Follow the lexion procedure with specific extension movements to determine location of the pain associated with extension. Based on the results of these procedures, you can now determine whether the patient will be treated in a flexion-based position or an extension-based position. If you only have a table that treats in a supine position with the patient’s legs up, then you unfortunately don’t have the same options as tables that allow you to put patients on their stomach and raise the table up into an extended position (Triton DTS, DOC table). With increased decompression experience, you will start to realize that angle, force, and time have a minor role in the therapeutic value of spinal decompression compared to the dramatic effect patient positioning can have on overall success. Start thinking less about force, angle and time and start thinking about which positions make the pain peripheralize and which positions make the pain centralize and you will see a boost in success rates by about 15 to 20%. Would you like to see improved outcomes in your practice? View our selection of Top Name Spinal Decompression Tables here.