Research indicates the disc is responsible for a significant number of lumbar/leg pain and neck/arm pain syndromes. Compression increases intradiscal pressure leading to annular compromise and possible extrusion of nuclear material.
Since the disc is an avascular structure, it doesn't receive fresh blood and oxygen with every beat of the heart. It requires "diffusion" created by motion and 'Decompression' to restore nutrients and enhance healing.
Decompression is defined as reduction in pressure (intradiscal). Recumbent positions (both prone and supine) decrease intradiscal pressures in comparison to standing and sitting. However focused, axial mechanical+Y translation traction, (creating 'Decompression' i.e. unloading due to distraction and positioning) has been shown to reduce disc pressure and enhance the healing response even further.
There is some suggestion in the literature that extruded nuclear material may be "drawn in" by the reduction of intradiscal pressures. This concept however is not uniformly accepted since the length of time the material stays 'drawn in' has not been established in controlled studies. However, a temporary reduction in intradiscal pressure can still have a profound effect on the healing process via increased contact with the blood supply and fibroblast migration (so called phasic effects). This is in addition to the pain relief created neurologically by stretching soft tissue (e.g. stretch receptors, mechanoreceptors etc.) make Decompression Traction Therapy a logical and viable addition to a "passive" pain care regiment.
Clinically it is important to establish criteria both in the utilization of DecompressionTraction Therapy and in defining its utility. (As with many therapies, hyperbole and overstatement are common.) Axial Decompression (both lumbar and cervical) is first and foremost a "passive" therapy and as such has definite limitations in "curing" a chronic musculoskeletal condition. Its value is most specific in helping referral pain not solely low back or acute low back pain (symptoms for which manipulation has proven beneficial).
Loss of local muscle control, abnormal posture and alterations in spinal curves are the probable underlying source of most spinal 'compression' and degeneration. Therefore a "passive" therapy has little effect in truly fixing the underlying problem.
However, that being said, Decompression Traction Therapy (done safely within established protocols and a clear understanding of it's limitations) can often effectively enhance the healing process and render quick, effective and often amazing pain relief in a properly selected patient population (many who have previously failed other treatments). Additionally it may also be very useful in determining the overall prognosis of passive care and expediting the phase-in of rehab protocols.
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