Spinal decompression is a relatively new form of spinal traction being promoted for the treatment of protruding and degenerated spinal discs in the lower back and neck. There has been considerable controversy surrounding spinal decompression since it first started gaining popularity in the United States. Part of the controversy had to do with marketing claims made by equipment manufacturers eager to capture market share that were overzealous and sometimes outright fraudulent, and part was due to confusion and ignorance about the differences between spinal decompression and regular spinal traction. When one looks past the controversy, it becomes clear that spinal decompression is a solid form of treatment for disc-related pain. It is neither the faultless miracle touted by its promoters nor the shameless scam claimed by its detractors. Like most things, the truth about spinal decompression lies somewhere in the middle. For those who have not looked beyond their preconceived notions about spinal decompression, it might appear to be nothing more than the same spinal traction that has been used for decades in the treatment of back and neck pain. But there are definite differences between spinal decompression and regular traction that are significant in terms of their effects and treatment outcomes. Regular traction systems simply pull on the spine at a pre-set rate and force. Spinal decompression systems gradually build up the force of the pull, and the more sophisticated spinal decompression systems can also adapt to the body's reactions to the treatment. For example, the DRX-9000 system monitors the body's resistance to the pull and if the body's muscles begin to contract and fight the treatment, the machine immediately (within 1/17th of a second) "gives" to the resistance by decreasing its pull. This adaptability of the machine allows the body to stay relaxed for the majority of the treatment and by keeping the body relaxed, the treatment effects are much greater on the spinal discs that what can be achieved with regular traction, or even the less-sophisticated spinal decompression systems. Studies done on changes in disc pressure from regular traction found that although traction did reduce disc pressure, it was insufficient to reduce disc bulging or to significantly improve disc hydration and nutrition. This is because muscular resistance to traction forces simply limits the effects of the traction pull. The least sophisticated of the spinal decompression systems improve on these results and do reduce disc bulging in some cases because the traction pull builds up very gradually and helps prevent muscular resistance resulting in dramatic reduction in disc pressure to a mild suction force sufficient to retract disc bulges. With the higher-end spinal decompression systems, treatment effects are greater still because they can largely eliminate muscular reaction and resistance. These systems have been shown to actually produce strong suction forces within the spinal discs which effectively pull protruding disc material back into the disc as well as pull in fluid and nutrients which are believed to promote disc healing. That being said, even the best spinal decompression systems do not work for every patient. There are of course situations that prevent the use of spinal decompression, but even with well-qualified patients, there are some people it just does not help. Although clinical studies claim a 90% success rate, the real world results are not as good. Formal clinical studies have the advantage of being able to exclude less-than-perfect test subjects and those who fail to follow the treatment protocol exactly to the letter. In the real world, there are complicating factors that can interfere with treatment results, people miss appointments, people engage in physical activities that they aren't ready for, etc.. With careful patient selection, the real success rate for spinal decompression is probably around 70- 75% as a stand-alone treatment, and perhaps somewhat higher when combined with other therapies. This success rate seems to hold up in the long run for most patients as well, with very few reported recurrences of symptoms a year after treatment. But even at a 70% success rate, spinal decompression is more effective than the most common disc-related treatments currently in use, such as spinal injections and surgery, which most studies have found provide long-term benefits in only about 50% of patients. Ultimately the effectiveness of spinal decompression for a given individual depends heavily on the specifics of the patient's condition. Generally, it works quite well for patients with degenerated and/or protruding discs of mild to moderate severity. Severe protrusions and extrusions (disc ruptures) will sometimes respond well to spinal decompression, but the results are much less reliable. It works well for patients of all ages. Interestingly, my experience has shown that spinal decompression seems to actually be somewhat more reliable for treating older individuals, perhaps because they are less likely to engage in heavy lifting and other activities that tend to re-injure the discs. So, as to the questions most disc-pain sufferers have about spinal decompression, is it a legitimate form of treatment? Absolutely. Will it help you? Probably, assuming that you are a good candidate for treatment. Just remember that spinal decompression is not a cure-all as it is sometimes hyped to be. I highly recommend that most disc-pain sufferers at least try it before resorting to an invasive surgery, and most of the time sugery will not be necessary. Best of all, for those patients who do get good results from spinal decompression, most are able to return to just about any activity they wish to do, whereas those who undergo surgery are often significantly limited. Spinal decompression is not perfect, but it is a very good treatment option for the majority of disc-pain sufferers.