Spinal decompression is the treatment patients ask the most questions about, and the one with the most overheated marketing around it. This post answers the twelve questions we hear most often — including the ones about evidence and FDA status that a lot of practices would rather skip.
1. What is non-surgical spinal decompression?
It's a form of motorized traction. You lie on a table, a harness is fitted around your pelvis (or a cradle around your head for neck treatment), and the table applies a controlled pull along the length of the spine, cycling between tension and partial release over a session of roughly 20 to 30 minutes. The goal is to reduce pressure within the discs and on the nerve roots while you're on the table. It is not surgery, there's no incision, and you walk out afterward. Our spinal decompression page describes the equipment we use.
2. What is it used for?
At our office, decompression is used as part of conservative care for disc-related back and neck pain — herniated and bulging discs, sciatica from a disc, and some cases of spinal stenosis and nerve root compression. The American Academy of Orthopaedic Surgeons notes that most people with a herniated disc feel much better with a few weeks or months of non-surgical treatment; decompression is one tool inside that non-surgical window.
3. Is it FDA-approved?
No, and you should be suspicious of any practice that says it is. Decompression tables are FDA-cleared, which is a different thing. Clearance means the FDA has reviewed the device as substantially equivalent to existing traction equipment and permits it to be sold. It is not an approval, and it is not a finding that the device treats or cures any condition. The FDA draws the same distinction between clearance and clinical benefit across imaging and other medical devices, and "cleared to treat X" is a phrase the agency doesn't use.
4. Does it work? What does the research say?
Honestly: the research is thinner than the marketing. The most rigorous summary is a Cochrane review of traction for low back pain — 32 randomized trials, 2,762 patients — which found low- to moderate-quality evidence that traction makes little or no difference to pain or function compared with sham treatment, for people with or without sciatica. That review covers traction broadly, not specific decompression tables, and the trials were mixed in quality. But it's the best-controlled evidence available, and we'd rather you hear it from us than find it later. What we can say from clinical experience is that some patients with disc-related pain report meaningful relief during a decompression course, particularly when it's combined with exercise and load management. What we can't say is that it's proven, that it works for most people, or that it cures discs.
5. Who is a candidate?
Patients with disc-related low back or neck pain, leg or arm pain from nerve root irritation, or stenosis symptoms who have no red flags and who want to try conservative care before considering injections or surgery. The exam decides. If your pain is muscular, decompression is the wrong tool; if it's a fracture or infection, it's the wrong office.
6. Who should not have it?
Anyone with a spinal fracture, spinal tumor or infection, severe osteoporosis, spinal fusion or hardware at the treated levels, an abdominal aortic aneurysm, pregnancy, or progressive neurological deficit. Recent spine surgery needs a surgeon's clearance. Those are the reasons the exam — and sometimes an X-ray — comes first.
7. Does it hurt?
It shouldn't. Most patients describe a stretching sensation; some fall asleep. The pull is set well below the level that would cause the muscles to guard against it, because guarding defeats the purpose. Tell the practitioner if you feel sharp pain or symptoms spreading down a limb — the session stops and the settings change.
8. How many sessions?
A typical course is several sessions a week for a few weeks, then a reassessment. We don't sell fixed packages of 20 or 24 visits up front. If you're not improving after a reasonable trial, continuing the same thing is not the plan; changing the plan is.
9. Is it the same as an inversion table?
No. Inversion hangs your whole body weight from your ankles with no control over the force at any one level. A decompression table applies a measured pull at a specific angle, cycles it, and can be stopped instantly. The underlying idea — unloading the spine — is related, but an inversion table is not something we tell people to buy.
10. Will I need an MRI first?
Not always. If you already have recent imaging, bring it. If your exam points clearly to a disc problem without red flags, a trial of conservative care can begin without an MRI. If findings are unclear, or symptoms include weakness or spreading numbness, imaging comes first.
11. What else is in the plan?
Decompression alone is rarely the whole plan. Most patients also do specific exercises to stabilize the spine, get advice on sitting, lifting, and sleeping positions, and may have adjustments or soft-tissue work to the areas around the involved level. The table unloads the spine for half an hour; the rest of the plan is what you do with the other 23 and a half.
12. What's the honest bottom line?
Decompression is a reasonable, low-risk option to try for disc-related pain when the exam supports it and you understand that the evidence is limited. It is not a cure, it is not proven to outperform other conservative care, and nobody should tell you otherwise. If it helps you, it helps you; if it doesn't within a reasonable trial, we'll say so and change course.
Ask the thirteenth question in person
If you're weighing decompression for a disc problem, book an evaluation or call (407) 909-4788. You'll get an exam, a straight answer about whether you're a candidate, and no pressure to buy a package. Se habla español.
Frequently Asked Questions
- Is spinal decompression covered by insurance?
- Often not, and it varies by plan. We'll tell you before you start what your plan covers and what the cost would be.
- Can I drive home after a session?
- Yes. There's no sedation and most patients feel loose rather than sore.
- What if I've had back surgery?
- Decompression is generally not used at fused levels or over hardware. Other levels may be treatable with your surgeon's clearance.
- Is it safe for older adults?
- Often, but bone density matters. Significant osteoporosis is a reason not to do it, which is one reason we ask about it.
- How is this different from a chiropractic adjustment?
- An adjustment is a quick, specific movement applied by hand to a joint. Decompression is a slow, sustained, machine-delivered pull. They address different things and are often used together.