Sunday, December 02, 2012

Spinal Decompression Therapy


The following is my personal opinion of Spinal Decompression, based on my experiences in the fall of 2012 at a Toronto back clinic.

I am a male, age 65, and have suffered from lower back pain (L5,S1) for more than half of my life. All back pain sufferers have different symptoms - for me, I was generally fine for most of the year, however every few months I would be the victim of seemingly random attacks, which would leave me completely debilitated and confined to bed unable to move for a week to 10 days. Despite the pain, recovery was usually quite sudden and complete, often finding me back to my normal routine within two or three weeks. During the period of the attacks, the pain was excruciating, often locking up my whole mid-section.

Over the years, I have tried virtually everything to free myself of these sudden and painful attacks - chiro, physio, acupuncture, yoga, steroid injections, etc. Nothing worked. I was adamant that I would not go under the knife - I had heard that for many who chose surgery, their back pain returned again after a number of years.
Then I heard about a particular back clinic in my area that was advertising heavily on the radio stations here in Toronto - glowing testimonials from previous patients. I decided to pay them a visit - it is unfortunate that I did not do my due diligence and research before my appointment; otherwise I would have probably made a different decision.

I met with the Director of this particular clinic (for the sake of this article, I will call him Robert). I mentioned that I was not currently in any pain, but that in my case, I get attacks every few months. As such, I stated that it would be difficult to gauge the success of any treatment, other than waiting 6 months to a year to see if the attacks returned.

Robert asked if I had any X-rays or MRI scans done recently. I mentioned I had an MRI done a few years ago, and he asked to see it. I obliged by getting a copy from the hospital and bringing it in for him to review. He examined the images, and stated that I had severe degradation of the lumbar disc at L5,S1. I already knew this; also, my last scan had indicated that my complete spine had degenerative disc disease, and the diagnosis was that there was nothing really that could be done for this.

However, Robert was quite emphatic that he could fix my condition with his combined treatment of spinal decompression, laser therapy, and supplements. This is where the high-pressure sales pitch came in. He claimed a 95% success rate with over 13,000 patients. Wanted me to sign up right away, as my condition was quite severe and he did not want me to waste any time before starting his program.

The cost?  It was quite high.. he offered several plans. Pay as you go: which would end up costing over $10,000 for 20 spinal decompression and laser therapy sessions. Alternatively, I could pay in 3 payments, and the cost would be reduced slightly. Or pay it all up front and save about $3,000. Despite this high cost, my wife and I agreed it was worth a try. But when we tried to defer our payment by a few weeks so as to have the payment appear on the next month's Visa bill, he would not allow it. He insisted on payment up front, despite the fact I was going on vacation and would not be able to start treatment for several weeks. That should have been a warning flag to me, but I missed it. I paid the $7,000+ dollars and left for my vacation.

When I returned and started treatment, I was surprised to see a new receptionist at the desk - the first of many staff changes yet to come. She provided me with a back support belt, which she seemed to have difficulty adjusting and fitting on me. No specific instructions were given as to the use of this belt. She also gave be a large jar of supplements that I was to take each day. When I got home, I found these supplements consisted of 3 large capsules of fish oil (Omega-3), 3 large capsules of Glucosamine, and 3 capsules of some herbal remedy. (I had already been taking Omega 3 fish oil and Glucosamine daily on my own, and mentioned this to Robert. He asked me to stop taking these, and use his own brands of these.)

The treatments consisted of:
  1. sitting with a heating pad on my back for 10 to 15 minutes
  2. then onto the rack (DRX9000 spinal decompression bed) for 25 minutes
  3. then lying down with an ice pack on my back for 10-15 minutes
  4. then having laser therapy (class IV K-laser) for about 8 minutes
This process was repeated for each session, usually 3 or 4 times a week.

Half way through the treatments, I had a 10 minute evaluation by Robert, who examined me with some high-tech monitoring device on my back that graphed out my areas of pain/inflammation. He claimed it had been reduced significantly - I said I did not feel any differently. He gave me a series of stretch exercises to perform each day.

After 20 sessions were complete, I had another short evaluation with Robert, where he said I had significant improvement, and gave me a few more stretch exercises to do each day. Robert also gave me an 'adjustment' to my spine - the typical back twist and cracking used by all chiropractors. I was to return the following week for another 'adjustment' and for orthotics fitting. These were included in the cost of the program. Oddly, the fitting was done by the receptionist - not a trained technician, chiropractor, or doctor.

I was to return the following week to pick up my orthotics, but as fate would have it, I had another back attack which left me confined to bed for a week, so I had to cancel my appointment. So much for the great success claims of this back clinic!

When I did return for my orthotics, I found them somewhat uncomfortable - the left one seemed to have a bump pushing up on the ball of my foot, just above the arch. The receptionist said this was normal, and would take some time to get used to.. she did not offer to check them or that they were correctly fit to my feet. Robert then came in for 5 minutes and gave me another 'adjustment' – he did not check the orthotics.

My final session was basically an exit interview with Robert, and a sales pitch for ongoing adjustments and a monthly or semi-monthly session on the rack and laser therapy. With my severe disc degradation problem, he suggested that actually a weekly visit would be best. I told him that I felt the therapy did not help me - I informed him of my back attack after the last session, and he was quite surprised and asked why I had not mentioned it. I said I had told his staff.  (I was surprised they had not informed him). Based on that, I felt it would not be in my best interest to continue therapy with him and his clinic. I asked if he offered a money back guarantee, and he told me that all patients are different and react differently to treatments, and therefore he could not make any such guarantees. Instead, he offered to give me 10 more treatments free of charge - I declined the offer.

Overall, I was disappointed with the whole experience. I kick myself for not doing due diligence - there are many non-success stories on the net. Unfortunately, the cost of this program was not covered by my company medical insurance.

I found the staff at this back clinic to be rather unprofessional. On several days I was left waiting 30 to 40 minutes for my laser treatment, only to be told (after I finally asked) that the laser technician was off sick that day. There were several other instances where I was left waiting for long periods - all that was needed was a brief explanation for the delay, but this was never forthcoming. Other days, I would observe staff laughing out loud and giggling uncontrollably like little girls - in front of patients. In another case, I was being attended to on the rack by Robert, all the while with his cellphone in his ear carrying on a conversation with someone else while treating me - very unprofessional.

During my treatment, I saw a very high staff turn-over - not once, but several times - to the point that when I left the clinic after 2 months, none of the original staff, other than Robert, had remained. This changeover of staff had an impact on my treatment as I found the new staff were being trained and learning on the job, with me as the guinea pig. I found myself being strapped onto the rack in different techniques, some of which I felt were wrong, as I did not have the same feelings and sensations as in previous appointments. Same for the laser treatments.. different from person to person.

Spinal decompression may not be for you. If you are considering this treatment, think twice and do due diligence. Search the web for information on spinal decompression. While there are many spinal decompression success stories, there are also some bad experiences. Try to get references from former patients of the clinic you are considering; try to speak to former patients who have had the treatments several years ago to see if there was a relapse. Many back clinics have websites. Check out the staffs' credentials, and check it out again in a month or two to see if there is frequent staff turnover – a red flag in my opinion. And do not rush into treatment – if you have been suffering from back pain for many years, you probably can wait a few more months while you check out the clinic.
 
As a long time back pain sufferer, I am of the firm belief that TIME HEALS. During peak pain attacks, I have often thought I was going to be left permanently disabled in some way. However, given time, the back will heal itself. In my personal case, I have found that severe back pain will usually leave me disabled for a week to 10 days (i.e., confined to bed, unable to move). Then, almost like magic, I can move with relatively little pain, and after 4 to 6 weeks, completely back to normal. That is, until I do something stupid like twisting, bending or lifting improperly. The key is knowing your limits and recognizing what causes the attacks.

CBC's Marketplace did a program on spinal decompression back in 2010.  I believe only Canadian residents can view this online. Well worth watching before you commit.  Here is a link to that show:
Stretching the Truth -
http://www.cbc.ca/marketplace/2010/stretching_the_truth/main.html

Another good resource is Donald S. Corenman’s website: www.neckandback.com. Dr. Corenman is an Orthopedic Spine Surgeon who has been working for the past 12 years at the Steadman Clinic in Vail, Colorado. One good aspect of this site is his forum, where he is said to personally answer all questions related to back pain.

Here are some quotes from Dr. Corenman, who was initially trained as a chiropractor before becoming an orthopedic spine surgeon:
 
“The decompression (traction) table typically used by chiropractors (DMX 9000 and others) I am generally not a fan of. The two problems are the costs and utilization. Generally, there is a "program" you have to sign up for. This programs consists of 20 visits regardless of the success of traction and traction can aggravate symptoms in some patients. The charges of using the machine are also very high. Now I am not against traction, but to state that this modality "decompresses" the disc is not valid or accurate. If traction is to be effective, you should know in 2-3 visits and if the initial treatment aggravates symptoms, do not continue.”

            “The "spinal decompression" machine is simply a traction machine. It does not put anything "back into place". I have no specific objection to these spinal decompression machines like the DMX 9000 except the "sales programs" associated with them. You do not need more than two "treatments" to find if they are effective for you personally. I personally think these machines are not that effective.”