Spinal Decompression

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58 Comments

  • Luciano Russo

    Reply Reply August 23, 2011

    My 75 year old mom has got 22 treatments on the DRX 9000 going 4 times weekly for 5 weeks . I am getting her to do the exercises finnally . Now she is going once weekly for treatment,but I feel twice weekly would be better . She hasn`t felt any better but I feel it could happen at any time .L4L5 bulging disc with sciatica pains going down both legs . Do you recommend the inversion table in addition to her treatments and is 2 times enough per week on the DRX9000 ..Thanks Luciano ..Caio

    • Dr. George Best

      Reply Reply August 24, 2011

      Hello Luciano,

      After 4 times per week for 5 weeks, I’d expect your mom to have had some noticeable improvement with decompression. In my experience using spinal decompression, some of the tougher cases might take 30 to 40 sessions to get maximum improvement, but generally if there’s no improvement within 10 to 12 sessions decompression is not likely to work. Since actual decompression treatment isn’t helping (and 2 times versus 4 times per week probably won’t matter at this point), I doubt that an inversion table would be of much help either. Sorry to dash your hopes for the decompression treatment, but I think it’s probably time to consider a different treatment approach.

      From what you’ve said, there must be a pretty large disc bulge at L4/L5 that it is effecting both sides. There might also be some additional problems contributing to her symptoms that might respond better to some other form of treatment. If you’d like to email me the imaging report, I’d be happy to give you my opinion.

      I think the exercises and other self-treatments are definitely worth a try, but if I had some more details of what the imaging showed, I could probably give you some more specific suggestions.

      Dr. Best

  • l. lagrave

    Reply Reply October 22, 2011

    Thank you again for all of your help, I have a 4cm disc bulge within my L5-S1 on the right side and a sciatica problem all the way down to my foot. I am seeking your help again.

    • Dr. George Best

      Reply Reply October 22, 2011

      Hello,

      A 4cm bulge is relatively large, but is still usually treatable with self-care methods. Frequent use of the McKenzie exercise that best centralizes symptoms (as explained in the videos and ebook) combined with applying cold packs to the low back for about 15 minutes every few hours will usually start to reduce symptoms within a week or so. Adding in the acupressure methods and other self-treatments from the members area will further help to reduce symptoms.

      The important thing to remember is that sciatica, especially when it is due to a bulging disc, is a condition that really requires ongoing management even after the symptoms are gone. Continued use of the exercises and being careful to avoid improper bending and lifting and long periods of sitting (particularly in a slouched position) are necessary to prevent the symptoms from returning and getting worse over time.

      If you have questions, please feel free to contact me.

      Good luck!

      Dr. Best

  • ken krenzelok

    Reply Reply November 8, 2011

    Could varicose veins cause these same symptoms, like shooting pain up and down your legs?

    • Dr. George Best

      Reply Reply November 8, 2011

      Varicose veins usually do not cause pain, and when they do, the symptoms tend to be dull and achy. Shooting pains suggest that the symptoms are likely to be from nerve and/or muscle problems.

      Dr. Best

  • Harry

    Reply Reply December 24, 2011

    What is your opinion about Inversion Tables. I have used one now for 2 weeks and my back and sciatica pain have almost disappeared. I use it twice a day for about 15 to 2o minutes at 30 to 45 degree angle. The table has an infrared heating pad and I let my back and hips warm up before I invert. It seems to work for me. Does anyone else have experience with it?

    • Dr. George Best

      Reply Reply December 24, 2011

      Hello Harry,

      Inversion tables can be helpful but I have also seen cases where they cause increased symptoms during the acute symptom stage. Because the results are a bit unpredictable, I recommend them more as a preventive measure than as a treatment during times of major symptoms. In any event, it is good that it has helped you and I recommend you continue to use it at least a few minutes each day for prevention.

      Dr. Best

  • Theresa Planning

    Reply Reply January 14, 2012

    Hi Dr Best I watched the video about spinal decompression and am really interested in trying this method. I do have disc bulging and some sciatica symptoms. My back no longer hurts but I know the problem does not go away. I would like to know where I can get this treatment in Mesa Arizona as I will be here for a few months. I am a snow bird. I definitely will try this. Thanks you have been the most helpful resource since my problem began and I appreciate you!!!

    • Dr. George Best

      Reply Reply January 14, 2012

      Hello Theresa,

      I don’t know any of them personally to recommend, but there are several doctors offering spinal decompression in the Mesa area. I suggest you do a search on Google using terms like “drx9000 mesa arizona”, “vax-d mesa arizona”, and “spinal decompression mesa arizona” to find a facility that is convenient for you. It is also worthwhile to consult with more than one spinal decompression doctor because the costs of treatment and what is included can vary considerably.

      Good luck!

      Dr. Best

  • Harry

    Reply Reply January 15, 2012

    Hi Doctor,
    I have bulging L4L5 .I had gone several treatment including epidural injection and 3 point trigger injection and phyisical therapy .Non worked for me . I do still have the pain going down to my leg and cuff.witch I can not stand on my feet longer period.
    I do have SAUNDER LUMBER TRACTION device for at home use.
    Are you familiar with this unit and if you are how effective and helpful it is ?
    Also what is the best way of using and getting the best result from this equipment ? .
    Is it better to use before or after the exercise .
    Thanks
    Harry T

    • Dr. George Best

      Reply Reply January 16, 2012

      Hello Harry,

      Home traction devices including the Saunders equipment can be very effective in some cases, but for most people it is most effective as a preventive measure after symptoms are gone rather than as a treatment during pain episodes. Such devices just don’t create enough decompressive effect in the discs to reduce disc bulging in most cases. High-end decompression machines used in the clinical setting get a much greater decompressive effect and much better results in relieving symptoms.

      With any kind of home treatment, be it the McKenzie exercises, acupressure, home traction, or anything else, using the treatment(s) frequently is often the key to getting symptom relief as quickly as possible. For example, someone who does the McKenzie exercise once or twice per day may not get any results, but that same person may get good results doing it for a minute or so at a time 3 to 4 times every hour they are awake. Once the worst of the symptoms are gone, then they can reduce the frequency and just do it a few times per day for prevention, but “intensive care” may be needed to get things headed the right direction. For the best results with traction, again the secret is to do it frequently, not just before or after exercise, but both before and after exercise. A few minutes of traction at a time as often as 6 to 8 times per day will do a lot more than once or twice per day. Some people get some back soreness with this much treatment, but as long as the sciatica symptoms are improving, then you are on the right track.

      Good luck!

      Dr. Best

  • Syed Mostaq Rubbi

    Reply Reply May 13, 2012

    Thanks for giving us hope.

    • Dr. George Best

      Reply Reply May 17, 2012

      You’re welcome.

      Dr. Best

  • Frank

    Reply Reply May 16, 2012

    Dr. Best what do you think about inversion tables that you can buy and use in the home for some one with just minor back aches from excersing at the gym frequently

    • Dr. George Best

      Reply Reply May 17, 2012

      Hi Frank,

      Inversion tables are fine for relief of mild symptoms and as a preventive measure in people with disc bulges and/or degeneration. It’s best to start with a mild decline on the table for the first few times and gradually increase towards more inversion with subsequent sessions to avoid triggering reactive muscle spasm and also to get used to the circulatory changes (increased blood flow to the head). I recommend the tables that strap you in at the waist/hips, rather than ones where you are simply hanging from your ankles. The one other caution I advise is to invest in a good quality inversion table that is rated for your body weight – the last thing you want is to have the table buckle on you and drop you on your head!

      Dr. Best

  • bijayeta

    Reply Reply June 28, 2012

    hi,
    my uncle is 39 year old and he is suffering from L4-L5 disc protrusion and foraminal stenosis…. initially he had radiating pain till ankle but aftr taking physiotherapy treatment for a month his pain has centralised to buttock area(near hip joint)… even aftr taking physiotherapy treatment he complains of deep aching pain in buttock area especially when he wakes early in the morning… and as he walks around for few minutes n after extension exercises ,the pain subsides…he was undergoing the following physiotherapy treatment…
    1.TENS with hot fomentation
    2.Ultrasound therapy
    3.Mc Kenzie exercise
    4.core stability exercises
    5.neural mobilisation
    his pain relapse after every 2-3 days… does this mean he has annulus tear….
    pls advice what should be done

    • Dr. George Best

      Reply Reply June 29, 2012

      Hello,

      The relapses don’t necessarily indicate and annular tear, but that is a possibility. It sounds like part of the problem may be ongoing inflammation. Once suggestion I have is to try using cold packs (see the instructions in my ebook) on the low back and stop the heat and ultrasound and see if that produces any improvement. I also suggest using the McKenzie extension exercise on a frequent basis throughout the day. If there is an annular tear, there is a good chance it will heal and stabilize with frequent use of extension over a period of a few weeks to a few months. If you have further questions, let me know.

      Good luck to your uncle.

      Dr. Best

  • alvin rakoff

    Reply Reply February 23, 2013

    Where can I get treatment on DRX 9000, etc? I live in London, England.

    by the way, I could not see the button to press at the end of the video.

    • Dr. George Best

      Reply Reply February 25, 2013

      Hello Alvin,

      I was not able to locate any providers with the DRX9000 in London. I did find the following Vax-D provider:

      VAX-D Back Pain Centre
      Address: Golders Hill Health Centre, 151, North End RdPostcode: NW11 7HT City/Town: London (London) Main phone: 020 8458 6400

      You may be able to find additional spinal decompression providers by contacting chiropractors in your area.

      Dr. Best

  • katia peltz

    Reply Reply February 27, 2013

    Hello Dr Best,
    Thank you for all the great information on your website.In nov 2011 I have spinal decompression DRX9000 treatment for my bulging disc L5 S1 4 times a week for 6 week, and also has two ESI in between the treatment. I feel like it’s working really well for me, the pain is gone.
    And I feel much better now ,but once in a while I still feel a little pain on the same spot in the hamstring ,especially when standing at work or sitting in the computer chair for a long time.
    I was wondering if exercise alone would help or should I sign up for maintenance with the spinal decompression?may be once a month or physical therapy? but the treatment is so expensive , so I’m a little hesitant , is it possible if I don’t do anything now,the bulging disc will come back?
    I also have degenerative disc disease
    Any answer from you would be a great help,I love the way you speak so clearly on the video, Thank you so much for the free ebook,do you have dvd for sale?
    Please let me know, Katia

    • Dr. George Best

      Reply Reply February 27, 2013

      Hello Katia,

      While you probably could maintain things adequately with daily exercise, since you have some disc degeneration (and some mild residual symptoms) and you’ve had good results with decompression, I think it would be helpful to get maintenance treatment on the DRX9000 as well. If cost is an issue, you would still get benefit doing it every 2 months rather than every month and that would reduce the cost – just be sure to be very consistent with your exercises if you are spreading out the decompression more.

      I don’t currently have a dvd available but I am considering it.

      Good luck!

      Dr. Best

  • SANDRA LACOUVEE

    Reply Reply April 2, 2013

    I tried to have spinal decompression, but the doctor told me he could not do the treatments as I have had hernia repairs that were done with patches in my groin area. I tried physiotherapy, but with little improvement. Now I am basically doing exercises morning and night and it is helping to relieve the pain. But I still get some pain in my groin area if I lift heavy bags etc. Are there specific exercises you can recommend that I could do. I have no idea what caused my sciatica, it began with a tightness in my lower back, reached around to my left buttock, into the groin and down to my knee. At one point I was limping and could not sit for any amount of time. I am much better now, but still feel the pain from time to time. Any comments would be appreciated. Thanks.

    • Dr. George Best

      Reply Reply April 2, 2013

      Hello Sandra,

      It sounds like you’re on the right track with the exercises you’ve been doing. You may get some benefit from stretching the piriformis (pulling the knee toward the opposite shoulder) and gluteus minimus (the “figure 4” stretch) if you are not already doing that. It is possible that you’re getting some general increase in inflammation from the back issue that is causing some irritation around the hernia repair too. I suggest you try putting cold packs on the groin area when it is hurting and see if that helps. Finally, dysfunction in the sacroiliac joint and possibly the pubic symphysis (the joint between the two pubic bones) could be causing some of your resdual symptoms as well. If the previous suggestions don’t solve the problem, I’d suggest seeing a chiropractor to have that possibility checked out.

      If you have further questions, let me know.

      Good luck!

      Dr. Best

  • Dušan

    Reply Reply May 21, 2013

    Hello,
    I have found some articles about research by University of Southern Denmark, published in European Spine Journal, saying that the low back pain might be caused by bacteria. They have performed tests (100 days antibiotics treatment), showing very promissing results.

    Here are the links to those articles.

    http://www.gulf-times.com/opinion/189/details/352749/back-pain%3A-will-antibiotics-cure-me%3F

    and

    http://www.scribd.com/doc/140126317/European-Spine-Journal-2

    Is there any further information about such treatment? What are the possible side effects (3 months antibiotics treatment would certainly have effect on body immunity)?

    Regards
    Dusan

    • Dr. George Best

      Reply Reply May 21, 2013

      Hello Dusan,

      Let’s start with the best case scenario provided by the research authors which is that antibiotics might be an effective treatment about 40% of the time. That leaves 60% of cases in which they would not be helpful. As such, it is unlikely that antibiotics will become a first line of treatment for back pain and sciatica. As you said, 3 months on antibiotics will tend to produce some adverse effects. This can include depressed immune function, gastrointestinal disturbance, and persistent dysbiosis in the gastrointestinal tract which could cause prolonged digestive issues. Such side effects might be worth suffering through if they were truly more effective in getting rid of the pain than other treatments, but as far as I can tell that has not been tested. Antibiotics were only compared to placebo, not other medications such as anti-inflammatories.

      This brings me to the fact that many antibiotics actually have strong anti-inflammatory effects. So, are they reducing symptoms because they are killing the bacteria, or are they reducing symptoms because of their anti-inflammatory properties?

      Finally, there is the issue of causation versus association, which so far they have not been able to differentiate. In other words, is the bacteria causing symptoms, or perhaps is the bacteria present coincidentally. As the study states, the association is between only anaerobic bacteria and the modic changes in the adjacent vertebra. Anaerobic bacteria thrive in the absence of oxygen. Likewise, tissue degeneration tends to be more prevalent in low oxygen situations (oxygen is necessary to efficient tissue healing and regeneration). So, it would seem logical that anaerobic bacteria would tend to be found in areas of degeneration. This brings into question whether or not the bacteria is causing the degeneration, or simply happens to be there due to the low oxygenation.

      Overall, in my opinion, antibiotics might be worth a try if more accepted treatments are not working, but I certainly would not suggest antibiotics as a primary treatment option for disc-related back pain and sciatica.

      Dr. Best

  • Jerome Rosen

    Reply Reply June 9, 2013

    Just finished watching your video on “Spinal Decompression” Dr. Best. I’ve mentioned in another Email I sent you that I have chronic sciatica-related pain on my right side (I think Piriformis-related).
    I have an Inversion Table (Teeter) that I must admit I haven’t used very often.

    Could you please comment on the potential benefit (s) from using it on a regular basis- in conjunction with sciatica exercises you’ve recommended?

    Thank you.

    • Dr. George Best

      Reply Reply June 9, 2013

      Hello Jerome,

      Inversion can be very helpful. It can sometimes irritate symptoms when things are acutely inflamed and in spasm, so some caution needs to be used in those circumstances. Once the major symptoms have subsided though, inversion usually does help alleviate residual symptoms and works well as a preventive measure along with the exercises. Interestingly, for many people, a relatively shallow angle works better than maximum inversion. 45 to 60 degrees down from horizontal seems to be the range where most people get the greatest benefit. When first starting with inversion, I recommend starting at the minimum angle your machine allows and just do a minute or so to start. Then you can gradually increase time and angle as you go along (just increase time or angle for a given session, not both at the same time). Different people have different levels of tolerance to inversion, so listen to your body. If you have increased pain or symptoms of lightheadedness or nausea, it’s best to reduce the time and/or angle to what works best for you.

      Good luck!

      Dr. Best

  • Jerome Rosen

    Reply Reply June 11, 2013

    Thank you for the quick response Dr. Best. You are a breathe of fresh air!

    • Dr. George Best

      Reply Reply June 11, 2013

      You’re welcome!

  • Steve Oyler

    Reply Reply August 30, 2013

    I have a Teeter Hang-Up machine at home
    that I use as much as possible. What is your
    professional opinion on this type of equipment?
    Thank you

    • Dr. George Best

      Reply Reply August 30, 2013

      Inversion can be very helpful and Teeter is the brand I recommend. During major acute symptoms, inversion can increase symptoms, so I primarily recommend it as a preventive treatment, but some people do get relief of symptoms with it as well. I recommend proceeding cautiously for anyone who is trying to use it as a treatment when they do have major symptoms and start with the minimum angle for short periods of time to see how things respond to it. For preventive use, many people get the best results when they do a moderate angle rather than full inversion, but everyone is different and I suggest testing different angles to see what works best for you.

      Dr. Best

  • ARTHUR ROLA

    Reply Reply December 12, 2013

    TODAY I FOUND OUT I HAVE DEGENERATIVE CHANGES WITH VACUUM DISC
    PHENOMENON THROUGHOUT THE LUMBAR SPINE CAN SPINAL DECOMPRESSION
    HELP THIS PROBLEM I FIND FROM A WALKS OF LIFE THE MEDICAL SYSTEM CANT
    SEEM TO FIX A SPINAL PERFECT WITH SURGERY ITS SAD. THANK YOU. BY THE WAY
    IM 87 YRS OLD

    • Dr. George Best

      Reply Reply December 12, 2013

      Hello Arthur,

      It will depend on the severity of the degenerative changes whether spinal decompression is a viable treatment option or not. If there are bone spurs or areas of thickened bone that are narrowing the central canal of the spine (where the spinal cord lies), spinal decompression cannot be used. If things aren’t too bad in that respect, then spinal decompression can be attempted. The problem is that you have multiple levels of degeneration, so it might take a lot of treatment to get reasonably good results and ongoing periodic treatment to maintain the results.

      Besides spinal decompression, other options would be low-force chiropractic treatment (such as with Activator Method or using an instrument called an Arthrostim), massage therapy, and acupuncture. There’s really nothing that will correct the degeneration, but these methods do often bring significant symptom relief.

      If you have further questions, let me know.

      Good luck!

      Dr. Best

  • Bonnie Ahn

    Reply Reply August 7, 2014

    Dr. Best,
    I am 64 year old female. From about two years ago, I have had pains on my left low back and they started shooting down on my left leg from last November. I saw a neurologist last year in July and he diagnosed that I have lumbar degenerative disc disease, lumbar spondylosis, lumbar radiculopathy. My MRI report says at the end:
    Impression: Disc degeneration along with facet disease and ligamentous thickening at virtually all levels. Process most marked at S4-5 followed by L3-4. Significant acquired stenosis of the canal at L4-5 with exiting nerve root compromise predominating on the left. No obvious soft tissue’s. It also says in Sagittal sequences, there is minimal anterolisthesis L4 on L5. I have tried physical therapy, personal medical trainer and gym including warm water exercise classes for arthritis. Nothing worked. Pains come and go. I read several books about back pains and yoga, and it is confusing as to what is the best treatment for me. When I travelled Korea in June, I even had a minimum invasion procedures (neuro plasty and nuclear plasty) there, but it even increased my pains. Prior to the procedures, when I got up after lying down more than 10 minutes or so, I felt severe pains in my left low back and through the leg all the way to my feet. After the procedures, when I get up after lying down, pains do not subside even after 30 minutes of walking or moving around. So, I stoop down and gradually lift my back, which is very tiring and stressful. From two weeks ago, I started seeing a chiropractor three times a week, but it is not helping me so far. One thing new that he told me was that I have a grade 2 spondylolisthesis, which I confirmed in the x-ray. My questions are:
    1. Spondylolisthesis can progress from minimal to grade 2 in one year at my age?
    2. Could this change in L4 slippage and significant more pains have been possibly caused by a wrong procedures done?
    3. Why do I get severe pains after getting up after lying down more than 10 minutes? My personal medical trainer taught me to do some pelvic tilts and baby bridge and leg extension before I stand up and they seem to help somewhat.
    4. I have a traction table at home. I like to use them on my spine, but after getting up, I get that pain again. Can I continue using it? I tried inversion table at the pt, again I got the same pains after. Looks like I get the pains on by buttock and the leg after any kind of decompression. What can I do about it? I tried ice pack, advils, now enzymes for inflammation as recommended by chiropractor, orthotics by foot leveller, flexion (due to stenosis and spondylosisthesis) and light extension. I learned that these help me the most so far and I learned it hard way by trial and error.
    I feel very depressed dealing with the pains everydayand seeing that they are not subsiding. I would like to avoid that steroid shots and surgery if it is possible at all. I need your help

    • Dr. George Best

      Reply Reply August 7, 2014

      Hello Bonnie,

      It’s unlikely for spondylolisthesis to progress much at your age even over several years, especially if it is a degenerative spondylo caused by facet joint hypertrophy (extra bone formation on the joint surfaces) pushing the vertebra forward as opposed to what’s called a pars defect (which is a separation/fracture where the vertebral arch joins the body of the vertebra). The two most likely scenarios in my mind are that either the radiologist on the inital imaging report greatly minimized the extent of the slippage (this happens more often than you might think), or the surgery removed enough bone from around the facet joints that it dramatically altered the stability ad/or alignment of that level of the spine. It’s even possible that there was an undiagnosed pars defect that was being hidden and stabilized by the degenerative bone and when they removed the degenerative bone, the segment became much more mobile and even unstable.

      This brings up the question of whether the surgery was improperly done, and while the outcome may have been bad, I can’t say that the surgery was necessarily improperly done. The surgeon does the procedure with the information available from the scan, and it’s possible he did what any other surgeon would have done and unfortunately things just turned out badly.

      My guess is that you probably have some ongoing inflammation related to the surgery (it’s not unusual for the inflammatory response following a surgery to last for a few months). Also, if there is instability in the spine, that will provoke ongoing inflammation and muscle spasm. When you lie still, there is a tendency for inflammatory swelling to build up, and this creates additional pressure on the nerves. In addition, if there is muscle spasm, the muscles tend to get tighter with less movement. Once you get up and move around a bit, the swelling gets “pumped” out of the area and the muscles gradually loosen up to accomodate the movement.

      In acute cases, traction/inversion commonly does increase symptoms. In some cases, traction will temporarily increase disc bulging because it causes the discs to take in fluid. While this is often good in the long run because it also pulls in nutrients that the disc needs for healing, it often does temporarily increase symptoms because more fluid = more bulging. As long as the increased symptoms following traction subside within several hours, it’s usually all right to continue it and it may prove to be helpful in the long run.

      Given the relative severity and chronic nature of your condition, and the fact that you had surgery in June, I’d say there’s still a reasonable chance that things will improve gradually over the next few months as things heal and the inflammatory response settles down. Use the things that seem to help on a frequent basis and try to be patient with it. I would suggest trying to get a hold of the original imaging and have your chiropractor or another physician compare the actual images to see what has transpired with the spondylolisthesis. If in fact it went from minimal to a Grade II, I’d recommend having flexion/extension X-rays to evaluate for spinal instability. If there is significant instability, you’re probably looking at another surgery, but hopefully that is not the case. If there’s no instability, then I think you’ve got a chance to get things to a manageable level over the next few months, but there will may be some ups and downs for quite some time.

      If you have further questions, let me know.

      Good luck!

      Dr. Best

  • samantha

    Reply Reply February 5, 2015

    Dr. Best:
    I notice in the before and after imaging in the video that the disc bulging on the right side was reduced but the bulging on the left side was increased by the treatment from the original image. In other words it looked like the treatment improved the bulging but increased as compensation for the reduction the bulging on the opposite side of the disc?
    What does that mean?
    Sammi

    • Dr. George Best

      Reply Reply February 5, 2015

      Hi Sammi,

      I think what you’re referring to is the appearance of the disc at the front and back of the spine (the images are side views, where the front of the spine is to the left side of the image and the back of the spine is to the right). There is a bit of an optical illusion as the after image is more contrasty (the darks are darker and the lights are lighter) than the before picture. So, I don’t think there’s actually a significant difference in the disc shape between the before and after at the front of the spine, but even if there was, it would still be considered a positive change. This is because there are no nerves to compress at the front of the spine like there are at the back of the spine. For this reason, anterior (front of the spine) disc protrusions usually don’t create a lot of symptoms like protrusions at the back of the spine.

      Dr. Best

  • Marilyn Colvin

    Reply Reply February 10, 2015

    Dr. Best,
    I tried a decompression treatment at the chiropractor’s and the next day I couldn’t hardly move. I had extreme low back and hip pain. My husband had to do all my barn chores, feeding the horses and changing water tub for 2 months. I went to another chiro and he asked me how may pounds of pressure the machine was set at and I told him 75 lbs. He said that was way too much for my weight 127lbs.and he should have used 41 lbs. 5 months later I am functional and can care for my horses and my home but I still have problems walking more that 200 feet and have trouble walking up hill. I also have sciatica on the left side and my left hip is very painful. But the exersizes you recommend have been very helpful. To be fair, I have a grade 2 spondy and some arthritis but I have never been out of commission for this long. What do you think happened? Can the decompression table activate underlying conditions? I think it was the DX9000 machine and it was new in his office. Thanks for helping me to understand what may have happened.

    • Dr. George Best

      Reply Reply February 10, 2015

      Hello Marilyn,

      Spinal decompression can exacerbate symptoms temporarily even when it’s doing good in some cases because the body may react to the sudden thickening of the disc due to re-hydration. But when that’s the case, the symptoms improve dramatically within a few days. In your case, there were two issues. First, as the other chiropractor told you, 75 pounds on the first session for someone your size was too much. The other issue, and possibly the bigger factor is that you have a grade II spondylolisthesis. While spinal decompression is fine in cases of degenerative spondlyo ( a stable situation in which the displacement of the vertebra is due to thickening of the joint surfaces), decompression is contraindicated in cases of unstable “isthmic” spondylo which is due to a non-union of the vertebral body from the vertebral arch (thought to be either congenital or due to trauma to the spine in chidlhood or early adulthood). Degenerative spondylos are usually Grade I. Isthmic spondylos range from Grade I to IV and anything above Grade I is usually at least somewhat unstable. With an unstable spondylo, decompression can cause shifting and/or increased instability, thereby triggering muscle spasm and inflammation which can take quite some time to settle down.

      If you are not already doing some type of abdominal exercises, I would highly recommend you start, as this helps to stabilize the spondylo and minimizes symptoms from any shifting that may be occurring. Regular crunches are good for this purpose, as is the pelvic tilt exercise if you’re just starting out. As your abs get stronger, planks do an excellent job. In my experience, the stronger the core muscles are, the fewer problems people with spondylos have.

      In addition, when there is a spondylo, patients often find that they need to alternate flexion and extension positions for the McKenzie exercises. Unfortunately, the extension positions that work best for disc protrusions can irritate the spondylo, while flexion positions for the spondylo may irritate the disc. Finding the right combination of flexion to extension is an individual thing and requires some experimentation to get it right, and it’s subject to change over time. It can be a bit frustrating to manage, but it can be done and if you’re exercising the core muscles well, you probably won’t need to do as much with flexion.

      I hope this is helpful for you.

      Good luck,

      Dr. Best

  • Marilyn Colvin

    Reply Reply February 10, 2015

    Thank you Dr Best, yes your explanation is very helpful. I’ve been doing the plank and lowering both legs together while lying down for lower abdominal strength. And yes I’ve noticed feeling like I need to do the opposite stretch, for example the cat back sag and arch. Thanks for pointing me in the right direction!

    • Dr. George Best

      Reply Reply February 12, 2015

      You’re welcome!

  • annie beam

    Reply Reply February 17, 2015

    Dr. Best,
    After reviewing your responses to a variety of spinal conditions that exist in conjunction with sciatica, I not heard or read anything of your opinion using a spinal injection with a thicker type of crystal fluid …kenalog. Are you familiar with this medication and, if so, are there any contraindications? My latest pain dr., after review of my MRI, plans to inject kenalog on the left lower of the spine to elevate the pressure where the sciatic nerve exits the spine. In the last four months, I have had two other injections from another physician with methodextridone (sp)and they both only increased the pain at the L4 & L5.
    Thanks so much for your advice and consideration of my problem,
    Annie

    • Dr. George Best

      Reply Reply February 22, 2015

      Hello Anne,

      First, I apologize for not getting back to you sooner. I usually get an email notification of new question posts, but I didn’t get one on yours and only saw it when I received notice of someone else’s question.

      Kenalog is one of several corticosteroids that are used in treating back pain and sciatica. As with all steroids, it’s mode of action is to reduce inflammation. They don’t directly address the underlying problem and when they do work, the results are usually temporary (lasting anywhere from a few days to several months before symptoms return). Steroid injections can dramatically reduce symptoms when inflammatory swelling is a significant contributing factor to nerve compression. When there is significant narrowing of the nerve canals from structural issues such as disc protrusions and/or degenerative bone and/or ligament thickening, they usually don’t help much, at least not for very long. In my opinion, they really are only useful as a temporary symptom reliever to allow the patient to undergo other non-surgical treatment (such as physical therapy, chiropractic, etc.) more comfortably, or as a means of controlling symptoms until surgery (if indicated) can be performed. It’s one of my pet peeves that some doctors will prescribe them without explaining the nature of the treatment, nor recommending other concurrent treatment that actually directly addresses the underlying problem. There are cases where other treatment options have been exhausted and periodic injections are helpful in maintaining the symptoms at a tolerable level, but those are unusual, and from what a number of patients have told me, there are some doctors who present such injections as a “fix” for the problem when it is nothing of the sort.

      I hope this is helpful for you.

      Dr. Best

  • Cathy Hunnicutt

    Reply Reply April 10, 2015

    I have a teeter inversion table with the lock in leg device. I have sciatia ref bad left athritic knee and bone spurs and arthritis in the L5 area.

    I also taught this website might give me a daily strech routine to help keep the sciatica pain from comming back.

    Do you have a daily routine you recommend.

    Thanks,

    Cathy Hunnicutt

    • Dr. George Best

      Reply Reply April 10, 2015

      I recommend the McKenzie exercise indicated by the testing procedure in the free ebook as the most essential daily prevention exercise. If you do not already have the free ebook, you may download it from the link on the right sidebar at: . For a more in-depth set of prevention exercises, you may be interested in my members area, or my book Sciatica Exercises and Home Treatment, which is available in print and as an ebook at most online booksellers.

      Dr. Best

  • arumugham

    Reply Reply July 1, 2015

    DEAR DR,
    I LEFT A RESPONSE YESTERDAY. AGAIN YOU REQUESTED THE RESPONSE. WHY? MY PROBLEM IS THE NUMBNESS IS TILL THERE IN RT LEG. IN THE LEFT THIGH HAVING BURNING ON THE TOP.
    BUT THE PAINS ARE AT LOWER BACK AND BUTTOCKS. WHAT TO DO WHEN PAIN IS MORE?
    THANKS ARUMUGHAM

    • Dr. George Best

      Reply Reply July 1, 2015

      I’m not sure what you mean by me requesting a response again. You are on my email list and are receiving my email newsletter that goes out automatically, so I assume that’s what you are talking about. The amount of pain is not an indicator of the nature nor severity of the problem, nor what to do about it. The best guide for what to do is the testing procedures in my free ebook. In case you do not already have it, you may download it from the link on the right sidebar of this page: . If those methods don’t significantly improve things within a week or two, I’d strongly recommend you see a doctor for further evaluation.

      Good luck!

      Dr. Best

  • Claire

    Reply Reply July 15, 2015

    Dear Dr. Best,
    I have had 9 treatments on the triton DTS for a mild bulging disk. So far I have not had much relief in sciatic pain and numbness in both legs. For the past week I’ve had new symptoms of chest tightness and dull upper back pain. Feels like someone is squeezing my chest. Could this be caused by being strapped into the table repeatedly? I weigh 125 pounds and up to 75Ibs pressure on the device. I am 37 years old so I doubt it’s symptoms of heart attack. These are not typical symptoms for me and I’m hesitant to continue with this treatment. Thanks!

    • Dr. George Best

      Reply Reply July 15, 2015

      Hello Claire,

      The chest and upper back symptoms could be due to the upper body straps on the machine. In some cases, the procedure can cause some misalignment/dysfunction of the rib joints and that sounds like what you’ve described. These joint issues are usually easily correctable with chiropractic manipulation, so assuming you are getting the treatment from a chiropractor, I recommend you discuss the issue with him or her. I don’t have any direct experience with the Triton DTS specifically, but in using a different decompression machine, I found that in cases where chest and upper back issues were caused by the harness, positioning the straps angling down lower on the torso and/or using a thick towel or foam padding underneath the harness would prevent the problem in most cases. The other thing I would consider in your case is reducing the pull somewhat, particularly if you aren’t comfortable on the machine. For best results from decompression, the patient needs to be relaxed and if the pull is uncomfortable, the tendency is for the patient to tense up and their muscles resist the decompression. In my experience, a lower pull with the patient relaxed will outperform a higher pull with the patient tense.

      Good luck!

      Dr. Best

  • Victoria healy

    Reply Reply July 19, 2015

    I see mentioned in many of your comments the McKenzie exercises. I have come across a description of this exercise, and would appreciate some more information. I am 53, and have scoliosis caused by an extra, malformed vertebra in my lower back. When I was younger, I didn’t really have pain issues. Now the pain in my lower back and shootishooting down my legs is constant

    • Dr. George Best

      Reply Reply July 19, 2015

      My free ebook covers the McKenzie method in detail. You may download it from the link on the right sidebar of this page:

      Scoliosis in and of itself usually does not produce sciatica, although back pain is relatively common due to muscular contraction around the spine. Your leg pain is most likely a result of either muscle referral pain from the hip and buttock area or there may a disc protrusion or some type of degenerative change in the spine that is causing compression of one or more of the spinal nerves. The McKenzie method is primarily useful for nerve compression issues, whereas stretching and massage typically is more helpful for symptoms related to muscle contraction (one muscle, the piriformis, that commonly produces leg symptoms is also covered in the ebook). Self-treatment can be very effective, but I’d also suggest you consider seeing a massage therapist and/or a chiropractor for treatment of the joint and muscle issues that are typical with scoliosis cases.

      Good luck!

      Dr. Best

  • amelia judd

    Reply Reply May 12, 2017

    I have been going to a chiropractor since nov.21 2016 I have had 45 spinal decompression treatments and other good stuff. I afell not too long ago and had light whiplash and concussion so I kept getting more sdc and 2 weeks ago I did some leg raises and I was suffering horrible symptoms so he said I was havimg a flare-up so now my neck shoulder arms back ache and chest mustles but I am scheduled for more sdc I was originally being seen for herniated discs in the neck your opinion I have been resting heating pad and tiger balm what is going on?

    • Dr. George Best

      Reply Reply May 13, 2017

      Let me start by saying that I’d strongly recommend you stop using the heating pad and try switching to cold packs. With a recent injury, inflammation is usually a significant symptom generator and while the heating pad may feel good while it is on, it tends to increase and/or prolong inflammation. Spinal decompression is an excellent treatment for herniated discs; however, when there has additional injury to the muscles and other soft tissue around the spine, other treatments may be better for dealing with the symptoms related to those issues. With whiplash injuries, massage therapy in combination with chiropractic adjustments works the best in my experience. Other therapies such as e-stim or ultrasound are helpful to an extent, but I think massage is far more effective in most cases.

      Dr. Best

  • amelia judd

    Reply Reply May 12, 2017

    can you get too much spd?

    • Dr. George Best

      Reply Reply May 13, 2017

      It’s certainly possible to over-do any form of treatment, but as long as there are no contraindications present, such as spinal ligament instability, and the treatment is done within established protocols, there’s not a significant risk of overusing spinal decompression.

      • jeremyN

        Reply Reply August 15, 2017

        what is dr best email?

        • Dr. George Best

          Reply Reply August 16, 2017

          You may email me through my contact form.

          Dr. Best

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