What Exactly Is Spinal Decompression?

physical therapist showing where pain is coming from with spinal decompression

In short, spinal decompression is an umbrella term we commonly use in practice to describe various surgical treatments that relieve back pain.

These mostly surgical procedures help to decrease pressure on the spinal neural elements (the neurons that connect your brain to your back and vice versa).

But what exactly is it?

Your backbone, or spine, provides essential support for the body. It is made up of vertebrae (back bones) along with spinal disks and stretchy ligaments that provide the flexibility to twist and turn and enable movement.

The spinal column that encases the spine also serves as a pathway for the nerves that travel down the back to the hips, pelvis, legs and lower body via disks, ligaments, and bones.

But due to age-related degeneration or any kind of back injury, the spine and surrounding structures can suffer damage.

In this situation, you probably have pain due to compression of the spine, which puts additional pressure on the nerves and/or the spinal cord.

So, spinal decompression surgery’s main purpose is to relieve this pressure and reduce pain and discomfort. 

Doctors use spinal decompression surgery to treat the following:

  • Herniated or slipped disk (when a portion of the disk compresses a nerve). 
  • When disk degeneration starts to occur due to the cushion between the backbones suffering wear and tear. 
  • When a disk bulge occurs due to the cushion in between bulging.   
  • In cases of sciatica where the sciatic nerve suffers damage.
  • In cases of spinal stenosis, where the spinal space narrows down due to a bulging disk or the growth of bone spurs. 
  • When nerve compression (a pinched nerve) happens, leading to tingling, pain, and numbness. 

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Which Spinal Decompression Surgery Should I Have?

x ray showing where pain in back is coming from

Your doctor will decide on the best type of spinal decompression surgery for your specific symptoms and how they impact your life. But before deciding on the best course of treatment, they determine the severity of your injury and the associated symptoms.

They also consider your current state of health, suitability for surgery and your full medical history before making a decision.

However, we must keep pointing out that we recommend that you take a gradual and conservative approach to treating back pain – starting with physical therapy first and giving that a good chance to work its magic before moving on to more invasive treatment and spinal surgery as a last resort.

Common Spinal Decompression Surgeries

As we’ve already said, but can’t stress enough – you should only consider spinal decompression surgery when all other treatment options have been exhausted – especially physical therapy.

But if you do require surgery to fix long-standing pain that doesn’t respond to treatment, there are some different types of spinal decompression surgeries, which you can explore your suitability for with your doctor. They include:

  • Foraminotomy: This process involves the removal of tissue or bone to increase openings for nerves to relieve pressure and pain on the nerves. 
  • Osteophyte removal: Also commonly known as bone spurs, these bone outgrowths occur due to aging. They can be surgically removed to relieve pressure on the nerves. 
  • Corpectomy: This procedure may involve removing a disk or vertebra. Or your surgeon may opt for spinal fusion to fuse the bones for spinal stability. 
  • Laminotomy: This process may result in removing all the bone arches or a single bone arch on the canal of the spine. Removal of the bone/s widens the spinal canal, reducing nerve pressure.  
  • Diskectomy: In this process, your surgeon removes a portion of a disk to relieve pressure on a nerve(s). 

After all these surgeries, your doctor will likely recommend that you remain in the hospital for several days.

But your overall recovery period – and how quickly you get back to your normal life, exercising and playing sports, etc. – will depend on your specific type of surgery.

But most surgeons also recommend that you have physical therapy before and after the surgery to prepare you for the procedure and improve nerve sensation, mobility, and strength afterward. 

Finding The Root Cause Of Back Pain

Finding The Root Cause Of Back Pain

To assess the root cause of your back pain and find out what is causing the problem (compression) and decide whether or not you require spinal decompression surgery, you may need some medical tests, including:

  • Imaging tests: Your doctor may ask for imaging tests to examine your spine and determine the cause of the pain and discomfort. These can include X-rays, MRIs, and CT Scans. 
  • Bone scans: This is another kind of imaging to look for infections, cancer (this is rare), or bone fractures. The bone scan is used to locate the source of your back pain and determine the underlying cause. 
  • Electrical tests: The process involves using electromyography to determine the electrical activity of the muscles and nerves and the speed at which electrical signals travel from the nerves to the brain. 
  • Diskography: A special kind of dye is injected into the back to be seen clearly on scans or X-rays. A CT-Scan is then generally done, which helps to determine if there is damage to any of the disks. 

What Are The Benefits Of Spinal Decompression?

spinal decompression shown on a diagram

We don’t believe anybody should have to live with pain if possible. So, pain relief is the number one benefit of spinal decompression.

But we also believe that any type of pain treatment should be minimally invasive, and the options with the least risk should always be the first choice. In the words of Hippocrates and the Hippocratic oath, “First, do no harm.” 

Spinal surgery, by its very nature, can be dangerous. Our clinic is built on the philosophy of “physical therapy first” – because, in most cases, physical therapy can help prevent surgery altogether.

But on the rare occasion when surgery is necessary to reduce chronic back pain and regain your quality of life, physical therapy can also help reduce any of the associated risks.

We can also help improve the surgery’s outcome, get you back on your feet faster, and prevent the need for further surgeries and/or medication in the future.  

So, talk to us first, regardless of whether you think you might need surgery or not. 

What Are The Risks Of Spinal Decompression Surgery?

Sometimes, physical therapy isn’t enough, and your doctor may recommend spinal surgery to fix the underlying issue.

There are lots of benefits to getting long-standing problems fixed once and for all with surgery. However, you should be fully informed of the risks before going ahead with the procedure.

Like all surgeries, but particularly those involving the delicate spine and spinal cord structures, there is a risk of tissue or nerve damage that can cause long-term disability.

There is also a risk of infection or bleeding that may require a blood transfusion or an additional unplanned procedure. But these are all worst-case scenarios and very low risk. But always try non-invasive treatment first.

Spinal Decompression Treatment Without Surgery

mri of back pain with spinal decompression

There are certain kinds of back pain that do not need medical treatment. In most cases, acute pain from an injury, pulling, or twisting improves in a couple of days.

Your doctor may suggest muscle relaxants or other types of pain medication help with pain relief while the body heals. Hot/cold therapy may also help. 

In the case of more chronic back pain (lasting 3+ months), there are also other options for treatment that don’t include surgery, namely physical therapy, which is one of if not the best treatments for chronic back pain.

We guide you through movements, stretches, and strengthening exercises to improve the health of your spine, relieve pain and increase flexibility and spinal mobility. In some cases, we may also use “traction.”

This process uses weights, pulleys, and a traction table to stretch and “decompress” the spine. If necessary, we can also use an inversion table for inversion therapy – placing you on a tilted table at an angle to relieve spinal pressure.  

Some other options for spinal decompression therapy without surgery include:

  • Nerve stimulation: TENS (Transcutaneous electrical nerve stimulation) involves tiny electrical charges that help relax the muscles and nerves and relieve pain. 
  • Chiropractic care: Subtle adjustments are made to the spine through chiropractic techniques that realign bones and help relieve pain. However, most patients report that the results of chiropractic are temporary, and symptoms do return. So, chiropractic treatment provides only short-term relief. It doesn’t cure back pain. 
  • Acupuncture: An acupuncturist inserts very fine needles below the skin at various body points. This treatment can be combined with physical therapy to reduce inflammation and aid healing.

Ready to get out of pain? 

Book a free consultation with one of our back pain experts.

Andrew Vertson