A Primer on “Decompression”

There are many treatment options available to chiropractors today.  Regrettably, many of them carry more hyperbole than technology.  Wildly expensive “cutting edge” technology can have its advantages, but can also really hurt your practice (and your credit scores!).  However, there are treatments which have proven their value and relevance over the last few years of successful clinical use.  If a treatment method is put to the test in hundreds of clinics and earns unreserved praise, with over 40% buying a second unit within the first year, it is probably not only an excellent investment but perhaps a necessary one as well. Such is the case with axial decompression/decompressive traction therapy.  My clinical experience with decompression has been a ten year clinical “grand slam”; a journey with few regrets—even in the face of having spent over $100,000 each on our first units.  Both clinically and as a practice builder, I have yet to see any other treatment as impressive.

In a very rudimentary sense, there are really only 2 passive mechanical treatments you can administer to the spine:  Thrust and stretch.  To limit your patients to just one option because of your own limited paradigm may be bad for them and bad for business.  Think about it.  Compressed discs are in need of “decompression” and avascular tissues are in need of renewed blood contact.  These effects are logically much more likely via stretch than thrust. (By stretch, I mean a prone or supine, restrained, +10 minute cyclical protocol).

Additionally, of course, mechanoreceptor types I, II & III are activated during “traction”.  Decompression is very likely to foster both pre-synaptic inhibition as well as phasic healing through enhanced blood and fluid exchange, a double shot, so to speak.  This basic fact seems somehow lost on many chiropractors, but it is incredibly well accepted and intuitive to the general public.  Of course, science is one thing; business is another.  We are in the unique position of being able to introduce our patients (and community) to scientific advancements and treatment methods and, in the process, get more business for ourselves.  This win-win situation is the essence of success.

The success of “Activator” practices and various pulsed adjustment devices is not hard to understand, if you place your “ear close to the rails”, i.e., listen to the general public.  Many people are afraid of or apprehensive about manipulation.  Many practices have found adding gentler adjusting methods and decompression therapy garners far and away more new patients than it ever discourages.  Adding additional methodologies deflects much of the criticism related to being limited and “dangerous”.  We have had hundreds of patients say, “My doctor said it was OK.  I come here because you’re gentle and use that ‘stretch treatment’.”  Additionally, proven and cost effective methods simply give a greater opportunity to appeal to a wider range of patients.  It establishes your practice as more eclectic and, as a result, fewer patients will “jump ship” looking for a different or more “thorough” approach (because that’s what you offer!).

I believe I have created that eclectic practice with the addition of decompression, stabilization exercises and various gentler adjustment methods.  This combination is so powerful as to virtually eliminate patient attrition due to treatment “failure”, per se.  That’s not to imply some patients do fail to respond, but we are able to be much better at prognostication and when to refer to other specialists.  An eclectic treatment practice allows a much easier determination of when “done is done”, something some practices may find difficult to identify.  If the patient didn’t improve, was it because they needed “supine decompression” and not flexion/distraction (they couldn’t lie prone) vs. rotary manipulation?  Though it is based on my own empiricism, I have seen very few patients with referral pain gain dramatic relief with adjustments if they had first “failed” decompression therapy.

Separating yourself and your practice from “the other guy” is no easy task.  However, offering a variety of reasonable, effective and safe treatment options makes it much more likely.  Most practices now offer manipulation (89%), flexion/distraction (65%) and modalities (75%).  As Napolean Hill said, “Being a little better that mediocre can get you great things in life.”  My initial $200,000 investment 10 years ago has paid off nicely, but not without some financial stress over those years!  At that time, more cost effective units were unavailable.  Now that decompression therapy is available for about the price of a quality adjusting table, there’s simply no good reason to miss out on it’s numerous clinical and business advantages.  My grandfather used to say, “A man who sees his life as small and limited makes his life small and limited.” I don’t want that as my legacy.  Stretching the limits of my practice has helped me build a reputation and practice I’m proud of. TAC

Dr. Jay Kennedy has been practicing Chiropractic Biophysics (CBP) in Western Pennsylvania since graduating Palmer College in 1987.  In the last nine years, he has owned and operated several decompression systems, treating over 2000 patients on them in his multidisciplinary clinics.  He lectures extensively and has authored various articles on axial decompression.

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