My client met with the spine specialist, and he showed my client on his MRI how the bone is pushing against the nerve. The doctor thinks my client should try physiotherapy and peidural shots. The best option, in his opinion, is surgery, but my client doesn't want surgery and wants to try spinal decompression. I'm not sure of this type of treatment and was wondering if this was safe.
The best results are achieved when the treatment plan is matched to a thorough assessment. For me, the most revealing assessment is to start with provocative testing. Here, the patient is placed in various postures, takes loads and performs movements to determine what causes discomfort or pain and also determines what is tolerable. The patient is then classed as flexion intolerant, shear load intolerant, unstable, etc. Further tests are then performed to see if any relieving postures can be found. Then a series of movement screens are performed looking for flaws that cause overload for the back. If any are present, they are addressed with corrective exercise. Now we have a patient who has removed the cause of his pains (with tolerable loads and movements), which is usually 50 percent of the cure. Now specific therapy is selected. This usually consists of matched therapeutic exercise. Sometimes some soft tissue work is helpful to deal with muscle and nerve snags. For your specific patient, we have proven that specific spine extension postures can reduce the size of a posterior disc bulge. We have also had substantial efficacy with some nerve flossing procedures for neural irritation. The techniques for this are shown in my “Low Back Disorders” book. And with this background, I can address the decompression issue. The only literature I know of has found that it can help some cases of stenosis with intransigent sciatica, but otherwise it fared no better than any other passive approach. I am skeptical in general of any passive therapy as it does not address the causes of the pain nor does it buttress the weakness. In contrast, the appropriate corrective and therapeutic exercise deals with the cause and the resulting weakness. I hope this helps.