Spinal Decompression vs Traction: Same, Different, or Semantics

Written by Dr. Don Geisler

Back pain is one of the leading causes people seek medical care each year (1). Treatments will vary from rest, over-the-counter medications, and prescription medications, to surgery, massage, exercise and/or physical therapy. Physical therapy can include a physiotherapist for muscle building or chiropractic for spine joint movement (adjusting subluxations), muscle building, pain control, and possibly traction or spinal decompression. So what’s the difference between traction and spinal decompression treatment for spinal conditions? 

Practitioners will confuse these two terms purposely or ignorantly. Any treatment which applies a force to the spine that, to simplify, makes the spine longer, is a ‘traction” force that also “decompresses” the spine. Traction is the type of treatment, and decompression is the result of the treatment but this doesn’t explain the practitioner’s use of the terms and the differences in the treatment between traction and decompression. 

Traction is a force applied to an object, in the reference which I am writing, this will include: a practitioner’s manual therapy, home inversion tables or spinal traction tables, or for that matter spinal decompression tables. So what actually happens with traction or decompression? 

At the end of every muscle is a receptor (2), a pressure receptor called a Golgi tendon organ (GTO). This Golgi tendon organ will cause the muscle to tighten in response if the applied force is too quick or too strong stopping the muscle from tearing. Once the force stops, the muscle relaxes but must rest (due to its utilization of energy reserves) called the refractory period, which typically is between 2.2 and 4.6 ms (4). Once the relaxation begins, the muscle is incapable of contracting, therefore during traction, a constant force is applied to the muscle, which will only cause the back muscles to load and unload with no pressure applied to the spine itself. 

Spinal decompression tables are different from traction tables, with the advent of computerization, these tables stop the applied force when the muscle guarding begins but start again during the relaxation phase, allowing the force to be applied directly to the spine before the muscle can react. Dr. Ramos and Dr. Martin determined the force created via a Vertebral Axial Decompression table can reach below -100 mmHg, a vacuum force (3). This type of table was a decompression table, not a traction table. 

To summarise, If one has back pain or ache, muscle spasm, sciatica, leg pain or numbness created from a bulged disc, herniated disc, osteoarthritis, stenosis, or other pressure on the nerve, a spinal decompression table is the best course of treatment.      

  1. What are the most common conditions in primary care?  Canadian Family Physician Vol 64: NOVEMBER | NOVEMBRE 2018 cfp.ca/content/cfp/64/11/832.full.pdf
  2. Fascia Mobility, Proprioception, and Myofascial Pain National Center for Complementary and Integrative Health, National Institutes of Health, 31 Center Drive, Suite 2B11, Bethesda, MD 20892, USA Life 202111(7), 668; https://doi.org/10.3390/life11070668
  3. Effects of Vertebral Axial Decompression On Intradiscal Pressure. Ramos G., MD, Martin W., MD, Journal of Neurosurgery 81: 350-353, 1994
  4. Biomedical Sciences, teaching.ncl.ac.uk/bms/wiki/index.php/Refractory_Period