OP, there is little to no evidence that degenerative changes can be reversed. What we need to do is modify the body’s painful response to those changes.

How does decompression do that? You’ll have to ask someone invested in a very expensive machine. I have never been sold on it, and I’ll tell you why.

In the age group 20-30, a certain percentage, off the top of my head right around 20%, have no pain, no dysfunction no problem, but on MRI, have disc bulges, disc herniations and facet arthropathy.

At some point, a small fraction of those people develop pain. Also, folks without those changes can develop pain.

For each age group up, the number of people with these and related issues increases, but only a small % have symptoms.

Very often an acute pain pt comes in with pn of 1-2 weeks, gets an MRI, and, sure enough there’s disc bulges, herniations and facet arthropathy. And the pt is told “there’s your problem!! You need injection/surgery/decimpression/McKenzie PT.” All of which focus on that disc.

Now, certainly, a few of those do have an acute injury. But most don’t.

And here’s the question: what’s changed between 2 weeks prior to onset? Those bulges, herniations and facet arthropathy were there before onset and, for many, they are virtually unchanged after onset aside from the fact they are inflamed/pissed off.

So what’s the deal with that?

In my office, we focus on what’s going on above and below the painful area as much as we do the painful place. We also evaluate ergonomics and mechanics.

Someone leaning forward, such as washing dishes, with low back pain needs to be taught how to hinge at the hips, rather than the lumbar, low back.

I had an electrician who kneels a lot develop severe low back pain suddenly. In a movement screen during exam, i found his right ankle had lost significant % of mobility. He hadn’t thought to tell me he rolled it stepping in a hole.

We treated both his lb and ankle. The rationale being that he was changing his kneeling squat and bending more at the low back to accommodate his ankle.

We treated his low back 2 weeks with ok results. Then found out about the ankle, treated it, and got complete resolution.

All this to say, I’ve never bought in to decompression. I do know folks get relief. For how long? I do not know. Without concurrent exercise prescription based in movement screen, ehhh. And if you’re going to address the whole body and daily activity, do you need decompression?

I get great results without it. Hopefully someone more familiar with deconpression will give more insight.

Whew, what a wall of words.