As a clinic seeing a high proportion of people struggling with unresolved back pain and neck pain, we are often asked about our IDD Therapy spinal decompression (IDD) service.
To understand IDD, let’s quickly put ‘unresolved’ back pain into context. Firstly, most back pain resolves itself. Or rather, the body has a natural healing mechanism.
Sometimes that doesn’t work or is taking too long.
This is where manual therapy and exercise typically come in. From relieving muscle spasm to manually mobilising a joint to help it move freely, clinicians can use a variety of techniques to help the body.
The spine is complex. Conditions can build up over time. In the same way that we might lose flexibility or strength in our leg muscles, the same can be true with the spine.
Movement is key to the health of our spine. So when there is an injury, such as a bulging or herniated disc, or where there is progressive degeneration leading to pressure on joints or nerves, the body may not be able to move adequately for the natural healing mechanisms to operate.
Spinal segments can become stiff and immobile, and this is particularly bad for the sponge-like discs in our spine. These intervertebral discs act as shock absorbers between the bones in our spine, the vertebrae.
Movement is vital for intervertebral discs. Discs rely on a process of osmosis to receive and thus replenish fluid and nutrients, movement or mobility are key to this.
Manual Therapy and IDD Therapy
Manual therapy and exercise to improve mobility and increase strength can help most conditions but at a certain point, these alone are not enough for some people.
This where IDD comes in.
IDD is delivered by the Accu-SPINA machine. This is a computer-controlled machine which enables us to decompress targeted spinal segments and gently improve mobility in the spine.
This treatment tool helps the body and in so doing, reduces pain and progressively restores function.
About IDD Therapy
In plain terms, IDD Therapy decompresses targeted spinal segment, gently working the muscles and ligaments around an injured spinal segment. Helping to restore function and the help the body’s natural healing mechanisms.
Through a series of controlled stretches, IDD Therapy opens the space between two vertebrae to take pressure off the disc. It creates a drop in pressure (negative pressure) which may help retract a bulging disc whilst working the tissues to free movement in the joint.
When the joint is opened, a series of oscillations or mobilisations (think wiggling) help to further work the tissues and create small pressure differentials progressively helping to improve the tissues and range of motion and stimulate fluid exchange across the joint surfaces. Taken together, these effects serve to progressively improve mobility and restore function, whilst reducing pain.
How does IDD Therapy achieve this?
Patients are connected to the machine by two harnesses. One harness is attached around the pelvis and is connected to a motor on the machine tower. A chest harness secures the patient to the top of the table.
The motor has a strap, rather like a car seat belt strap instead of a rope, which connects to the pelvis harness.
The motor is raised in the tower of the SPINA to a specific level to create a measured angle to the body of the patient.
At this point the computer programme is set and the motor gently pulls on the pelvic harness.
The harness acts like a big pair of hands on the pelvis, holding it securely. There are several key things about the way the pulling force is administered which make the difference.
Spinal problems such as a bulging or herniated disc are typically located at a level in the spine.
In the lower back (lumbar spine), the two discs at the bottom of the spine are common areas where problems occur, the L5S1 and L4L5 account for perhaps 80-90%% of the disc problems we see. But we can treat other levels too. In the neck (cervical spine) it is the C5C6 level.
By changing the angle at which a force is applied, or by changing the angle of pull, the pulling force (distraction force) is focussed to the affected level.
Whilst some older systems like traction apply pulling forces generally to the spine, they are not focussed to a specific level.
This is one element of the differences between IDD Therapy and traditional traction because traction was not specific and thus results were poor. This explains in part why traction went out of use.
The force is the amount of pull used. The spine is incredibly strong. The muscles, tendons and ligaments support our whole body weight and enable us to move, walk or run upright and carry loads.
In order to open the space between two vertebrae, decompress the disc and work the tissues, we need an adequate force. So the pulling force needs to be quite strong.
In actual fact it is far stronger than what can be delivered by the hands.
This force is strong enough to do the job required. But the way the force is administer and controlled, means that despite the high force (built up overtime to up to and even over half bodyweight), the patient remains completely relaxed.
Of course, a lower force is applied initially. It’s rather like starting weight lifting, the weights are a lot less initially and you don’t start with the heaviest weights. They are built up over sessions as your muscles, tendons and ligaments adapt and get stronger.
Over the course of the IDD Therapy treatments, the body adapts and small increases in force are added, which remain comfortable.
This conditioning helps to progressively improve function which as we have said is so important for healing.
This refers to time on the SPINA machine. Each IDD treatment includes 25 minutes on the machine. The pulling forces are done in cycles. That is, we pull to a high tension or force, hold for one minute, release to a low tension for 30 seconds, then repeat.
So there are 13 minutes when the affected spinal segment is decompressed and the tissues are being worked. And because the tension does not go to zero tension, the soft tissues are stretched for the full 25 minutes of the time on the machine.
Additionally, and unique to IDD Therapy is the oscillation. This is where we apply a high tension and then at that point, we oscillate which acts as a small but controlled mobilisation.
Number of treatments
Have you ever gone to a gym once and got fit? Have you ever gone to the gym once a week and got fit?
The IDD Therapy programme is exactly that, a programme.
To bring about change in the tissues and allow time for healing, it is not possible to resolve certain spine conditions within a standard physical therapy model of 4 to 6 treatments.
The programme is spread over a six to eight week period and consists of twenty treatment sessions. In some instances, patients may need more than twenty sessions.
Some patients experience symptom relief very quickly but the programme is intended to create a platform of long term healing.
A few treatments will not bring about change. Hence having an intense programme where initially patients come three to five times a week is key the success of the treatment.
The body adapts to the treatment and progresses as we are able to increase the tensions and condition the tissues.
Note: This is another factor explaining why traditional traction failed because it was just a small number of treatments. Like going to the gym a few times it simply does not bring about adequate change or lasting change.
All sessions are tracked and patient progress is monitored and measured using internationally-recognised research tools.
Thus a patient who has made progress and is continuing to make progress but who still has some pain or impairment, may benefit from additional treatments.
This is noticeable with cases where there are multiple problems.
An analogy might be going on a programme of weight loss. Through diet and exercise, a person may experience improved strength and loss of body fat.
But at a certain point, may still have more weight to lose. That does not mean that the programme is not working, simply that it needs more time.
Of course if there was not satisfactory progress, then an alternative strategy would be needed.
Exercise and Manual Therapy
IDD Therapy is a treatment tool. It is a programme of care, of rehabilitation. We combine it with gentle exercises which serve to strengthen the muscles.
The word exercise can crate thoughts of boot camp, especially for those who have rarely exercised.
But the exercise is gentle and even the most exercise-averse can do them, because it is an essential part of maintaining the health of the spine and avoiding recurring pain.
Manual therapy can be used to address other issues. The body is one organism where the whole works in unison.
A herniated disc for example can occur due to a combination of factors which may have built up over time and weakened the wall of the disc. Manual therapy may be used to address some of those factors.
The combination of targeted force, amount of force, duration of time under tension and the programme of treatments are what make the difference with IDD Therapy. That is why it is the gold standard in spinal decompression treatment.
Pain relief from medication will not address the underlying stiffness and immobility in a spinal segment to enable the body to heal efficiently.
Spinal injections such as an epidural steroid injection with anaesthetic, can ease inflammation or numb pain but they do not address stiffness and compression. They are intended to create a window for rehab. That can be manual therapy and exercise, but if that is not enough or if those standard treatments have not been working prior to the injection, this is where IDD Therapy comes to the fore.
And lastly spinal surgery.
There are times when spinal surgery is the right treatment. It can help avoid long term nerve damage and relieve debilitating pain. But it is not without risks and it is generally accepted that non-invasive treatment should be first choice.
Unless there is an urgent need for surgery, we would recommend IDD Therapy.
If you are struggling with unresolved pain, have tried manual therapy and exercise and feel you need something more, then we can assess you and advise if IDD Therapy would be suitable for you.