My Letter to the Editor in Chiro Trade Pub

dynamicchirologo1

 

 

Just came across a letter I wrote a while ago to Dynamic Chiropractic that was published earlier this month…I must have missed it. Link is here and the letter is reprinted below:

Decompression: Thanks for Separating Fact From Myth

Dear Editor:

Thank you for Dr. Edwards’ article on nonsurgical spinal decompression (“Decompression Facts, Myths and Hyperbole, Part 3,” Sept. 23 DC). It is so refreshing to read an article about decompression that isn’t filled with marketing exaggeration, false claims of superiority and invented statistics. Dr. Edwards (and Dr. Dan Kennedy) present decompression for what it is: an expensive treatment that is similar to other traction devices in its effectiveness. I would like to see more real-world device examinations and debunking of chiropractic myths in future issues of DC.

Brett L. Kinsler, DC
Rochester, NY

 

The fact is, that happened to be a decent article and is worth reading.  Much of what shows up in the trade mags is either the same old drivel or else not worth the time it takes to read.  Once in a while we get surprised by a quality piece.

Honest Decompression Salesperson One Flight Up

A lawyer relative used to have a sign in his office that read “Honest Lawyer – One Flight Up”.  The oxymoronic possibilities of the phrase ‘honest lawyer’ struck me at a young age.  I would have thought, with all of the hyperbole and dogma attached to non-surgical spinal decompression therapy, finding an honest spinal decompression representative would prove to be equally difficult.  Not so fast.  This week I met Chris Peetros from the Chattanooga Group.

I am not writing to endorse any product or company and my readers know that I will not hesitate to call someone on their bullcrap when I see it.  That is why it was so refreshing to hear Mr. Peetros discuss the line of spinal decompression devices from Chatt.  I asked him numerous questions about research and superiority and each time, he answered with honesty.  There was no exaggeration, no dogma, no suggestions on how to squeeze more money out of patients.  Here were some take home points:

(1) Chiropractors are getting ripped off by spinal decompression companies.  In many cases, doctors are spending two to ten times more than a product is worth.

(2) Chiropractors in turn upcharge their patients in order to pay off these ridiculously overpriced machines.

(3) Spinal decompression is a result, not a procedure.  These machines are mechanical traction guided by a computer for accuracy and repeatability.  There is nothing magical, mystical or truly new about this therapy.

(4) Non-surgical spinal decompression is traction.  Period.  It is mechanical muscle and ligament stretching in the axial plane.

(5) There is no proof of superiority for spinal decompression to flexion-distraction or any other means of traction but some patients tolerate it better and with an acute patient, it might be easier to start slowly with a computerized traction device.  Many traditional traction devices do not have the same control of depth and rate.

None of this is news.  None of this is groundbreaking.  All of it was honest and was spoken by someone whose company sells these units.  The difference from what I can see is that Chattanooga sells theirs for a much more fair price (around 10k) and without all the hype and claims of the other companies.

Am I buying one?  Probably not yet.  I am still not convinced that I cannot achieve the same results and with better control manually.  Most of our patients do extremely well without spinal decompression so I am not sure where the advantage would be.  However, I have now located a device that I would consider using should the research so sway me.

Got an opinion or comment?  Do you have any experience with these tables?  I’d love to hear it.

 

Dr. Brett Kinsler is RochesterChiro, a skeptical chiropractor in Rochester, NY.  www.RochesterChiro.com

More Spinal Decompression Lies You Should Know

None of my blog articles have caught more attention or been the subject of more flack than when I tell the truth about non-surgical spinal decompression like the VAX-D, DRX-9000 and other pieces of equipment that are similar.  You will recall that I am not against the use of these machines in general — only that the marketing of them is seriously misleading and the practitioners who use them frequently sell patients on long term, prepaid care plans that are highly unethical.  The marketing of non-surgical spinal decompression also frequently falsely claims superiority over other techniques like flexion-distraction — such claims have not been proved.

As a result of some of the feedback I have received, I came across an article from the journal Chiropractic & Osteopathy titled “Non-surgical spinal decompression therapy: does the scientific literature support efficacy claims made in the advertising media?” published in May 2007.

What’s the bottom line?  Does the decompression hype live up to the claims?  That’s a big, giant, whopping “NOPE!”

A little more detail, you say?  Okay.  The article examines this “heavily marketed” version of traction therapy that “can cost over $100,000.”  The authors extensively search all the major medical and scientific literature databases to find every scientific research article published on nonsurgical spinal decompression.  It turns out,  there was only 1 randomized controlled trial, 1 clinical trial, 1 case series and 7 other papers.  Each was reviewed individually. 

The authors concluded that “In general the quality of these studies is questionable.”  And that there was “only limited evidence…available to warrant the routine use of non-surgical spinal decompression, particularly when many other well investigated, less expensive alternatives are available.”

Gee, that sounds just like what I told you a few months ago.

 Also interesting was that this intervention has never been compared to exercise, spinal manipulation, standard medical care or other less expensive conservative treatment options which have an ample body of research demonstrating efficacy.  How the practitioners can get away with claiming any superiority and not be restrained from doing so is a mystery to me.

I’m not saying that any chiropractor who has a spinal decompression unit is a crook.  If he or she is charging you the same as a regular visit in order to use the experimental equipment, then that may be fine.  If he or she tries to convince you to pay in advance, sign up for a dozen or two visits or tells you how fantastic the device is compared to other treatments, don’t walk….run away and find another chiropractor.

Non-Surgical Spinal Decompression – Fact or Crap?

Yesterday, a patient came to my office and told me her medical doctor sent her to me to see if I did spinal decompression.  For those of you who don’t know, non-surgical spinal decompression uses a specialized type of chiropractic table that provides computer assisted traction in order to separate the spinal bones and promote disc and ligament healing.  Devices are known as the DRX-9000, VAXD, Lordex, DRS and others.  The problem is, there are too many problems.

  • Spinal decompression is a good procedure but has not been shown to be any better than techniques like Flexion-Distraction.
  • Providers of spinal decompression almost always claim superiority of their technique over others.
  • Spinal decompression devices are much, much, much more expensive than traditional flexion-distraction devices.
  • In order to pay for their expensive, computerized tables, many spinal decompression doctors resort to false or misleading advertising, pre-paid treatment plans and other unethical practices.
  • Decompression chiropractors frequently prescribe a 20 visit minimum treatment protocol (usually at about $200 per visit!!) for which there is no clinical rationale.  Many of these patients would get better faster with other treatment methods.

I don’t have a problem with the DRX-9000 or other SD tables in and of themselves.  The theory is pretty good and mirrors the excellent results we obtain with flexion-distraction for disc herniations and bulges.  I have a major issue with the false and misleading practices, the high-pressure sales tactics, the false claims of superiority and the pre-paid treatment plans.  I also don’t feel like paying an extra $60k to hook my table up to a computer. 

I sent the MD who inquired about the technique a nice letter along with a copy of some of the articles naming lawsuits concerning the spinal decompression practices and some of the major insurance company positions on decompression (is it considered experimental and no better than currently available procedures).  It would be nice to see this become a legitimate piece of equipment as a tool for chiropractors to use but as of now, there is too much controversy and too many unethical practices associated with it.

Dr. Brett Kinsler is a chiropractor in Rochester, NY.  He gets excellent results with patients who have disc injuries in his Rochester chiropractic office and does not need to resort to hype and lies. His website is http://www.RochesterChiro.com

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