Retrospective Chart Review of Nonsurgical Spinal Decompression as a Therapeutic Modality for Low Back Pain

Low back pain (LBP) is a leading cause of disability and health care costs worldwide. Despite its prevalence, many patients fail to respond to surgical interventions and often face opioid dependency. Nonsurgical spinal decompression (NSSD) is a conservative treatment that may alleviate LBP by decompressing intervertebral discs, but it remains underutilized as a result of limited evidence and lack of insurance coverage.

This retrospective chart review aimed to evaluate the effectiveness of NSSD and LBP outcomes, including pain intensity, neurological function, and activities of daily living (ADLs) from community clinics nationwide. A total of 267 patient records from 7 clinics were analyzed. Patients underwent ≥20 NSSD sessions for over 6 to 8 weeks, with a median of 2 treatments per week. Demographics, subjective pain scores, clinical examination (reflex, myotome, and dermatome tests), and ADLs were collected. Statistical analyses included McNemar's, matched pairs t-tests, and subgroup analyses using a Kruskal-Wallis test of duration of current LBP.

The cohort demonstrated significant improvements in all measured outcomes. Pain scores were decreased by an average of 4.4 points (from 6.9 to 2.5; P < .001), with 90.5% of patients reporting pain reduction. Reflexes, myotomes, and dermatomes showed improvements of 60.9%, 74.8%, and 77.6%, respectively. ADLs improved significantly, with odds ratios ranging from 4.0 to 40.7 (P < .001). Subgroup analyses revealed consistent benefits across different chronicity levels of LBP.

These findings suggest NSSD is an effective conservative treatment for a diverse population with LBP, addressing pain, neurological deficits, and functional impairments. NSSD may offer a cost-effective alternative to surgical interventions and pharmacological treatments, reducing the risks of opioid dependency and surgical complications. Future studies should include randomized controlled trials and long-term follow-ups to further validate these results. This study emphasizes NSSD as a first-line therapy for LBP, warranting broader adoption and coverage to improve patient outcomes and reduce health care costs.