Spinal decompression

Term that may refer to nonsurgical traction or surgery relieving neural compression. The method must be specified because their indications and effects differ.

Lire cette fiche en français

Understanding the approach

Spinal decompression is a broad term that can describe two very different interventions. Surgical decompression removes tissue responsible for pressure on neural structures. Non-surgical decompression applies a traction force from outside the body. These techniques have different indications, evidence and risks, so the exact procedure should always be identified before discussing likely benefits or giving consent.

Indications and assessment

Pain radiating into a limb, numbness or difficulty walking may prompt assessment for nerve irritation. Examination includes strength, sensation and reflexes when appropriate. Imaging is used when it can change management. Progressive weakness or new bladder dysfunction associated with low back symptoms requires urgent assessment, rather than a routine trial of treatment on a traction table.

Benefits, limitations and precautions

Surgery may be considered when symptoms match a documented compression, after appropriate non-surgical care has failed or in certain neurological emergencies. It carries operative risks and does not guarantee that all pain will disappear. NICE recommends against offering traction for low back pain with or without sciatica. Devices marketed as decompression do not remove this uncertainty.

Place in the care pathway

TAGMED offers motorised non-surgical decompression, which is controlled traction. It does not remove a herniation and is not a miniature surgical procedure. Assessment should identify contraindications and define treatment goals before an offer is made. Adapted activity and other appropriate options remain relevant; a possible surgical indication requires evaluation by a specialist.

Goals should be practical: walking farther, returning to a chosen activity or reducing symptoms that interfere with sleep. Improvement immediately after a session does not establish lasting benefit. Follow-up compares function with the starting point, records adverse effects and considers progress between appointments. An inadequate response should prompt a review of the clinical explanation or proposed approach, rather than an automatic extension of the same treatment.

Frequently asked questions

Are the two forms equivalent?

No. One applies external traction; the other changes structures causing compression during an operation.

Does a traction table repair the disc?

Available evidence does not support promises of disc repair, regeneration or disappearance of a herniation.

Is MRI required before every course?

Not routinely. Imaging depends on the clinical assessment and whether its findings could change management.

Which symptoms should stop a session?

Markedly increased pain, weakness or new neurological symptoms require stopping treatment and reassessing the situation.

Can traction prevent surgery?

This cannot be guaranteed. A neurological emergency must not be delayed by a trial of traction.

Educational information from The Spine Page. This entry does not replace an individual assessment. Documentary version: October 12, 2026. Sylvain Desforges, B.Sc., D.O., N.D., osteopath and naturopath.