The Research

The published evidence for non-surgical spinal decompression is limited.

We are going to say that first, because a field that overstates its evidence has already had its reckoning — and because you are a doctor, and you will check.

What follows is what we have published, what the wider literature shows, and what none of it proves yet.

What we have published

Two papers, both peer-reviewed, both open access, both by Dr. JD Dudum with co-authors.

Reduction of the Size of a Lumbar Disc Herniation Using Non-Surgical Spinal Decompression Combined with Chiropractic Care

Dudum J, Gatterman B. Journal of Contemporary Chiropractic. 2024;7(1):146–155.

A case series of four patients. Each had low back pain with radicular symptoms. Each received non-surgical spinal decompression alongside chiropractic care, low-level light therapy, electrical muscle stimulation and rehabilitation, over 20 to 30 sessions.

MRI was taken before treatment and again four to six months later. Herniation size was measured using a herniation index calculated from the axial images.

What the four patients showed:

All four reported improved function and reduced pain.

What this paper does not show. It is four patients with no control group. It cannot separate the effect of decompression from the effect of the other treatments delivered alongside it, or from natural history — disc herniations are known to resorb on their own, and an uncontrolled series cannot rule that out.

The paper says so. Its conclusion reads: “Prospective and controlled trials are needed to confirm our findings.”

Reduction of Cervical Intervertebral Disc Extrusion in Patients with Segmental Instability

Dudum JD, Gatterman B, Buonopane S. Journal of Contemporary Chiropractic. 2026;9(1):240–247.

A single-patient case report. A 50-year-old man with a C5-C6 disc extrusion who had declined fusion surgery. Follow-up imaging showed a 52% reduction in the extrusion, with continued improvement at one year.

One patient. A case report is the weakest form of clinical evidence. It describes what happened to one person. It is worth publishing because the imaging is objective and the mechanism is worth investigating — not because it establishes anything.

Further papers are in preparation. We will describe them when they are published and not before.

The wider evidence

This is the part most companies in this field leave out.

What the systematic reviews say

They do not support decompression.

The most authoritative synthesis is the Cochrane review of traction for low back pain (Wegner et al., 2013), covering 32 randomised trials and 2,762 participants. Its conclusion: there is low- to moderate-quality evidence that traction “may make little or no difference in pain intensity, functional status, global improvement or return to work” compared with placebo, sham traction or no treatment.

Macario and Pergolizzi (Pain Practice, 2006) reviewed seven randomised trials of motorised decompression specifically and concluded that efficacy “remains unproved.” Six of the seven showed no difference against controls.

Daniel (Chiropractic & Osteopathy, 2007) found “only limited evidence” to warrant routine use — and noted that marketing claims in this field routinely outran what the studies actually showed.

No later review has overturned these findings.

Where the evidence is more favourable

Choi et al. (International Journal of Clinical Practice, 2022) is the strongest controlled result available. A randomised trial of 60 patients with subacute lumbar disc herniation, decompression against a sham that applied no force. Herniation index fell 27.6% in the treatment group against 7.1% in the sham group — a statistically significant difference. Just over a quarter of the treatment group showed more than 50% reduction; none of the sham group did.

One modest single-centre trial. It is genuinely promising and it is not confirmation.

Vanti et al. (Physical Therapy, 2021) meta-analysed eight trials of mechanical traction for lumbar radiculopathy. Supine traction added to physical therapy showed short-term benefit for pain and disability. Prone traction did not. The evidence was rated low quality and the effects were short-term.

And where it is not. Demirel et al. (2017) randomised patients to physiotherapy with or without decompression and imaged them at three months. Herniation reduction was larger in the decompression group, but the difference between groups was not statistically significant.

The 267-patient chart review, and what it is

You will see this study cited widely, usually as validation.

Schueren S, Luginsland LA, Ariza Medina G, Schilaty ND. Retrospective Chart Review of Nonsurgical Spinal Decompression as a Therapeutic Modality for Low Back Pain. Military Medicine. 2025;190(Supplement 2):134–140.

267 patient records from seven clinics. Pain fell from 6.9 to 2.5. 90.5% of patients reported improvement. Neurological findings improved in 60 to 78% of those affected.

Three things you should know about it.

It is not our study. It was led by researchers at the University of South Florida. Dr. Dudum is not an author, Dudum Decompression was not among the seven clinics, and DRA had no involvement of any kind.

It was partly funded by a device manufacturer. The paper discloses that the study was partially sponsored by Excite Medical, which makes the DRX9000 — the device used by the participating clinics. That does not invalidate the work. It is a fact a reader should have.

It has no control group. The authors say so plainly, and list their own limitations: possible selection bias, since clinics chose which cases to submit; concurrent treatments that make it impossible to isolate the effect of decompression; no adjustment for confounders. Their words: without a control group it is “difficult to determine if the benefit… could be because of a placebo effect.”

They call for randomised trials. So do we.

What all of this means

Non-surgical spinal decompression does not have proven efficacy by the standards of randomised evidence. The best systematic review is neutral to negative. The most favourable recent synthesis supports short-term, adjunctive benefit on low-quality evidence. The supportive imaging data — including ours — is observational.

What we think the evidence does support: that a subset of patients experience meaningful improvement, that measurable change in disc morphology occurs in some of them, and that the mechanism is worth investigating properly.

That is a smaller claim than you will hear elsewhere in this field, and it is the one we can defend.

Why we publish at all

Because someone has to, and almost nobody in decompression does.

The field has a documented history of claims outrunning evidence. In 2008 the Eleventh Circuit found a decompression manufacturer’s advertising claims literally false. State attorneys general followed. Individual doctors were fined for deceptive advertising, and some were prosecuted for fraudulent billing.

That history is why every success percentage in this industry deserves scrutiny — including ours, which is why we publish the study designs and the patient counts rather than a headline number.

Collecting clinical data and publishing it is part of what Disc Renewal Academy is for. Not as marketing. Because the evidence base is thin and the only way that changes is if practising clinicians document what they see and submit it to peer review.

A note on devices and FDA status

Decompression tables are FDA-cleared, not FDA-approved.

510(k) clearance means a device was found substantially equivalent to one already on the market. It is a regulatory pathway, not a finding of effectiveness. Any company describing its table as “FDA approved” is making a claim that a federal court has already found to be false.

DRA does not sell, endorse or resell equipment. We teach protocol, not hardware.

Individual results vary. The published evidence for non-surgical spinal decompression is limited and largely observational. Nothing on this page is clinical, legal, or billing advice. Scope of practice is determined by your state licensing board.