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Getting Rid of That Aching Back

Avoiding the Knife
By
WebMD Feature
Reviewed by Craig H. Kliger, MD

April 2, 2001 -- Eric Taylor suffered from back pain for almost 30 years. He tried physical therapy, pain relievers, anti-inflammatory medicines, and surgery, but nothing worked. His doctor told him he could have steel rods placed in his spine or put up with the pain for the rest of his life.

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Taylor sought an alternative. A friend told him about a new procedure called vertebral axial decompression (VAX-D) that might relieve pain without surgery. Taylor thought, why not?

"As long as it was nonsurgical and noninvasive, I was open to it," says Taylor, a 54-year-old attorney in St. Louis. "I was ready."

Nearly 70% of all people will suffer from low-back pain at some point in their lives, according to the CDC. It is the most common work-related injury, the Occupational Safety and Health Administration (OSHA) reports. There is little, however, that can be done. Bed rest is the most prescribed remedy, followed by exercise, muscle relaxants, pain medication, physical therapy, chiropractic intervention, and surgery. These and other methods often fail to provide long-term relief. But researchers say there is new hope: The VAX-D therapeutic table.

Approved by the FDA in 1996, the device was designed by Allan E. Dyer, MD, PhD, a former Canadian deputy health minister who helped develop the heart defibrillator. Treatment using the table is said to relieve lower back pain by applying tension to the spinal column to decompress the intervertebral discs.

A study published in April 1998 in The Journal of Neurological Research found that VAX-D is effective in relieving pain in 71% of cases. The majority of the 778 patients -- cases reviewed from 22 centers across the country -- reported a reduction in pain to a level of 0 or 1 on a 0 to 5 scale (with 5 being the highest level of pain). About 1% of patients reported an increase in pain, while 7% experienced no change. About 4% of the patients had had previous lumbar disc surgery. The researchers suggest that postsurgical patients who still have persistent pain should try VAX-D before considering further surgery.

"This table has been shown to have a significant benefit for patients," says William Naguszewski, MD, co-author of the nonrandomized study (meaning patients were not randomly assigned to other treatments for purposes of comparison), conducted in conjunction with researchers from the University of Illinois at Chicago and the Coosa Medical Group in Rome, Ga. "When the patient completes the treatment, they are back on their feet and walking and working the rest of the day."

The table's use, however, is controversial, and insurers generally do not cover it. "Since there are really no clinical, randomized trials on this, there is really no way of gauging whether it has any advantage over standardized, conventional treatment," says Matthew Schiffgens, spokesman for Kaiser Permanente.

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