Spinal Decompression Therapy, Part 1 Selecting clinically appropriate patients O Dr. Ron Nusbaum graduated from CMCC in 1989 and began practis- ing in a multidisciplinary clinic in his first year, associating with Dr. How- ard Vernon. He has been practising in Richmond Hill for more than 20 years. Dr. Nusbaum is the director of Back Clinics of Canada where he also provides spinal decompres- sion therapy while serving patients from the greater Toronto area, Rich- mond Hill, and across Canada. He works closely with each patient to diagnose the underlying causes of their condition, and determine the appropriate treatment. Learn more about spinal decompression at www.backclinicsofcanada.ca or by calling 1(877) 828-3472. ur profession has a wonderful track record for helping Canadians reach a higher level of health, and maintain it naturally. But there is a certain group of patients who do not respond to traditional chiropractic care as well as we’d like them to. Often, these challenging back and neck pain patients are suffering from bulging or her- niated discs or advanced degenerating discs. Spinal decompression therapy is one op- tion that has demonstrated a degree of success in many of these cases. By its very nature, it is a procedure that complements our approach, as it is non-invasive, non-surgical, and requires no drugs or medications. While one might expect an article on this topic to launch into the available spinal decompression therapy technology, comparing performance, maintenance and costs, I firmly believe that the topic of patient selection for candidacy must be discussed first. Not every patient with spinal disc pathology is a candidate for spinal decompression therapy. It is through a meticulously performed consultation and examination that the doctor will be able to determine how well a patient is suited for spinal decompression therapy or whether they are suitable for this option, at all. Inappropriately selected pa- tients may suffer poor or even damaging results with this therapy. (Of course, this could be true for any misdiagnosed or mistreated patient, in any area of the health-care sys- tem.) Furthermore, patients want desperately to trust their doctor’s recommendations. It is therefore imperative that we are comprehensive in both our consultation and ex- amination steps and in communicating the outcomes and implications of these with our patients. We find that only when the patient is properly determined by the doctor to be an ideal candidate (for any therapy), and doctor and patient have established a trusting relationship and developed a true healing partnership, will the best possible outcomes be achieved. Therefore part 1 of this article will focus on the consultation and examination process to select, or deselect, patients to ensure safe and effective spinal decompression therapy. For most doctors most of this information should be an important and welcomed review as this process is relevant in all patient situations but the importance of some particu- lars, here, cannot be overstated when deciding to include spinal decompression therapy within a patient’s program of care. EVALUATING THE PATIENT’S OVERALL STATE Ideally, you should schedule sufficient, uninterrupted time for each patient consultation and examination. Allow yourself to truly get to know your patient. It’s helpful, also, to recognize the profile of a typical patient with a disc herniation, bulging disc, degenerative disc as well as stenosis and then decide if spinal decompres- sion therapy might be an option for that patient. Look for the following features: • suffering from serious chronic pain, lasting anywhere from a few months to 20 -30 years, or more • age ranges usually from 30 to 75 years old • is experiencing long-standing, serious lumbar or cervical pain • pain can include radicular/sciatica signs and symptoms, and may include 34 • CANADIAN CHIROPRACTOR | MAY 2010 www.canadianchiropractor.ca Ron Nusbaum, DC feature
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