Ask An Expert: VAX-D Treatment for Spinal Problems

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Ask An Expert: VAX-D Treatment for Spinal Problems

Question:

Can you tell me the purpose and basis of VAX-D treatment for spinal problems?

Answer:

VAX-D stands for Vertebral Axial Decompression and refers to a procedure in which the lower spine is gradually stretched and relaxed as a treatment for people with low back pain, particularly those with disc disease.

Each session of VAX-D involves lying on your abdomen with a harness around the hips; the hands are stretched out above your head holding onto hand grips. A special table then slowly pulls the hip harness and your arms in opposite directions; if it isn't comfortable, you can simply let go of the handgrips. Each treatment lasts 30 to 45 minutes; treatments begin daily with a typical course including 20 to 40 treatments. The idea is to alternately stretch and relax the muscles and soft tissues surrounding the spinal bones and the cushioning disc in between to reduce pressure in the disc and even "retract" the bulging disc back to where it belongs.

The cost of VAX–D treatments (which can run $150 each) may not be covered by insurance, so the multiple treatments can be quite expensive. It's clearly not for everyone — people with fractures, serious spinal cord problems (such as infection or fracture), osteoporosis, or serious shoulder disease may not be able to safely receive VAX-D treatment. At least one case of worsened disc disease requiring emergency surgery has been reported but, in general, the treatment seems to be safe.

Does it work? There are studies with positive results (including one in which 70 percent of recipients reported a 50 percent or greater reduction in pain); however, no definitive studies comparing VAX-D to standard treatments or placebo have been published.

The VAX-D is similar to "traction" that you have heard about in the past. Physical therapists and other health care practitioners used to recommend traction, the application of gentle tension to "stretch out" the spinal bones, for neck or back pain. This approach has fallen out of favor, based at least in part on a lack of definitive evidence that it works. However, it is occasionally still offered, especially when other types of treatment are not working well.

Robert Shmerling, M.D., is associate physician and clinical chief of rheumatology at Beth Israel Deaconess Medical Center and an associate professor in medicine at Harvard Medical School. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program and has been a practicing rheumatologist for over 25 years.

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Last updated:	January 24, 2007