Spinal Decompression Devices VS ELDOA - Which is the best?
When you are suffering from back pain caused by spinal compression, it makes sense to seek out a way to decompress the spine, right?
If you Google “spinal decompression” you will find two main categories of therapy: surgical and nonsurgical.
In the example of disc herniation, only about 10% of disc herniation cases actually qualify or require surgical intervention. So what do you do if you are the other 90% looking for the best nonsurgical option to get the benefits of spinal decompression?
Do you rely on machines or can you actually do it with exercises like the ELDOA?
Which is better?
First it helps to start with a description and comparison of PROs and CON’s for each.
Lets’ start with spinal decompression machines.
What are spinal decompression machines?
There are a number of different types of devices that have been designed and marketed to help utilise traction to decompress the spine.
The most popular and affordable type of spinal decompression device is the inversion table.
Inversion Table
How it works:
Inversion therapy involves being positioned upside-down, or “inverted” in opposition to gravity. This usually consists of hanging by the legs, ankles, or feet.
Using an inversion table, a person essentially straps him/herself to a vertical platform and uses this platform to turn him/herself upside down, allowing gravity to stretch the spine.
Typical recommendations for use are to start with 15˚ angle for a minute and then build up to a higher degree of angle sometimes fully inverted for 3 minutes or more.
Pros:
Uses gravity to help to remove the pressure from the spinal discs and the surrounding muscles and nerves. This could relieve painful muscle spasms caused by spinal disc compression.
Convenient and affordable non surgical therapy that can be done at home
Easy to do - passive treatment that requires minimal effort by the patient
Cons:
Inversion tables utilize gravity and your full body weight to stretch your spine. As the ligaments and tendons continue to stretch, they can no longer protect spinal vertebral discs from further injury. In essence, you just “keep stretching”.
Inversion therapy may be helpful for a select few people if used correctly. However, most people are not spinal experts (neither, generally, are the people making and selling these tables), and our culturally-embedded tendency is to say “if something is good, then more is better!” This often translates to people overindulging in this therapy, doing it too hard, for too long, or too often. This can lead to injury and occasionally, permanent damage.
As fun as it is to go completely upside down, there is no additional benefit of inverting more than 45˚ and doing so may lead to serious injury
This type of spinal decompression is extremely general - there is no way to target a specific area of the spine or joint.
Does not address the cause of back pain. Only can relieve the symptoms of spine compression temporarily. Needs to be used in combination with physical therapy exercises.
Another popular device is a big computerised spinal decompression machine (such as the DRX9000® pictured below) that is available at specialised therapy offices.
This machine is designed to stretch the spine gently, relieving pressure on the discs and nerves between the vertebrae. It is often used to treat conditions like herniated discs, degenerative disc disease, sciatica, and spinal stenosis. The person’s muscles remain completely relaxed in a neutral position.
Programmable Spinal Decompression Machine
How it works:
The patient lies down on the machine, typically on their back or stomach. Straps or harnesses are placed around the pelvis and the upper body to secure them.
The machine gently pulls the lower or upper half of the body, depending on the area being targeted. This stretching creates negative pressure within the discs, allowing any bulging or herniated material to retract.
Each session usually lasts between 20 and 45 minutes, and a full treatment plan can require multiple sessions over several weeks.
Pros:
The professional table only exerts a certain amount of highly-controlled “pull” on the spine, which equates to being pulled a certain distance. A professional spinal decompression table contains the software technology to monitor the amount of “pull” and it will adjust to your body weight and other parameters.
Programmed to exert gradual, gentle force for short intervals of time before releasing. It does this in specific patterns for specific tissue types (muscle or tendon) and it can also target different areas of the spine.
Easy to do - passive treatment that requires no effort by the patient
Cons:
Expensive up front cost. Some providers schedule patients five times per week for four weeks or four times per week for five weeks.
Inconvenient. Must be done at a location that provides the treatment which may not be close
This type of spinal decompression is still general - a general area may be targeted such as the lumbar spine or neck bot not a specific joint
Does not address the cause of back pain. Only can relieve the symptoms of spine compression temporarily. Needs to be used in combination with physical therapy exercises.
Now, let’s look at the ELDOA exercises.
First, a brief history of the ELDOA, According to Guy VOYER DO
Over 40 years ago: Upon completion of Dr. VOYER’s medical training, and at the same time as he began his osteopathic studies; “Back Pain” was a very popular topic.
The fields of medicine, physical therapy, and osteopathy spoke and wrote articles about back pain:
“How is it possible to correct back pain, the pain of the world?”
The view of the spine at that time was limiting – “one vertebra in relationship to another.”
During many years of travel, study, attending myriad courses on back pain, Dr. VOYER picked up one or two points each time and added them to his practice, mixing them altogether. Listed below are some of his influences:
MAC (Methode Analytique Correctrice)
The R. KLAPP Method
NIEDERHOFFER
The KABAT Method
The BRUNNSTROM Method
BOBATH
PIRES and BEZIERS
MEZIERES
GODLIEVE STRUYF-DENIS
At the same time, Dr. VOYER began an intensive study of biomechanics in a NEW WAY – tensegrity biomechanics – B. Fuller
The way of tensegrity biomechanics – the spine and vertebrae are in relation to all the body via the fascia (connective tissue)
Dr. VOYER began to speak about C-S-S-C or Cranial-Spinal-Sacral-Coccygeal.
His work in this field has resulted in numerous techniques that he either developed or modified in order to harness the power of the fascia as a means to improve the flexibility of the muscles and the mobility of the joints.
He is one of the first medical professionals to organize the fascia into “fascial chains”, to recognize the role of the fascia as an organ, and the role of fascia in human movement.
“I put all of this information together in the form of the ELDOA, and used it with all my patients”
– Guy VOYER, DO
What is the ELDOA?
Etirements Longitudinaux avec Decoaptation Osteo-Articularae
The ELDOA are postural exercises (LOADS – Longitudinal Osteo-Articular Decoaptation Stretches) that you can do yourself with the primary goal being to increase the space within a chosen articulation.
How does it work?
The basic principle at work during an ELDOA consists of creating a posture that will target a specific functional unit. The posture is created by the clients themselves actively creating tension through myofascial contraction to “fix” all inferior to the targeted joint and create traction by stretching the superior myofascial chains to mobilise or free the space above the fixed point.
Cortico-corporeal awareness is created in order to maintain a precision of all these tensions, which combined with active diaphragm and passive cranio-pelvic breathing, will generate the targeted osteo-articular decoaptation.
Gentle and precise listening can be added to guide the myofascial motor controls in the direction of the lesion to free the restraints.
Pros:
As the ELDOA “creates space”, there is an improvement in joint mechanics, increased blood flow, reduced pressure on the discs, a reduction of pain, spinal disc rehydration, better muscle tone, improved posture, and a sense of well-being and awareness.
Convenient and affordable non surgical therapy that can be done anywhere
Very specific programming that can target exactly the joint space that needs the correction
Addresses the cause of most joint compression including reinforcement of postural strength and normalising asymmetries in spinal alignment for longer lasting back pain relief
Minimal counter indications because postures can be adapted for each person
Active self-normalising technique - Like doing Spinal Decompression Machine and PT exercises at the same time
Cons:
Relatively steep learning curve to perform the postures correctly. Takes time to master the techniques
More challenging than passive therapy and requires effort and consistency to experience benefits
Can be difficult to find a Certified ELDOA Practitioner with the skill level to work with specific spine injuries
There is a different posture to work more specifically with each disc of the spine. Here is a video example of the ELDOA for the L5S1 intervertebral disc. There are many adaptations that are being used to work with this specific client.
**This video is for demonstration purpose only. If you have a spinal injury we do not recommend practicing this exercise without first getting clearance for exercise from a medical professional.
SO, WHICH NON SURGICAL SPINAL DECOMPRESSION METHOD IS THE BEST?
Fundamentally the biggest difference between spinal decompression machines and the ELDOA is that:
Spinal Decompression Devices are PASSIVE and GENERAL while
ELDOA Exercises are ACTIVE and SPECIFIC.
Passive/General:
Spinal Decompression Devices do feel great, right?!
Strap in, put your feet up, take compression off spine, no effort - feel better!
Except here’s the kicker… because this process is completely passive with no effort by the patient, the moment the person stands up, all of the spine compresses again and there has been no educational process for the ligaments, muscles, and correct posture to maintain the effect. The pain relief may be fast but temporary.
Also… the decompression method using a device is very general. Yes, it can work more with the lumbar, thoracic, or cervical area possibly - however it is not able to target a specific joint within the spine.
You may think, “well that’s okay - if you decompress all the spine then it will surely help the intervertebral disc or joint space where there is an injury.”
However, when a joint sustains an injury, it loses range of motion for several reasons:
1. Inflammation and Swelling: After an injury, the body responds with inflammation to protect the affected area. This causes swelling, which can limit the joint's movement. The increased fluid buildup around the joint creates pressure, making it harder to move.
2. Pain and Guarding: Pain from the injury can lead to muscle guarding, where the surrounding muscles tighten to protect the joint. This is a protective mechanism, but it restricts movement to avoid further injury.
3. Muscle Spasms: Muscles around the injured joint can spasm, further limiting movement. Muscle spasms are involuntary contractions that can stiffen the joint, preventing it from moving freely.
4. Damage to Soft Tissues: Injury to the ligaments, tendons, or cartilage can cause structural damage. This affects the joint's ability to move through its normal range of motion. For example, a torn ligament can destabilize the joint, and scar tissue may develop as it heals, restricting flexibility.
5. Joint Stiffness: Prolonged immobility following an injury can lead to stiffness. If the joint is not moved for an extended period (e.g., during immobilization in a cast or splint), the tissues around the joint may contract or become less flexible and atrophied, further limiting range of motion.
6. Fibrosis and Scar Tissue: During the healing process, the body forms scar tissue in response to the injury. While scar tissue helps with healing, it can also restrict joint movement if it forms excessively or in areas that limit the joint’s natural function.
These factors together limit the ability for a dysfunctional joint to move fully.
So, when you get general spinal decompression from a machine or inversion table…
it is the healthy joints that are actually more likely to decompress - not the joint or joints that are actually damaged!
Active/Specific:
Active Spinal Decompression through ELDOAs involves clients actively working and exercising to stimulate and reeducate all components of the functional spinal unit.
While it's true that movement reintroduces some spinal compression, the process progressively strengthens the supporting structures—like intervertebral muscles and ligaments—helping to maintain spinal space over time.
By engaging the myofascial chains and adjusting postures in relationship to tensegrity biomechanics, clients can specifically target damaged or compressed joints, ensuring the therapy benefits the affected areas rather than just the healthier ones.
So, in conclusion, I do think that there are benefits to utilising spinal decompression devices. I think that the programmable machines are more effective and safer than inversion tables, especially for people who have a specific disc injury because, for some people, it does bring much needed pain relief. However, I hope that you will see that it is not necessarily the most effective for long term healing and spine health.
I believe the best possible therapy to heal back pain from spinal compression is the combination of osteopathic treatment and ELDOA exercises.
The manual therapy by an osteopath can help normalise the connective tissue and realign the joints and then the patient is able to actively reinforce the alignment using the ELDOA Exercises and continue to create spinal decompression to help target and heal the specific joint space that they need for lasting results.