“Maintenance” Decompression

Post a treatment regimen (assuming the patient had a successful intervention with the traction component of care) invariably in my experience the patient asks about “continuing once a month…” If not the patient then clearly you or the staff needs to be suggestive about “minimal dose” decompression maintenance. We have typically ramped up the discussion by the 10-15^th session as close to 75% are turning-the-corner in their subjective and objective findings and “stabilization” is likely commencing. Ideally in your ROF the (3) phases of care should be delineated with the: “reduction phase” first, “stabilization” second and “maintenance” of function third. Maintenance “axial traction/decompression”, like manipulation needs to be dispensed judiciously in this phase so as to not routinely create “reactions” of pain and/or excess stiffness. I have found the simplest way to avoid this is asterisk (*) those patients who demonstrated ANY adverse reactions during (or at the outset) of treatment and be sure the staff sets the tension approx. 20% LESS than during the “reduction phase” and often choose the Vax-short protocol. A very mild 10 minute session to another wise asymptomatic patient is well accepted and appreciated if the doctor & staff explain: “maintenance decompression is always less-intense”. Of course some patients are enthusiastic to get “really stretched out” at each monthly session…your experience and their outcome must dictate. And of course IF the patient comes in with the findings of a “sprain” and manifests moderate to severe AM pain etc be VERY cautious of traction, just as you would at the initiation of care.